Most of what we do â the websites we visit, the places we go, the TV shows we watch, the products we buy â has become fair game for advertisers. Now, thanks to internet-connected devices in the home like smart thermometers, ads we see may be determined by something even more personal: our health.
This flu season, Clorox paid to license information from Kinsa, a tech start-up that sells internet-connected thermometers that are a far cry from the kind once made with mercury and glass. The thermometers sync up with a smartphone app that allows consumers to track their fevers and symptoms, making it especially attractive to parents of young children.
The data showed Clorox which ZIP codes around the country had increases in fevers. The company then directed more ads to those areas, assuming that households there may be in the market for products like its disinfecting wipes. The Centers for Disease Control and Prevention recommends disinfecting surfaces to help prevent the flu or its spread.
Kinsa, a San Francisco company that has raised about $29 million from venture capitalists like Kleiner Perkins since it was founded in 2012, says its thermometers are in more than 500,000 American households. It has promoted the usefulness of its âillness data,â which it says is aggregated and contains no identifying personal information before being passed along to other companies.
It is unique, Kinsa says, because it comes straight from someoneâs household in real time. People donât have to visit a doctor, search their symptoms on Google or post to Facebook about their fever for the company to know where a spike might be occurring.
âThe challenge with Google search or social media or mining any of those applications is youâre taking a proxy signal â youâre taking someone talking about illness rather than actual illness,â said Inder Singh, the founder and chief executive of Kinsa. Search queries and social media can also be complicated by news coverage of flu season, he said, while data from the C.D.C. is often delayed and comes from hospitals and clinics rather than homes.
The so-called internet of things is becoming enmeshed in many households, bringing with it a new level of convenience along with growing concerns about privacy.
Makers of smart televisions like Sony have put software on their sets that track what people are watching and allow advertisers to target other devices in their homes. Roku sells boxes that stream television along with advertising aimed at viewers. And there are smart speakers from the likes of Amazon and Google.
Amazon has submitted a patent application, recently granted, outlining how the company could recommend chicken soup or cough drops to people who use its Echo device if it detects symptoms like coughing and sniffling when they speak to it, according to a report by CNET. It could even suggest a visit to the movies after discerning boredom. Other patents submitted by the company have focused on how it could suggest products to people based on keywords in their conversations.
Christine Bannan, the consumer protection counsel at the Electronic Privacy Information Center, said that even though Kinsa appeared to be using the information in a privacy-compliant manner, its business model highlights the need for federal regulation around how consumer data is handled.
âUltimately there should be a more uniform standard and it shouldnât be up to the whims of each company,â she said. âItâs less of a privacy question and more of an ethical question on what we think is acceptable for targeting people who are ill and what safeguards we want to have around that.â
Kinsa sells its data to other companies under the name Kinsa Insights. While Mr. Singh declined to share the names of other customers, citing confidentiality agreements, he said other companies had used the data to target advertising. It has also been used by pharmacies and manufacturers that make and distribute medicines and cough and cold products to keep retailersâ shelves full with flu-related products when fevers spike in certain areas, he said.
One model of Kinsaâs thermometer plugs straight into phones, while another child-friendly version looks like Elmo from âSesame Street.â The company said that most app users opt to share their location and that Kinsa does not link the information to phone numbers or email addresses.
âWe take data from our users, we aggregate it, we do all sorts of machine-learning techniques with it and combine it with other data sets and what we ultimately get is a signal,â Mr. Singh said. âThatâs on a ZIP code basis and county-by-county basis.â
He said the data provided unique insight into flu-related illness in specific areas. âWe can tell you if itâs high or low, whether itâs rising, if itâs bigger than the three- or five- year average, when itâs going to peak and how severe the symptoms are, too,â Mr. Singh said.
Clorox used that information to increase digital ad spending to sicker areas and pull back in places that were healthier. Consumer interactions with Cloroxâs disinfectant ads increased by 22 percent with the data, according to a Kinsa Insights case study that tracked performance between November 2017 and March of this year. That number was arrived at by measuring the number of times an ad was clicked on, the amount of time a person spent with the ad and other undisclosed metrics, according to Vikram Sarma, senior director of marketing in Cloroxâs cleaning division.
Being able to target ads in this way is a big shift from even seven years ago, when the onset of cold and cough season meant buying 12 weeks of national TV ads that âwould be irrelevant for the majority of the population,â Mr. Sarma said. The flu ultimately reaches the whole country each year, but it typically breaks out heavily in one region first and then spreads slowly to others.
While social media offered new opportunities, there has been âa pretty big lagâ between tweets about the flu or flulike symptoms and the aggregation of that data for marketers to use, he said.
âWhat this does is help us really target vulnerable populations where we have a clear signal about outbreaks,â Mr. Sarma said.
Mr. Singh, who was an executive vice president at the Clinton Health Access Initiative, said that Kinsa worked only with clients that can help with its mission of preventing the spread of illness through early detection. It made sense to work with Clorox, he said, because of the C.D.C. recommendation about disinfecting.
While Kinsa has a public health mission, other smart-device companies may not have similar mind-sets, Ms. Bannan said.
âI can just think of how cigarette and alcohol companies could use strategies like this, or other industries that could really have more harmful effects on people,â she said.
Kinsa can make recommendations to individuals in certain situations, Mr. Singh said, pointing to its partnership with Teladoc, a telemedicine company. There is no financial arrangement between Kinsa and Teladoc but the two companies have an agreement that allows people with both apps to transfer their illness history from Kinsa to a Teladoc doctor, he said.
âWeâve made the call that we donât want to target the individual unless the individual is going to be helped by the intervention,â Mr. Singh said. âSo for example if you have a newborn who has a fever, you need to see the doctor right away and if itâs 3 a.m., Iâm very happy to present you the option to talk to a telemedicine doctor.â
âTo me,â he added, âthat is not advertising in the strict sense of advertising.â
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