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Insurers Continue To Flirt With Electronic Health Records

Written by: John Hilton

The use of electronic health records in insurance underwriting has long held terrific potential to boost the industry. Progress has been slow to date, but that is about to change.

By late-2022, EHR will be standard at 50% of the top 20 carriers, said Nicholas Irwin, director of life underwriting at Verisk.

"I think once we get to that 50% hit rate threshold and same-day turnaround time, I'd be very surprised it didn't become a standard at that point," Irwin said Tuesday during the Society of Insurance Research annual conference.

The acquisition of a medical record, a crucial part of life underwriting risk-assessment, largely remains largely an inefficient paper process. The availability of healthcare information as a data stream is a critical advantage for insurers using rules-based decision engines for accelerated underwriting.

Insurers made much faster progress switching to EHR during the COVID-19 pandemic, Irwin said.

"In a post pandemic world, we find that the majority of carriers are either using, piloting or considering using EHR," he explained.

Problems To Address

There are still several issues that need to be ironed out before EHR can truly attain a widespread uniform usage throughout the insurance world, Irwin noted.

For starters, the health records do lack the consistency required to be reliable. There are more than a dozen different medical coding systems representing over one million different codes. Creating one system to handle that many different codes, while limited things like human error and other variables is proving to be a challenge.

"Quality is a key concern," Irwin said. "We do find a lot of information in unstructured form, meaning that it's not coded using medical codes that require some type of natural language processing in order to pull in that information. We'll also see key detail missing. For example, blood pressure readings are often missing, or you'll often be missing metabolic panels."

Despite those challenges, the promise held by EHR keeps the insurance industry spellbound. Several software and technology companies are working to perfect an EHR delivery system. A lot of regional health systems are contracting with different EHR vendors, Irwin said, meaning insurers will need to be able to work with a lot of different EHR software.

In the end, the headaches associated with EHR will be worth it, he predicted.

"The ideal vision of EHR is to enable a truly automated underwriting approach where you're able to get the same accuracy as traditional underwriting, or fairly close to it, while also being able to underwrite the risk on a real-time basis," Irwin said. "And EHR today are falling short of that vision. And I think the main reason for that is the challenge of automated processing of these data."


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