5 Key Takeaways From Our June Electronic Health Records (EHRs) Panel Featuring Insurance Industry Experts
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In this post, we share highlights from our latest webinar panel featuring life insurance experts who have gained valuable experience using EHR data for accelerated underwriting, better customer experiences, and innovation.
For the last several years, Human API has been helping carriers not just get their hands on EHR data, but actually make use of it. We’ve been working with experts and companies across the entire insurance ecosystem to drive the adoption of EHR data. We recently gathered a group of our customers and partners together for a conversation so they can share their insights about using EHRs to accelerate underwriting and deliver better customer experiences.
Here are the common themes that emerged and what these industry experts had to say about using EHR data to drive innovation.
COVID significantly drove the adoption, scale, and success of patient portal and EHRs usage.
“From our perspective, especially because of COVID last year, we immediately jumped to Human API and the use of the patient portal as an opportunity to provide underwriting in a situation where getting an exam completed was going to be difficult. Because of COVID, we just couldn't get examiners out. People didn't want examiners in their homes. So early on, we emphasized the expansion of age and face amount limits to underwrite without an exam. We absolutely saw the value in using it in lieu of a traditional APS, and fully pursued that path.” - Neal Halder, Assistant Vice President & Chief Underwriter at Principal
“We gave applicants an opportunity right away as they're going through the process to connect their records through the patient portal. We track that quite a bit, and do a lot of segmentation around that. It's been great. When customers understand that they can share something with you that's going to help them get a better, faster decision, they’re in.” - Jaime Hale, CEO at Ladder
“We raised our accelerated underwriting limit during COVID, and made it permanent in October of last year. We weren’t entirely comfortable going without any kind of requirement, especially in those over $1M to $3M face amounts, so we decided to get EHRs from Human API in place of an exam. However, we learned that sometimes when you get 200 pages of EHR, it's a lot to review manually. When we brought this to Human API, they were able to quickly create a custom report called the “Health Check'' from patient portal data. The report gives us two years worth of data that's basically your vitals and some really key labs. This abbreviated EHR report has been an amazing tool for us. If our team sees something that's abnormal, they have the option to go and pull the full EHR record, which is a really nice option. That was a huge time saver and it gave us that peace of mind that we're not just letting cases go through without any additional evidence.” - Gretchen Juneau, VP of Underwriting Transformation at Prudential
2. The time to start with EHRs and learn is NOW. As EHRs take on a bigger role in the future of life insurance, the companies that have already started their EHRs journeys are gaining the most value with time.
“We've been using EHR for about two years now, and it's been quite a journey. We started with a pilot where we ordered both an APS and an EHR, but we really felt like we could really quickly pivot to just ordering the EHR from Human API. We saw some success really early on, even though our hit rates were lower. So we were able to just quickly eliminate that APS and go right to just the EHR. We've seen some consistent improvements in our hit rates, especially last year during COVID when we were using the patient portal method and we were able to obtain records where a lot of other people couldn't. That was a big win for us last year, and it’s because we started experimenting with EHRs early. And just in the past few months, we've partnered with Human API to develop a new robust process that's a one-stop shop for medical records. We still have our highest level of success with the patient portal method but now we're able to get records from two other EMR data sources. It feels great to be learning and progressing over time.” - Gretchen Juneau, VP of Underwriting Transformation at Prudential
“The companies that jumped in during COVID with a “test-and-learn” mindset are the ones that are benefiting more because they jumped in, started using the EHR and figured out where it’s valuable in their market. They asked themselves how they could use it best in one place, and then expanded to all of these other areas of underwriting. Clients who are more advanced are starting to use the EHRs in a digital format and incorporating that data into their automated and accelerated processes. Training underwriters on when they can use EHRs and what areas where you need to pivot automatically to maybe that traditional APS is something these companies are learning. The question of how to train underwriters, what situations can we use the EHR where there's no further requirements needed, and putting together new guidelines and really a new philosophy to make it easy for your team to follow those guidelines. These are all things that early movers are figuring out.” - Kristin Ringland, SVP & Chief Underwriting Officer at SCOR
“I think there's two facets to a cost-benefit analysis. First, there’s the true return on your mortality, but the other consideration is R&D. Some people would say that you would get a low return rate, or you still have to order some APSs, or the value is just not there, or you're spending a lot of time reviewing electronic health records. But I think that is a short-sighted approach. Doing any large retro and looking back is not necessarily predictive of what's going to be in your future. This additional third-party data lets you look at things holistically and maybe see a different picture. So I think you need to be careful when you do a cost benefit by just saying - was this a full replacement of the APS?” - Kevin Oldani, Senior Vice President at Hannover Re
3. EHRs are proving to have very measurable, tangible business impacts. Conversions and business metrics are all increasing.
“SCOR has done a deep dive into the clients where we reinsure their accelerated underwriting programs over the last several months. For this analysis, we especially focused on the impact of acceleration and pass through rates. Based on the reporting we received from our clients, we're seeing that the companies who are using EHR information in their processes - either in a light touch process to eliminate ordering some other requirements or the fully underwritten - have an increased acceleration and pass through rates. EHRs are clearly becoming a very powerful tool for the accelerated market.” - Kristin Ringland, SVP & Chief Underwriting Officer at SCOR
“If no electronic records are available, the new Human API platform can now pivot and order an APS for us, which is a huge time saver for our underwriters. With these smart orchestration capabilities, we no longer have to cancel one record and go out to order another APS record. It’s been a really huge time-saver for us. Our current hit rates are in the mid 40s right now, and one of our distributors that we segregate volume for actually went over 50% last week, which we’re absolutely thrilled about. And we're receiving those EHR records in just about three days. So really happy with that and looking forward to even seeing those numbers go up. I mentioned we've seen success mostly in the patient portal method in terms of getting those records. So even though we're using other data sources, we're encouraging our producers and our clients to still reinforce that that patient portal has the quickest and really high success rates there.” - Gretchen Juneau, VP of Underwriting Transformation at Prudential
“EHRs allowed us to take some of the temporary guidelines that we put in place last year because of COVID and make them more permanent. A lot of AAU programs initially were going after the best class preferred risks and everybody else had to be examined. We can now expand our AAU programs in multi-dimensional ways and go higher ages and higher face amounts, but we can also get deeper into some of the other risks classes where somebody maybe isn't as perfect as we want them to be, because we can get digital data through the patient portal or EHRs. We're more comfortable with some of the face limits of our accelerated underwriting programs where we can underwrite more individuals without exams. The EHR data quality and the completeness of it continues to get better all the time. I saw a significant improvement in the volume of data that is available in my own patient portal probably 18 months or so ago. Now I can go out to my patient portal and get information that goes back at least five years. It's inclusive of lab information and other studies that have been done. It's the doctor's notes and so it's pretty complete both with regard to the time period that it covers and the depth of the information that's out there. I think that's just going to continue to improve as we go along.” - Neal Halder, Assistant Vice President & Chief Underwriter at Principal
4. People + Process + Technology = Innovation. Empowering internal teams, distribution partners, and clients helps drive faster EHR adoption and better results.
“We’ve done a lot of work with our distribution partners to encourage them, and I think sharing success stories is one thing that's been really working. If you have a case waiting for medical records and you can get the patient portals immediately, that's a big win. So I think sharing success stories, bringing your distribution folks along for the journey has been another thing and really just emphasizing that it's not hard, it's actually pretty simple. We developed some marketing materials as well so we have one for our producers, one for our clients, and we know that they use them because they come back and ask questions about the process.” - Gretchen Juneau, VP of Underwriting Transformation at Prudential
“Communication is key. Explaining to the advisor or to the agency office what you're looking forward to, why you want to go with this approach, and what you need from the client is very helpful. We've experienced about a 40% conversion rate, and we attribute a good part of that success to the fact that we have been pre-filling or providing the doctor or facility information.This way, when the applicant goes into their patient portal, they get us the information we need from the right facility.” - Neal Halder, Assistant Vice President & Chief Underwriter at Principal
“As a chief underwriter, I'm engaged at very early stages of evaluation and understanding new data sources. I have to do a good job of engaging the underwriters and having them understand not only what the information is, how valuable it can be, but also how to use this information. We one study with a client and found that 40% of the cases in which they got an EHR, it was unnecessary to order the full APS. So figuring out your risk tolerance and communicating that to the team is really important. How do we accept this information versus getting full APS? Do I really need this information or is it just information that I want? It’s pivotal to provide clarity on how to use this information so our teams are empowered.” - Kevin Oldani, Senior Vice President at Hannover Re
5. Embracing new data sources can give a more complete picture of health histories and drive new ways of underwriting and moving applicants along.
“One thing we've really tried to do is make a mindset shift. Not only do we have to look at EHRs as a new data source and not just an APS replacement, but we also try to use this analogy that it’s a tool in your underwriting toolbox. Where there are gaps, can you look at an RX check or another data source, medical data, lab picture, to put together a picture of this client's health? Can you look at the RX check and see, well, they filled all their medications since that time, so we can assume they had followed up? This kind of thinking combined with new data sources allows us to make the move away from the traditional APS. We can use all of these pieces of data together and really come up with a decision. We’re really trying to reinforce these ideas.” - Gretchen Juneau, VP of Underwriting Transformation at Prudential
“If we could get electronic health records up in the funnel much earlier in the game that could drive our requirement list. If I have an electronic health record that has labs, has RX history, has a lot of things, and I get that upfront to drive the questions I ask, that could also derive the other requirements. So I might be able to build that waterfall effect and answer where I need additional information. I think in the future, electronic health records will really drive that need. And I think that's going to be really special to our industry - to be able to move people along seamlessly.” - Kevin Oldani, Senior Vice President at Hannover Re.
“As you see more instantly available data, it’s going to allow you to really change the customer path. You can really get to fully underwriting each customer in the best possible way as you're taking all that data in real-time and adjusting. Hey, what are the impairments I really care about and what's going to get me comfortable with that impairment? Can I make an offer here with the digital information available right now? Hannover Re has been really great in helping us think through questions like this.” - Jaime Hale, CEO at Ladder
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