Sam Liebert of healthcare tech group Clanwilliam and Dr Monique Esterhuizen of Hannover Life Re of Australasia Ltd (HLR Aus) explain how their companies are collaborating on new ways of improving access to EHRs from healthcare providers.
Finding the best way for the insurance and health sectors to work together more efficiently and achieve better outcomes for insured patients is a challenge facing markets across the world.
Hannover Life Re of Australasia Ltd (HLR Aus ) has been looking into improving access to electronic health records (EHRs) from the region’s healthcare providers for the past five years. Having completed two pivotal exploratory projects, the company is about to embark on a third pilot project, this time launching within a live environment with the third-party electronic health record vendor, Konnect NET, part of the global healthcare technology group, Clanwilliam.
Over a six-month period, Konnect NET will securely retrieve health data of consenting prospective insurance customers diagnosed with specific medical conditions that require ongoing management by a healthcare provider. By assessing these records, the underwriters at HLR Aus will be able to determine the value of using targeted, objectively-verified and structured health data in an underwriting assessment, with the goal of streamlining the manual underwriting process and incorporating electronic health data into automated underwriting assessments.
Pilot Plan
Originating in New Zealand, Konnect NET, which is a core platform in Clanwilliam’s expanding ANZ division, already supplies the technology linking major insurers and healthcare providers in its home market. Konnect NET’s SureMed product, which manages insurers’ health information requests, forms the basis of the Australian pilot.
As Konnect NET’s Melbourne-based head Sam Liebert explains:
“Insurance companies use our platform when they want to retrieve medical records for underwriting purposes or if they need to retrieve information or services as part of a claim. They choose the data they need and identify a practitioner; we package that message based on what sort of practice management system the health provider has.”
Delivering medical information to underwriters quickly and securely is a priority, he says:
“Turnaround time is very important to insurers in a new business context. The longer the time gap between receiving the application and providing an insurance offer, the more likely the applicant will lose interest. Turnaround time is not only a key driver of insurer revenue, it also helps close a potential protection gap in the market.”
In some cases, the online system is augmented by Konnect NET agents who personally call practice managers to help them complete the data request.
Australia features
Insurance markets around the world have their own characteristics, presenting different challenges to timely data retrieval:
“In Australia, for example, people can register with multiple practices, meaning that their records with any single GP might not be complete,” Liebert notes. “The structure and quality of data can vary by practice as well.”
As he goes on to explain, it is not always clear whether the different data fields in the practice system are as comprehensive as those in the original consultation notes:
“You don’t know how imperfect the data is.”
Another characteristic of the Australian market is that compared with New Zealand, for example, medical practices are relatively slow to respond, sometimes taking weeks rather than days to return completed forms.
Liebert says that the pilot will help all participants get a better understanding of how the EHR retrieval process can be accelerated in Australia:
“Understandably, responding to data requests is a distraction for practices and we need to be fully aware of that. We want to minimise the set of questions for them and at the same time deliver as much structured data to the insurer as possible. GP user experience is a key element in any market launch.”
Making faster decisions
Dr Monique Esterhuizen, Chief Medical Officer and Head of Medical & Health Services at HLR Aus, says that customers today expect the best decisions to be made in the shortest possible time:
“For many years, insurers have grappled with the challenge of maintaining robust underwriting decisions in an automated underwriting environment where decisions rely on customer-disclosed information and can be provided much faster than through a traditional underwriting channel.”
But digital health and electronic health data availability is growing fast, with practitioners and patients having more data insights about their health available than ever before. Gaining access to EHRs directly from the GP thus opens the door to obtaining structured, verified health data immediately for use in automated underwriting assessments. As Dr Esterhuizen points out:
“By using bespoke underwriting algorithms, insurers could provide underwriting decisions in real time based on information comparable to that obtained through a traditional underwriting channel.”
In this context, the initial project objectives of HLR Aus are to measure the quality and completeness of the required data within a customer’s EHR and to determine the efficiency of the process. The pilot will also help HLR Aus and Konnect NET to understand how willing customers and GPs are to release and share their EHRs.
“By identifying the gaps, we will learn how best to use other third-party data in automated underwriting to complete a comprehensive risk assessment, further enabling large-language models and artificial intelligence to augment the underwriting process.”
About Clanwilliam
Clanwilliam ANZ is the anchor for Dublin-headquartered Clanwilliam ’s continued growth, investment and innovation in the Australasian healthcare markets. Auckland-based healthcare technology companies HealthLink and Konnect NET have been part of the Clanwilliam family of businesses since 2017 and 2018 respectively. These two companies combine their expertise to lead the market in standards and security to improve patient outcomes and interactions with the health sector.
Insurance companies interested in finding out more about Konnect NET, can contact us at info@konnectnet.com.au