Scottish WidowsApr 19 2017

Patient reports go electronic

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Patient reports go electronic

The very word underwriting may conjure up images of long paper forms, clunky technology and complicated decisions. But the underwriting landscape has changed dramatically in recent years, and no more so than in the world of financial protection.

In order to decide whether to offer someone insurance cover, and how much, providers use two types of information. The first is anonymised, aggregated population-level data, which helps them understand trends in the population’s mortality and morbidity and enables them to make cover available to as many people as possible.

This is relatively straightforward, for the underwriter at least. It is the second type of information that can bring frustration, when personal facts about the individual are required, and if this needs to go beyond typical questions about their medical history, lifestyle and so on; medical evidence may also be needed.

While some great advances in automated rules engines mean more customers receive an underwriting decision at point of sale, there are still a sizeable number of customers who require further underwriting. For nearly half of those people, some form of medical report from their doctor is important to understand their current and historic health to ensure the correct price is charged for any additional risk. Continuous refinements to underwriting approaches have speeded up the ability for insurers to make a decision on these cases, but there are delays outside their control while they wait for the medical information to be returned.

Cutting down on paper

GPs have been providing necessary medical evidence to support their patients' applications for life cover for more than 40 years in the same, paper-based approach. This is one of the time-consuming, additional tasks that GPs provide for their patients. And patients are often left awaiting a decision while burdened practices manage the paper administration, GP workload, and remove sensitive information in a manual fashion that can take weeks, even months, before a report is ready for release to an insurance company.

The good news is that this cumbersome task is being transformed with intelligent general practice reporting (iGPR), which has been developed in consultation with GPs and the insurance industry to address the time consuming and paper-heavy problem of producing medical reports on behalf of patients. In partnership with Niche Health, the software provider of iGPR, electronic GP reports digitise the inefficient paper-based process, improving patient data security and speeding up the process for GPs and insurers, and ultimately the patient/customer.

More customers

Anecdotal evidence indicates that the longer a customer remains in the underwriting pipeline, the less likely they are to proceed with the cover when they eventually get a decision. It is here where the frustration lies for all parties. However, the decrease in turnaround times for GP reports, which is set to improve further as users become more familiar with the new iGPR process, will ensure more customers across the market have valuable cover in place. 

The system itself is encrypted to NHS standards to ensure customer-sensitive data is transmitted to the highest security standards and provides benefits throughout the process. It takes much less time for a GP to produce a report, with the software delivering an automatically redacted version. This ensures that only the relevant data needed for underwriting purposes is provided, and gives the GP the option to further manually redact information if they see fit. The electronic medical reports will continue to include patient consent obtained in line with the Access to Medical Reports Act (AMRA).

The new system enables practices to complete insurance reports in minutes and enables doctors to save time and reduce manual paperwork while improving the consistency of reporting. 

Numerous insurers have introduced this system into their protection policy underwriting process and the results so far are excellent. In Scottish Widows' experience, turnaround times for those using the system are just under seven working days (down from an average of 25 days). There is still room to improve within these seven days as GPs get more familiar with the system. On average, three working days pass before a GP picks up the report, at which point, 43 per cent complete and return the report on the same day. 

Earlier this year, the Association of British Insurers (ABI) published guidelines on electronic paperless requests, with input from the Information Commissioner's Office (ICO) and British Medical Association cementing this important development still. The BMA also included the guidelines in one of its recent GP newsletters. Switching to electronic reporting is a simple process that takes about 30 minutes for GP practices to complete. Most importantly, it is provided at no cost to practices or the NHS.

The key now is to increase the number of general practices using the system. The software is already deployed to approximately 70 per cent of GPs across the UK and Niche Health aims to cover the remainder in 2017.

With GP access to software reaching critical mass levels, it is now up to us as an industry to raise awareness and make iGPR the default option for insurance reports, improving the experience for advisers, customers, GPs and insurers alike and  work together to make it a success.

Case study: The Old Machar practice, Aberdeen

Dr David Cooper at The Old Machar practice in Scotland was one of iGPR’s pilot sites. He said: “Though initially reticent, I could very quickly see how easy to use the software was. It’s much safer than our current paper process as the software's redaction feature takes out non-permitted information automatically and it's easy to make further redactions.

“This gave me great confidence having recently been made aware of heavy fines from the ICO for practices that have shared non-permitted, third party information in reports.

“My other concern was over the proposed fee, but the speed and ease of the system was good enough to convince me that the fee was reflective of the work required.

"It’s much faster than the previous paper based method and all payments have been rapidly received."

With a high list-size, The Old Machar is now a prolific iGPR user and extremely happy with the new, electronic process.

Scott Cadger is head of underwriting and claims strategy at Scottish Widows

Key points

There are still a sizeable number of customers who require further underwriting beyond the point of sale.

The task of underwriting is now being transformed with Intelligent General Practice Reporting (iGPR).

Numerous insurers have introduced this system into their protection policy underwriting process and the results so far are excellent.