There are nearly 3 million requests into GP practices for patient medical reports each year, requests submitted by insurers, third parties and government agencies.
GP practices are busy, even more so at this present time. It’s not uncommon for there to be just one person within a practice that’s responsible for managing the completion of reports. That person might work just one day per week. So contacting GP practices to chase reports can be very frustrating for the GP practice and the requesting party.
In addition, there are key times throughout the year that are particularly busy for GP practices. Planning for the flu vaccination programme starts in the summer, it’s implemented from the autumn through to year end. Quarter one each year is the time when data needs to be supplied to the NHS Commissioners for service contract fees to be paid. The pandemic and specifically the vaccination programme has increased that pressure.
Quite simply, the pressure for GP practices to supply medical data to third parties is too great and is certainly not even on the priority task list. Over the last 12 months, the average turnaround time for medical reports returned to requesting parties has been 30 to 35 days. That equates to tangible delays in the payment of claims and delays to when cover can commence.
Delays in supplying medical data are extremely unhelpful for all concerned. For instance, if a client needs underwriting for life cover for a mortgage application, delays can mean they can’t progress quickly enough to proceed with an offer on a house. Key person insurance can be delayed, and this can put companies and their shareholders at risk. Any unusual, impaired or high levels of cover that are reliant on medical evidence can be particularly problematical for employers wanting to get cover for senior members of staff.
Historically, the inefficient process for gathering medical data can mean that insurers have sought to find other methods on which to base their underwriting decisions. Some products are medically underwritten at point of claim, and this can result in a poor claims experience for both the insurer and claimant. Advisers can also be asked by their clients to explain the decisions made by the insurer, and this can mean a potentially complicated explanation when cover may not always result in a payout. The outcome is that they’re less likely to recommend some products: even when the majority of claims will be honoured, the poor experience of the few can taint market perceptions.
The more relevant medical data that insurers have sight of, the better for the end customer. It enables insurers to price cover more accurately, and they’re able to develop products that are relevant and appropriate. It also provides a more accurate risk profile which is much easier to manage at the claim stage.
Technology now exists – with an electronic medical reporting (eMR) platform – that cuts the turnaround time of supplying medical reports right down from 35 to five days.
Technology enables more client/patient involvement, as clients can authorise data sharing more quickly and with transparency. That involvement is vital: the shift of responsibility from GP practice to patient means increased engagement with the end beneficiary. The claimant becomes an integral part of the claims journey and the black hole of medical evidence gathering disappears.
The future has the end customer at the centre of the process. Along with GP medical records, multiple sources of health information can be shared multiple times from one central source. This gives a comprehensive and more accurate picture of people’s health. People today don’t just have treatment from or via their GP, they may deal with pharmacies directly, or have treatment from different private clinics such as physiotherapy. Wearables, too, can also play a part by providing information on general fitness, exercise and diet. The more frequently that data’s shared, the more accurate a picture can be built of a person’s health, and the more dynamic underwriting can become.
This is as beneficial for employers as it is for individuals. Actuaries and insurers don’t have to use generic data to model underwriting decisions and pricing. They can base their risk profile on actual data received from the individual, pricing the cover more accurately and fairly, making it more affordable and sustainable for the employer.