Actuarial Innovation and Technology Topic - Electronic Health Records White Paper

Background and Purpose

The digitization and increasing availability of individual personal medical information, and related claims details, is driving a significant shift in the way that insurers are operating their businesses. As a result, almost every facet of the insurance business is likely to change in the future. Underwriting, reserving, claims management, customer engagement - amongst other areas - will be impacted. The purpose of this white paper is to provide information to actuaries regarding:

  • The various types of Electronic Health Records (EHR’s) that are available
  • Detailed background and current state information regarding this information and how it is being used by the actuarial profession
  • Discuss the future potential for this information and how it may transform the insurance business, with a focus on its impact on actuaries.

Research Objective

The Actuarial Innovation & Technology Program Steering Committee (AITPSC) is seeking a researcher to prepare a white paper that provides information regarding the use of Electronic Health Records by the actuarial profession. The report would additionally provide the reader with background information regarding the history of EHR’s, as well as ways in which the use of EHR’s are likely to impact the profession in the future. The goal is to illustrate the current and future evolution of the use of EHR’s and provide an informative report to the actuarial community on the topic.

Proposal

The paper should cover the following topics:

  • Background information regarding Electronic Health Records
  • Detailed summary and history of EHR’s
  • Background regarding Health Information Exchanges
  • Types of companies
  • Discussion around accessing EHR’s through an Application Programming Interface (API)
  • Current state of EHR’s and how they are likely to change in the near future
  • Detailed discussion regarding exchanging health information:
  • How is this done in practice
  • Difficulties with aggregating the data (because of vendors and health care organizations having different systems)
  • Managing Health Insurance Portability and Accountability Act (HIPAA) legal requirements
  • Dealing with confidential information – psychological/psychiatric information, etc.
  • Quantified self-data – wearables, etc., and how API’s are making this information usable
  • How EHR’s have been impacting the underwriting process
  • Discussion around protective value being provided from using EHR’s
  • Benefit / protective value considerations of using EHR’s instead of or in conjunction with Attending Physician Statements
  • Brief overview of difficulties associated with measuring the impact on emerging experience
  • How EHR’s are affecting other parts of the insurance business
  • Some observations as to where EHR’s and the sharing of data may go in the future
  • Costs of accessing EHR data
  • Case studies

Selection Process

The AITPSC will appoint a Project Oversight Group (POG) to oversee the project.  The AITPSC and POG are responsible for recommending the proposal to be funded.  Input from other knowledgeable individuals also may be sought, but the AITPSC and POG will make the final recommendation, subject to SOA leadership approval. The SOA's Research Actuary will provide staff actuarial support.

Questions

Any questions regarding this RFP should be directed to Dale Hall, SOA Managing Director of Research (phone: +1-847-273-8835; email: dhall@soa.org)

Notification of Intent To Submit Proposal

If you intend to submit a proposal, please e-mail written notification by August 9, 2019 to Korrel Crawford, SOA Senior Research Administrator, at kcrawford@soa.org.

Submission of Proposal

Please e-mail a copy of the proposal to Korrel Crawford.

Proposals must be received no later than August 30, 2019. It is anticipated that all proposers will be informed of the status of their proposal by September 20, 2019.

Note: Proposals are considered confidential and proprietary.

Conditions

The selection of a proposal is conditioned upon and not considered final until a Letter of Agreement is executed by both the Society of Actuaries and the researcher.

The SOA and AITPSC reserve the right to not award a contract for this research. Reasons for not awarding a contract could include, but are not limited to, a lack of acceptable proposals or a finding that insufficient funds are available. The SOA and AITPSC also reserve the right to redirect the project as is deemed advisable.

The SOA and AITPSC plan to hold the copyright to the research and to publish the results with appropriate credit given to the researcher(s).

The SOA and AITPSC may choose to seek public exposure or media attention for the research.  By submitting a proposal, you agree to cooperate with the SOA and AITPSC in publicizing or promoting the research and responding to media requests.

The SOA and AITPSC may also choose to market and promote the research to members, candidates and other interested parties.  You agree to perform promotional communication requested by the SOA and AITPSC, which may include, but is not limited to, leading a webcast on the research, presenting the research at an SOA meeting, and/or writing an article on the research for an SOA newsletter.