Electronic health records (EHRs) are essential tools for modern life insurance underwriters, but not all EHR aggregators are created equal. Choosing the right one can make a big difference for your organization’s efficiency and profitability goals.

Conferences are great opportunities to meet with vendors and learn about the latest features, innovations, and trends in the EHR space. In 2022, I published a list of “Tips to Navigate the Electronic Medical Data Conversation this Conference Season” to help our members consider the appropriate questions and also to help them understand the potential differences in the answers they receive. With two years passed and AHOU upon us again in a few short weeks, it’s time to dust off that advice and give you a “new and improved” top 10 list of questions to ask in 2024.

The Top 10 Questions to Ask Potential EHR Aggregators

1. How do you calculate your release rates, and what do they include?
   Not all “release rates” are calculated the same way, so be sure to probe to understand how the data provider determines the number. Does it include a single released record per individual life searched or a total number of records? Are different workflows combined to create a single release rate number (HIPAA consent PLUS patient assisted access or other process)?
2. What workflows do you support, and how do you handle different scenarios?
   There are different types of workflows, such as HIPAA consent only, patient assisted access, or a hybrid approach which is a combination of both. The type of workflow used can have an impact on release rates, turnaround times, and customer experience. Be sure to understand if a data provider’s retrieval process involves a HIPAA consent only or if the patient is required to assist in access through an identity verification process.
3. What is the aggregator’s process to determine if a potential new data source yields value?
   Not all data sources are easy to integrate, and some may have specific requirements or limitations. It is important to gain an understanding of how this process works for each vendor.
4. Do you offer an option to reflex to an APS when an electronic record is not found, and how does it work?
   Not all EHR vendors offer this service, and those that do may follow different processes. Ensure you gain a full understanding of the process each vendor follows, the cost and if the solution it is fully automated.
5. Do you manage special authorization requests, and if so, how?
   A special authorization requirement can delay or prevent the record retrieval process and require extra effort and communication. Discuss each vendor’s workflow for this situation to gain an understanding of their process.
6. What type of reporting and metrics do you provide, at what level (all users nationwide view vs carrier specific details) and how often?
   This information can help you monitor and evaluate the quality and efficiency of the EHR data and identify areas of improvement. Make sure you understand what type of information is provided and if the data reflects aggregate performance across the vendor’s entire book of business as well as for your own company’s individual performance.
7. What type of training support do you offer to underwriters and in-house trainers
   Training and support can make a difference in optimizing use of electronic health records – both in terms of underwriter adoption and workflow management to maximize returns. Gain an understanding of the level of support you will receive as well as the data aggregator’s experience within the unique underwriting space.
8. How are problems regarding EHR data retrieval handled through to resolution?
   Problem resolution can affect the timeliness of the records that you receive. It is important your vendor(s) have an appropriate way to receive information about potential problems and an efficient way to address through resolution.
9. How is sensitive data, specifically PII and PHI, securely transmitted and stored?
   Data transmission and security can affect the integrity and confidentiality of the records that you receive, and the compliance with applicable laws and regulations.
10. What is your fee structure, how are fees calculated and are there any extra add-ons
    Vendors can have varying ways of pricing, and the structure of the charges, such as subscription fees, search fees, integration fees, record retrieval fees and any premium service fees, which may affect the full price you pay. It’s critical to get a complete breakdown of potential fees and minimum requirements in order to accurately compare pricing.

I hope you find this updated list of questions helpful in gaining a deeper and clearer understanding of EHR aggregator’s capabilities, strengths and weaknesses. And also feel better equipped to compare and contrast the answers you receive from different EHR partners.

If you have any questions or comments, please feel free to reach out to the MIB team. We look forward to seeing you during this year’s conference season.