When we make a purchase in our personal lives, we often need help knowing what questions to ask. We may ask family, friends, or neighbors for leads and advice - especially if we know someone who has expertise in a specific field. Making a decision about a partner for digital medical data is not all that dissimilar. Digital medical data is a fairly new frontier and many of our members are still evolving their methods for assessing partners. When designing questions for an RFP or RFI (request for proposal or information) or simply interacting with the data partners you are considering, the verbiage we use may yield varied responses. As such, while there are no rules or right approaches per se, with big purchases such as this, the questions you ask and the way you word them matters.

With advice from someone who knows the space and a few guardrails, you can ensure that the questions you are asking glean meaningful insights. Here are some tips for how to formulate value-based questions in these situations to ensure you get answers that are the most useful in your assessment process.

Tips:

When asking about HIT rates & RELEASE rates. It is critical to consider the following:

• How do you define the difference between hit rate and release rate in your organization? Are you counting at least one record received per individual life searched or are you asking for a release rate for the total amount of records received for all search activity?

• How do you access records? Is it with a HIPAA consent form or do you require credentials for patient portal access? The latter requires input from the customer to provide a unique ID or password to their respective healthcare providers’ portal access and represents a very different way of accessing data than the former. And that has a significant impact on vendor reported hit rates.

• Which use case(s) will leverage electronic data? Member carriers search for a variety of use case ‘reasons.’ It is best to separate the metrics for specific use cases, in order to independently assess the value that electronic medical data brings to each scenario. For some use cases, a high hit rate is desired. But for other use cases, not finding a record is the optimal outcome.

When asking about USABILITY, which is a broad term with multiple potential meanings, consider how your company defines it. Possibilities include:

• The ability to use an EHR record without having to obtain any additional information to assess risk (exam, lab, 3rd party data).
• The ability to use an EHR record without having to order an APS (attending physician statement).
• Providing data in a standardized format that creates efficiency for the underwriter to view the record.
• Ensuring that the records holds a minimum amount of data requirements (Vitals, Smoking Status, Medication information included, etc.).

In addition to the above, I propose you consider assessing the commitment of your potential new data providers to the life insurance industry:

• What differentiates the provider from others that offer similar services?
• What % of the company’s resources are dedicate to the Life/DI/LTC industry?
• Is the potential partner new to the industry and do they understand the existing and emerging regulatory environment?
• Do they understand your organization’s market, distribution, products, and challenges?
• How long has the organization been in existence and more importantly, supported the life/DI/LTC industry?

Obtaining meaningful information to assess the value of a potential data partner is critically important. However, answers to RFP(s) and RFI(s) are not always clear and may be misleading. By carefully considering how your organization defines certain terms, being clear on these definitions in your RFP/RFI and asking careful follow up questions to ensure you level the playing field, you will get answers that are the most useful to your assessment process.

The use of electronic data is nuanced and requires a deep understanding of workflows and industry opportunities, as well as challenges. MIB’s Medical Data Solutions team is 100% dedicated to data access and is focused on building a sustainable future to support advances in usability. We welcome questions and a conversation about how to construct questions to glean valuable answers. Let us help you with this task.