How Data Science Is Redefining the Medical Director’s Role

April 20, 2021| By Dr. Thomas Ashley and Jean-Marc Fix | Disability, Life | English

Region: North America

Data analytics projects have become increasingly common across the insurance industry in the last few years and have really taken off in the Life sector. It’s a trend that requires the input of Medical Directors - and it gives the Directors a chance to shine.

Data analytics projects come in all shapes and sizes. For example, in marketing and segmentation, analytics projects are answering business questions around how, when and to whom to sell. Such projects tend to be non-controversial: they don’t have legal issues and are therefore relatively easy to implement.

Risk assessment and underwriting, on the other hand, are more difficult areas, but they can be the most interesting to Medical Directors. They might have to do with accelerated underwriting (AU), for example, or workflow optimization - including triage and presentation of underwriting information in the optimal sequence.

Product evaluation is another particularly interesting area for Medical Directors. Such projects frequently involve evaluating new Insurtech and data science company solutions or their tools. Gen Re recently looked into LabPiQture, a relatively new tool that reports clinical lab results in the extensive data of Quest Diagnostics and LabCorp.

In-force behavior and maximizing client retention is another area that’s on Life and Health companies’ data analytics radar. And of course, claims analysis and fraud detection is always an issue in our industry.

The Language Barrier

We believe that the close involvement of Medical Directors is key to getting the best out of data analytics projects. But there are some natural obstacles that require Medical Directors to think about how they can up their game on a sometimes unfamiliar playing field.

We accept that the insurance data scientist is still a rare breed and that, at the same time, data analytics technical specialists tend to have only a little insurance or underwriting knowledge. This is the gap that Medical Directors need to learn how to bridge.

It always makes sense for Medical Directors to try to speak the lingo of as many different areas as possible. In data science projects, it’s especially important for everyone to understand the potential business consequences of any mistakes because often a small error for a data scientist can actually be a big one for a Medical Director.

A New Way to Work

We suggest that Medical Directors consider a new way of working when dealing with data scientists on business projects. To start with, it’s preferable to use teamwork in the process of formulating the business question. After all, a data scientist can answer any question - even a dumb question. The Medical Director needs to have a question ready that will have a quantifiable, measurable answer pointing to the business impact.

Teamwork is also important when it is time to look at the answer. You need to ask yourself, does the answer make sense? It’s worth remembering that the data scientist(s) involved may not have industry experience or even knowledge of medical risks. The reality check that your experience provides can be extremely important in such circumstances.

After all, from an insurance perspective, the answer (or correlation provided by a tool, for example) needs to be reasonable, logical and make (biological) sense.

Old and New Skill Sets

Medical Directors have gained valuable experience and skills in their professional journeys. Their medical skill set - especially around interpretation of medical research, prescriptions, lab results, and how they flow into electronic records for example - are invaluable in data projects.

Medical Directors understand underwriting data components; they’re good at data analysis and applying that to business questions. These skills can be applied to tool evaluation as well as data-cleaning support, where context can be crucial in individual cases to avoid misclassifying them.

Medical Directors are good communicators. It’s a softer skill that is useful where analytics projects need to be explained to non-technical people across disciplines within the company. They have done that with patients and also physicians throughout their careers.

Of course, there are further skills that Medical Directors can develop. You may not want to hone your code writing ability(!) but obtaining some expertise around datasets, finding relevant datasets, and knowing the caveats of those datasets will be very useful.

Overall, it will pay to improve your understanding of the data scientist’s approach. Remember that this is not just about what data scientists and Medical Directors want from each other, but also what they can give to each other.

If you can demonstrate or advertise your expertise in a domain that’s not typically associated with a Medical Director, you will add value to your company. At the same time, you could also find yourself immersed in some exciting new projects.


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