{ "$schema": "https://json-schema.org/draft/2020-12/schema", "$id": "https://api-evangelist.github.io/reinsurance-group-of-america/json-schema/reinsurance-group-of-america-health-score-schema.json", "title": "Digital Health Data Risk Score", "description": "Schema for the risk score returned by RGA's Digital Health Data (DHD) scoring API based on structured electronic medical record and claims data.", "type": "object", "required": ["requestId", "applicationId", "scoreDate", "riskScore"], "properties": { "requestId": { "type": "string", "description": "Unique identifier for this scoring request." }, "applicationId": { "type": "string", "description": "Identifier of the insurance application being scored." }, "scoreDate": { "type": "string", "format": "date-time", "description": "Timestamp when the risk score was generated." }, "riskScore": { "type": "number", "description": "Calculated risk score. Higher values indicate higher risk.", "minimum": 0 }, "riskCategory": { "type": "string", "description": "Risk category derived from the score.", "enum": ["Low Risk", "Moderate Risk", "High Risk", "Very High Risk", "Uninsurable"] }, "scoreConfidence": { "type": "number", "description": "Confidence level of the score from 0.0 to 1.0.", "minimum": 0, "maximum": 1 }, "dataAvailability": { "type": "object", "description": "Summary of data sources available for scoring.", "properties": { "ehrDataAvailable": { "type": "boolean", "description": "Whether electronic health record data was available." }, "claimsDataAvailable": { "type": "boolean", "description": "Whether medical claims data was available." }, "rxDataAvailable": { "type": "boolean", "description": "Whether prescription drug data was available." }, "labDataAvailable": { "type": "boolean", "description": "Whether lab result data was available." } } }, "healthSignals": { "type": "array", "description": "Key health signals that contributed to the risk score.", "items": { "type": "object", "properties": { "signalType": { "type": "string", "description": "Type of health signal (e.g., 'Diagnosis', 'Medication', 'Lab Result')." }, "code": { "type": "string", "description": "Medical code (ICD-10, NDC, LOINC, etc.)." }, "description": { "type": "string", "description": "Human-readable description of the health signal." }, "riskContribution": { "type": "number", "description": "Contribution of this signal to the overall risk score." } } } }, "recommendation": { "type": "string", "description": "Underwriting action recommendation based on the score.", "enum": ["Straight Through Processing", "Accelerated Underwriting", "Refer for Review", "Order Additional Requirements", "Decline"] }, "processingTimeMs": { "type": "integer", "description": "Time in milliseconds to process and return the score." } } }