MSL activity reporting: avoiding the data quality trap

Here is a number that should embarrass the entire Medical Affairs function: 92% of organizations evaluate their Medical Science Liaisons primarily through activity-based metrics — the count of KOL visits, the number of presentations delivered, the tally of emails logged. The same survey, which covered 1,023 Medical Affairs professionals across 63 countries, found that only 3% rated their current KPIs as very effective. I want you to sit with that dissonance for a moment. The overwhelming majority of us are running a performance system that almost nobody inside the system actually believes in. We know, on some level, that it doesn't work; we just keep doing it.

I've watched this dynamic play out more times than I care to count. A new MSL joins a team, gets a laptop and a territory map, and within months their annual review hinges on whether they hit a numerical interaction target — a target that was set upstream by a commercial operations team using forecasting logic designed for primary care representatives. Meanwhile, the most valuable thing that MSL did all year — surfacing a skeptical academic's concern about a study endpoint that influenced a downstream protocol or labeling decision — never makes it onto a dashboard. It lives in an email thread, or in the head of the Medical Director, or, worse, nowhere at all. And the next planning round, leadership asks, again, why MSL strategic impact is so hard to demonstrate.

This is the data quality trap. And it isn't really about technology, or about the field team's effort. It's about which questions we bother to ask — and which ones we pretend not to hear.

We measure MSLs the way we measure pharmaceutical reps — and then we wonder why Medical Affairs keeps losing the argument at the leadership table.

The disconnect between activity metrics and strategic impact

The 2024 global KPI survey published by the Medical Science Liaison Society laid the contradiction out with almost clinical precision. Activity-based metrics dominate measurement across the industry: 92% of organizations lean on them as the primary lens for evaluating their field medical teams. Yet when the same respondents were asked how easy it is to accurately measure MSL performance, 67% reported that it was difficult or very difficult. Only 3% — a rounding error in any serious analysis — said their current KPIs were very effective.

You don't need a biostatistician to spot the problem. A performance system that nearly everyone agrees is hard to interpret, and that almost nobody considers effective, is still being used as the spine of how we assess our field medical organizations. The reasons aren't mysterious, but they are unflattering.

The first is institutional inertia. Sales force automation platforms were built for commercial teams, and Medical Affairs inherited the architecture, the dropdowns, and the reporting cadence. When your CRM was designed to track calls per day and message adoption, it will track calls per day and message adoption — regardless of what your MSLs actually do in the field. Adapting such a system to capture the texture of a high-stakes scientific exchange is not a configuration change. It is a category redesign, and category redesigns are politically expensive in any large organization.

The second reason is comfort. Counts feel fair. Counts feel defensible. If two MSLs each made 80 KOL visits last quarter, you can put them in a spreadsheet and rank them — even though one spent those visits building a relationship with a national guideline committee chair, and the other cycled through the same three local opinion leaders to hit the number. Quantitative metrics create the optics of rigor; they give leaders a clean line on a slide. And in Medical Affairs, where we are perpetually fighting for budget, headcount, and a seat at the strategy table, clean lines travel further than messy truths. We have, in effect, optimized our reporting for the easiest audience — and the easiest audience is not the one we actually need to convince.

The third reason — and this is the one we don't talk about at conferences — is that activity metrics are easy to optimize against. An MSL can learn to game their way to a green dashboard without ever changing the strategic value they deliver. The metric becomes the mission. And the moment that happens, you have lost the entire point of having a field medical team in the first place. You have a field commercial team in a lab coat.

Why quantitative KPIs fail to capture scientific value

There is a telling figure buried in the field medical leadership data: activity metrics are the primary measured KPI for 35% of teams — yet Field Medical leaders themselves rate them among the least relevant metrics for evaluating their people, at just 6%. Let that asymmetry breathe. The very thing that shows up most often on a performance dashboard is the very thing the people responsible for those dashboards consider least useful. You cannot write a more damning indictment of an evaluation system than "the managers using it don't believe in it."

The failure is not random. Activity metrics measure frequency; scientific value lives in consequence. A routine follow-up with a community cardiologist who is a peripheral contact looks identical, in the CRM, to a difficult conversation with a clinical trial investigator reconsidering site activation because of a safety signal. Both register as a single visit. The system has no way to distinguish them — and was never built to.

Consider what a high-value MSL interaction actually looks like. It might be a two-hour deep dive with a translational scientist that surfaces a hypothesis about a biomarker-driven subgroup, which later informs a publication strategy. It might be a private meeting with a health-economics researcher who questions the generalizability of a cost-effectiveness model — feedback that quietly reshapes a payer engagement plan. It might be a single, well-timed email connecting a skeptical academic with the right clinical lead, which unblocks a stalled advisory board and changes its agenda. None of these are well-served by a visit counter. All of them are precisely what Medical Affairs leaders say they want from their field teams.

This is why 52% of respondents say they prefer qualitative impact metrics, while 70% advocate for KPIs built on relationship and engagement quality, and 67% want KPIs anchored in the quality of actionable insights gathered. The preference signal from the field is unambiguous. What is also unambiguous is that, institutionally, we have done almost nothing to follow it. The echo chamber around MSL measurement has been so persistent for so long that even leaders who suspect the system is broken hesitate to say so out loud — because then they would be expected to do something about it.

The data quality trap: CRM limitations and insight decay

Even when an MSL has the presence of mind to log a substantive insight, the system often loses it twice — once on the way in, and once on the way out.

The first loss is temporal. Insights decay rapidly with delay. An MSL meets a KOL on a Tuesday afternoon; the KOL floats an off-the-record concern about the comparator arm in an ongoing trial. By the time the field medical manager pulls the CRM report at week's end, that concern — if it was entered at all — has lost its urgency, its context, and often its attribution. MSLs who wait to log their insights until the end of the week are not lazy. They are simply human. But the institutional expectation that they will faithfully reconstruct the texture of a sophisticated scientific conversation three days later is, frankly, unrealistic. The process demands perfect recall under conditions that make perfect recall impossible.

The second loss is structural. Commercial CRMs were built around structured fields: indication, product discussed, call outcome, next steps. These fields are useful when you are selling a pill. They are violently inadequate when you are trying to capture the substance of a scientific dialogue. So the MSL faces an uncomfortable choice: compress a nuanced exchange into a dropdown menu and watch it become meaningless, or write a long-form note that no reporting tool will ever surface to leadership. Most choose compression; leadership then complains, every quarter, about the shallowness of field insights. Both sides are responding rationally to a system that wasn't designed for the conversation they are having.

It is worth being precise about what this table is — and is not — saying. Commercial CRMs are not unusable for MSLs. Anyone who has spent time in the field knows they remain useful for activity tracking, territory planning, and basic compliance documentation. They are, however, optimized for a fundamentally different job than capturing unstructured scientific insight. Pretending they are field medical insight engines is what produces the very disconnect that leaders complain about, year after year.

Building a hybrid framework for meaningful performance measurement

The path forward is not to abolish activity metrics. That is a fool's errand in any large organization, and it would hand the doubters an easy political victory. Instead, the practical move is to build a hybrid frame where quantitative and qualitative measures coexist, and where each compensates for the blind spots of the other.

A workable hybrid has three components. First, frequency metrics — visits, presentations, advisory board touchpoints — should remain in the picture, but recast as coverage indicators rather than performance verdicts. They tell you whether the field team is reaching its intended universe of stakeholders. They do not, on their own, tell you whether the reach mattered.

Second, qualitative outcome metrics need a structured home in the evaluation framework. Direct manager feedback is the most commonly used qualitative performance measure today, at roughly 70% — and for good reason, because it is the natural place to assess judgment, scientific credibility, and stakeholder handling. But qualitative measurement cannot depend entirely on the attention of one manager. Internal stakeholder support of Medical Affairs programs — used by about 50% of teams — captures whether MSLs are advancing internal priorities, not just external relationships. And expanding KOL or HCP scientific knowledge, used by 44%, tracks a tangible outcome that leaders can grasp without needing a free-text narrative to interpret.

Third — and most importantly — you need an insight quality layer that goes beyond manager judgment. This is where 67% of survey respondents say they want their KPIs anchored. In practice, this means evaluating a sample of logged insights per MSL per quarter against a clear rubric:

1. Was the insight novel within the organization — that is, did we already know it?

2. Was it actionable — could a specific team do something different as a result?

3. Did it influence a downstream decision: a protocol amendment, a publication, an advisory board agenda, a label discussion, a payer engagement strategy?

4. Was the source credible and the attribution clear enough to act on without follow-up?

That last criterion is the one that gets leadership attention, because it connects an MSL's field conversation to a strategic outcome the organization already values. It is also the criterion that is hardest to game, which is exactly why it earns its place.

If you cannot connect a logged insight to a decision that mattered, you do not have an insight — you have an anecdote with a CRM entry date.

A word of caution, because I have learned this the hard way in more than one organization: any framework that introduces qualitative scoring will, within a quarter, be turned into a checkbox exercise by someone downstream. Build the rubric with explicit criteria and train managers in calibration. Without that discipline, "qualitative" degrades fast into "subjective" — and then, predictably, gets rolled back into pure activity counts the next budget cycle. The hybrid becomes a hostage to whichever side is louder that quarter.

Operationalizing qualitative insights for Medical Affairs leadership

The hardest part is not the framework. It is the politics.

Medical Affairs leaders who genuinely want to shift their measurement culture need to do three things at once — and they need to do them deliberately, because each one will be resisted by someone whose current incentives depend on the old system, or whose strategic alignment with the commercial function rests on shared metrics.

First, they need to give the qualitative layer an audience. A recurring forum — a quarterly medical insights review, a cross-functional insight council, even a standing agenda item at the medical leadership team — where insight quality is reviewed, debated, and acted upon. Without an audience, qualitative data is a dead letter. People eventually stop logging insights that nobody reads, and then the system confirms its own irrelevance.

Second, they need to invest in the capture infrastructure, not just the reporting layer. That means lighter, faster, mobile-friendly insight entry that works in a taxi or between meetings. It means tolerating long-form notes rather than demanding dropdown compliance. And it means a culture that treats insight capture as a high-leverage scientific activity — not an administrative chore to be completed at 11 p.m. on Friday, after the children are asleep.

Third — and this is where most organizations quietly give up — they need to retire the worst of the activity-based theatre. Not all of it. But the metrics that have been empirically shown to be decoupled from strategic value — like raw visit counts ranked across MSLs working in different therapeutic areas, geographies, or stages of a product lifecycle — deserve a quiet burial. Replacing them with coverage and consequence indicators is not a soft-metric fantasy. It is the only honest move available to a function that claims to be evidence-based.

I have one piece of advice that I have given, in various forms, to every Medical Affairs leader who has asked me how to fix this. Stop measuring whether your MSLs are active, and start measuring whether the organization is better informed because they were active. The first question produces a tidy dashboard and a year of quiet frustration. The second produces the kind of strategic clarity that justifies field medical's existence at the leadership table — and that, ultimately, is the only metric a Medical Affairs function truly owes anyone.