The Ways Healthcare Organizations Send and Receive Patient IDC Feb 2016

Faxing in health care ranks higher in patient data information sharing than using secure email, online portals, health information exchange (HIE), or leveraging electronic health records.

Welcome to the American healthcare system in 2016, as described in a market spotlight published by IDC, The Rocky Road to Information Sharing in the Health System.

IDC’s survey research among healthcare providers forecasts the “rocky road” to information sharing. That rocky road is built for medical errors, duplication of services, greater healthcare costs, and continued health il-literacy for many patients.

“The holy grail of interoperability — lower-cost, better-quality care with an improved experience for the patient facilitated by the secure exchange of information about participants in the health system — is still elusive for most providers,” IDC recognizes on page 1 of the paper.

Short-term costs savings may be found via paper-based methods like copy and fax, but not jumping to the second curve of digital health data exchange sacrifices security, quality, and risk — especially risk that might be assumed is new contracting and payment regimes like value-based care, bundling, and pay-for-performance. That’s because you [healthcare providers] can’t manage what you don’t measure.

The bar chart illustrates that the most prominent methods for sending and receiving patient information are paper-based methods, used by 9 in 10 providers to receive and 8 in 10 to receive that information; informal methods like phone calls, used by about 8 in 10 providers to send or receive; and that never-to-disappear fax machine used by 81% to receive and 70% to send patient information.

The HITECH Act’s incentives for adopting and fully implementing electronic health records (EHRs) don’t seem to have made a big difference in patient information data sharing. Only some 40% of healthcare providers are sending or receiving patient data via EMR/EHR integration, roughly the same as are using health information exchange (another HITECH Act artifact, still not hitting the tipping point of use).

The most important consequences of this current scenario are loss of business, decreased operational efficiency, billing and medical coding errors, and — worst of all — medical errors, IDC notes from healthcare providers’ input.

Health Populi’s Hot Points:  Patients in the U.S. increasingly see the presence of EHRs in their clinicians’ offices and hospitals. But the presence of an EHR is no guarantee that the patient’s personal health information is secure or digitized in ways that promote high quality, efficient care and as well as manage the risk of medical errors.

The most recent Digital Health Funding Rankings report from Startup Health published that a record (high) of $1.88 bn in funding for digital health startups was invested in the first quarter of 2016. One-fifth of that money (about $400 mm) went to Oscar Health, the new-new health insurance plan which is expanding from New York to California, Texas and beyond. That leaves some $1.4 bn for startups dealing with big data/analytics, personalized health, behavioral and mental health, wellness, and clinical decision support. In addition, deals involving “patient/consumer experience” garnered $195 mm.

What fell into patient/consumer experience in this first quarter of 2016 included $95 mm going to Healthline, the online consumer health information portal, and $40 mm to Higi, the retail health kiosk company, among smaller deals in the segment.

There are a lot of sexy new areas of digital health investment here – Oscar has serious plans to disrupt health insurance as we know it, Flatiron Health  and Health Catalyst will drive data analytics to support population health, and wellness companies may attract consumer and employer dollars to promote self-health. But only one of the big investments, in Captricity, deals with the kind of workflow we’re talking about when it comes to battling the monster that is paper in the healthcare system.

To this health economist who abhors wasting money and time, and hates medical errors, the real sexy investments will be in getting faxing relegated to the healthcare tech graveyard where it belongs.

 

 

4 Comments on Paper and Fax, Not EHRs or Portals, Are Popular for Health Data Sharing

Judson P. Bruno said : Guest Report 3 years ago

Thank you for compiling this research. It is interesting to note that a large majority of companies and individuals in the Healthcare IT space are having difficulty believing that physicians still rely heavily on that 40-year-old technology, the fax machine. Even though companies are trying to get physicians to move away from exchanging information through a fax machine most physicians still like the ease of sending and receiving documents using a fax machine. As was noted in the article "The HITECH Act’s incentives for adopting and fully implementing electronic health records (EHRs) don’t seem to have made a big difference in patient information data sharing. Only some 40% of healthcare providers are sending or receiving patient data via EMR/EHR integration, roughly the same as are using health information exchange (another HITECH Act artifact, still not hitting the tipping point of use)." What about the other 60% of physician offices that need to exchange documents that have not fully implemented an EHR? The fax machine is still a reliable method of exchanging information fast. What most people probably do not know is that in the pharmaceutical industry there are programs in place called Patient Assistance Programs. Almost every specialty drug has one of these programs. The core method of sending and receiving of information in these programs is the fax machine. The amount of faxes sent and received daily with these programs is very large. We have noticed a change in the number of pharmaceutical companies and specialty pharmacies interested in improving their Patient Assistance Programs that require heavy use of faxing every day to support their programs. These programs require physicians to complete forms related to patients who require specialty medications. The completed information is either mailed or faxed back. With more Life Sciences companies switching over their legacy processes and adopting Salesforce to manage their Patient Assistance Programs, companies are choosing zPaper because of our integration with Salesforce to improve workflows on the daily demand from incoming and outgoing faxes. The fax machine may in the future become obsolete however in 2016 it is still a viable method of communication as "used by about 8 in 10 providers to send or receive; and that never-to-disappear fax machine used by 81% to receive and 70% to send patient information."

Victor Pinsker said : Guest Report 3 years ago

Hello Dr. Jane, The Office of National Coordinator (ONC) ‘promotes’ Direct Messaging which is BTW a precedent where a government agency has done such thing, yet it stopped short form suggesting it exclusivity. Nevertheless, the on-going debate about healthcare interoperability continuously pivots between the legacy fax (simple and inefficient) and the Direct (complex and restrictive) as there are no other alternatives… The facsimiles has been introduced and adopted during the 70ies as the cost effective alternative to postal mail as processing of information and knowledge sharing has been mainly paper based. Conversely, about the same time most of other industries such as finance, manufacturing, logistics, etc. were automating their processes by implementing Electronic Data Interchanges (EDI) technologies to simplify and automate information exchanges focusing on increased productivity and customer satisfaction. The EDI enabling vendors have adopted the concept of interoperability as a prerequisite thus supporting a wide range of secure and efficient IT communications protocols and ‘eradicating’ the practice of faxing. Protecting users/customers privacy and security is not unique to the healthcare industry although many healthcare IT vendor would like you to believe it is. The Direct and the associated HISP hub methodology actually regress back 20 years to the era of dial up connections and Value Add Networks (VANs). We can learn from the non-healthcare industries how they successfully ‘de-coupled’ the method of secure data delivery from the end user s/w (EHR in our case), leveraging content independent, encrypted, authenticated and collaborative data protocols to share information among systems and humans. Take a look at this simple comparison between Direct Messaging / HISP and this off-the-shelf secure messaging system we have presented at a recent HIMSS conference.

Wendy Odell said : Guest Report 3 years ago

Interesting to read. I do believe that as ACA is expanding it's value-based payment system, patients are beginning to recognize the use of technology as part of their customer service experience. Personally, this issue just occurred in our home. My husband had a dermatology referral for secondary skin cancer excision. When he arrived at the dermsurgeon's office, he noticed that the pictures of his primary excision area had been sent to the office via fax, and was barely discernible. The physician began recommending his treatment to my husband, and my husband stopped him, asking, "Are you basing my treatment on that blurry B&W faxed copy, or a digital image?" When the physician confirmed it was the faxed copy, my husband stood up, and told the physician he was going to find a doctor that was UTD in the latest technology. He arrived home this morning from a new office that used digital technology, and was given the good news that no further excision would be necessary. Educated patients are recognizing equating technology with value. Thanks for the article!

Peter Elias said : Guest Report 3 years ago

Dr. Smith: "Can you send me that info on Mr. Jones so I can complete is prior authorization forms?" Payor rep: "Sure. What's your fax number?" Dr. Smith: "That won't work Where I live we don't have fax." Payor rep: "Wow. Where do you live?" Dr. Smith: "The 21st Century."

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