The speed and quality of data transmission have become a matter of life and death during the COVID-19 pandemic. A recent article from The New York Times, “Bottleneck for U.S. Coronavirus Response: The Fax Machine,” illustrated the challenges that plague health systems to allow data to transmit effectively and in a timely matter.
While the digital capabilities from Electronic Medical Record (EMR) vendors and third-party vendors have brought data interoperability light years ahead, why are healthcare organizations still so dependent on faxing vital information? It is primarily due to cost and process, but as COVID-19 grips the country, it’s more pertinent than ever to invest in more interoperability of healthcare.
Gaining popularity 40 years ago, fax machines were a genesis to digital platforms and faxing was one of the only methods to transmit HIPAA data securely. Faxing has a place in some instances, but it quickly became an antiquated method of data transmission. The dirty secret of the faxing processes still in play today is that the forms entered are not standardized, and healthcare organizations have to hire teams of staff solely for data entry — it’s wildly inefficient. Faxes still need to be entered manually in EMRs and coded correctly in the system; nothing is automated.
According to The New York Times article, Washington State brought in 25 members of the National Guard to assist with manual data entry, and in Austin, TX, the public health authority office reports receiving approximately 1,000 faxes a day, including duplicate results. The article states the Austin public health authority, “is getting all the information it needs about a test result 11 days after the test is taken — far too late to make contact tracing worthwhile.”
As healthcare organizations moved from paper records to digital in the past, it was incredibly expensive. Health Level 7 (HL7) was revolutionary because it allowed payors and providers to transfer healthcare claims more efficiently and securely. But, investing in data transmissions and standardization methods like HL7 that allowed consistent communications between organizations was largely lagging. Especially within smaller clinics, faxing remains the most effective system for transferring data. As healthcare organization consolidation occurs, many smaller organizations sell to larger systems because the infrastructure cost is simply too expensive.
COVID-19 poses an increasing threat to the already fragile healthcare system. Data interoperability needs today — especially during COVID-19 — have evolved beyond just applications and now serve the opportunity to save lives with faster data transmission. It’s hard to imagine scenarios like hospitals where all the beds are filled with COVID-19 patients, but leaders still have to discuss staff layoffs. As new therapies evolve to combat the coronavirus, most organizations aren’t equipped to leverage new techniques because data availability just isn’t there. Simply put, COVID-19 is moving faster than our infrastructure to combat this pandemic. Data interoperability is part of the solution to send data faster and more securely.
Government organizations like Centers for Medicare and Medicaid Services (CMS) have made strides in pushing for standardization methods and transmissions like HL7 in lieu of faxes. CMS is frequently the largest customer of most healthcare providers, and with its size comes enormous influence. It will be the responsibility of CMS to help end the need to fax altogether and push for fully-digital record management. The most significant opportunity lies in healthcare organizations promoting digital interoperability methods to specialty clinics. For example, funds for helping providers transition could be distributed through an update to the State Health Information Exchange Cooperative Agreement Program or by amending existing federal EHR interoperability programs to include funding to help providers transition to Directed, Query-based, and even Consumer Mediated electronic health data capture and transmission.
Leveraging APIs and data transmission methods like HL7 are the first step in taking reliance off faxes for data transmission. The coronavirus presents a once-in-a-generation threat to our world that has shown how resilient our healthcare workers are in the face of adversity, and it’s beyond inspiring. Healthcare as an industry owes it to the people who are giving everything they have to help those affected by COVID-19 through faster, more efficient data transmission methods.