KLAS recently published our first ever report on digital fax, which is something we really hadn’t even considered before. A group of digital fax vendors had come to us claiming capabilities that would really make a difference for providers, and they wanted us to measure them. To understand the full impact digital fax solutions can have, we talked with organizations that are using the very latest and greatest technology the vendors have to offer.
Every hospital organization has the ability to fax and is very fax intensive. Independent research suggests that somewhere between 50 and 60 percent of communication between parties involves faxing (see citations in report). Nearly every provider organization also has an EMR of some sort, but interoperability (in all its many varieties) continues to be a challenge for many. When providers talk about interoperability, the prevalence of fax is often cited as evidence that the industry is failing to move the needle. So why is KLAS studying this old technology?
Mike Davis, a developer of HIMSS Analytics EMRAM, helped create a model to measure the capabilities of digital fax solutions. This Digital Fax Maturity Framework provides a continuum to measure how far a digital fax solution can go in helping providers seamlessly get information from a fax. On one end of the spectrum is a simple secure fax that comes in digitally rather than on paper. On the other end is a solution that automatically routes faxes to correct places (like a patient’s chart), extracts relevant data, and incorporates it into the workflow to be easily reconciled.
Where Are We Now?
When we started the study, we expected the biggest benefits providers would talk about from digital fax would be increased security and ROI (i.e., saving costs by reducing paper). As wonderful as it is to be able to point to hard ROIs, we think that’s only the start.
For most provider organizations we spoke with, saving costs on paper and toner was the biggest immediate benefit of a digital fax solution. Very few mentioned security benefits. However, what was most exciting was the few providers we spoke with who are just starting to push for the pinnacle of the Digital Fax Maturity Framework. Those providers talked more about reducing FTEs to manage faxes, expediting the flow of information, and improving clinician decisions based on information in their workflow. No organization is pursuing these goals in the same way, and some have involved third-party vendors to get there, but the potential benefits are something healthcare providers have wanted for years.
Of course, digital faxing is far from perfect. The technology to extract information off a page is still rather new to healthcare, and being able to understand the context of that information is even trickier. This assumes that the information coming in is correct and formatted in a way that is usable. These are real problems that digital fax vendors will need to solve in order to make the entire process seamless. We will have to wait and see whether their claims come to fruition.
What Will the Future Look Like?
One day, there could be a race between digital fax and EMR interoperability. If you could easily and digitally incorporate data into clinical and financial workflows from any document source, that would negate the need to set up more complex means to exchange data. And to be frank, unless the government mandates EMR interoperability like they did in banking system with the Federal Reserve sitting in the middle, it is unlikely that EMRs will reach seamless interoperability anytime soon.
At one point, it seemed that HIEs would fill the interoperability need, but they largely failed. CommonWell Health Alliance and Carequality are currently showing promise for increased connectivity, but barriers still exist. Throw in the complexity of communicating with pharmacies, payers, and other groups that are not using an EMR, and the road toward full interoperability gets even longer. While healthcare vendors certainly haven’t solved all the issues yet, the door is wide open, and third-party intervention via digital faxing may be more realistic and more likely than EMR vendors holding hands and coming together.
Partnerships a Must
It takes two to tango, and likewise, an obstacle to interoperability is that it requires two parties. For example, Concord and Allscripts have a partnership. Without partnerships already in place, providers may need to help establish those and translate things into their workflows. If we are going to reach the pinnacle of this technology, digital fax vendors will need to further streamline integration between their solutions and EMRs and be able to work with all the major vendors.
If moving to a digital fax solution is on your radar, look at the Digital Fax Maturity Framework and figure out what you want or need to achieve, remembering these results represent the very tip of the spear for vendors. Then talk with the vendors and see what they can do with your EMR and how soon they can get it done. What are your goals, and what technology can match your goals?
Digital fax technology has tremendous potential and can make a difference. We hope more provider organizations are digging deep to see how digital faxing can eliminate interoperability challenges.