Not long ago, ONC held its 2nd Interoperability Forum in Washington, DC. One of the big ideas being kicked around at the event was killing the use of fax machines to share health data.
During her keynote address, CMS leader Seema Verma went so far as to say that she’d like to see all provider organizations go fax-free by 2020. Apparently, Verma wants providers to switch to other means of digital information sharing.
Sounds good, right? Well, maybe not. Despite its flaws, faxing does have the advantage of being easy to use, available in virtually every provider office and fairly reliable. I’m not sure we can say that about most other forms of digital health data exchange. In fact, dropping faxing may leave doctors with bigger problems than they had before.
After all, before we stop faxing, we’ll have to find a digital document format that plays nicely with other systems and makes patient information easy to access. That, not surprisingly, may be tougher than it sounds.
I particularly like the way Jay Anders, MD, broke these issues down in a recent email message. Anders, chief medical officer of Medicomp Systems, makes the following observations:
- E-paper may not be interoperable: In fact, it may create new barriers to data sharing, he suggests: “Electronic paper is not effective. It [can] create a data tsunami in healthcare – a flood of clinical data that physicians cannot access at the right time with the right patient.”
- Free text is a burden: While e-documents may be easy to pass back and forth, making use of the data within can be really tough, he says. “When the EHRs receive these PDFs with mountains of free text, how do they interpret that data? How do they present that data to physicians? How do they make that data into actionable information?
His bottom line here is that while providers can use e-documents to share data, there’s no point in trying unless they can offer useful information at the point of care.
After taking in Anders’ questions, I have another one of my own. If providers will still need to go through contortions to extract data from e-documents, how is that better than using faxes? After all, if you run faxed documents through a sophisticated OCR process, you can capture and even format health data information.
In other words, given the issues inherent in using digital documents, putting faxing to bed may not be worth the trouble. I have to agree with Anders’ conclusion: “So, how does sending electronic communication of scanned PDFs rather than faxes enable interoperability? The answer is that it doesn’t.”
For another view on Seema’s comments and the fax machine in healthcare, check out John Lynn’s post on the real problem when it comes to replacing fax machines in healthcare.