Interoperability Requires More Than Just the Latest Tech

Ever since medical data has been stored electronically, healthcare has struggled to share it. Frustratingly, we have the technology to overcome this challenge, yet we remain in a siloed world. Perhaps it’s time changed our approach.

Healthcare organizations have spent years waiting for incumbent vendors to make their systems interoperable. However, there is little incentive to do so, and vendors have not prioritized those features. In the meantime, many organizations have purchased and implemented third-party interoperability solutions to connect their systems together. It’s a mess.

Why is interoperability so hard? Why can’t we have a ubiquitous technology that is easy to use, secure, and reliable that can connect any two organizations or systems together electronically. It turns out this technology exists.

What is this technology? Keep reading and you’ll find out.

Exacerbating the Problem

I recently had the chance to sit down in-person (physically distanced) with John Nebergall, COO at Consensus Cloud Solutions, a new organization that enables better care coordination through interoperability, connectivity and compliance. He had this to say when I posed the question about why we have yet to achieve full interoperability in healthcare: “Part of the problem comes from our constant forward movement in healthcare technology stack. It makes it hard for people to keep up and ensure that the systems can communicate with each other.”

Nebergall went on to say that “backwards compatibility is not something that enters the conversation” in healthcare. Be honest, when was the last time you ever heard someone talk about making a new system 100% compatible with the prior one?

Cloud technologies were supposed to absolve us of this burden, but there are still many legacy systems in healthcare that have not been moved the cloud. It remains a slow process.

These two factors in combination are exacerbating the interoperability problem in healthcare.

The solution, according to Nebergall, is to create a “big tent” and invite as many healthcare organization inside as possible. Instead of building new tents that only a select few can afford to join, we need to build something that everyone can use.

A New Approach

In our conversation Nebergall strongly advocated for a new approach to solving interoperability. Rather than forcing healthcare organizations to keep up with the latest technologies in order to have their systems share data, why don’t we look at ways to leverage the digital framework that healthcare organizations already have in place and work within it.

What if there was a way to have an interoperability solution that would not require an army of developers or completely new workflows. It turns out we have exactly such a solution.

“Consensus has been very successful at delivering results using a technology that many consider old and crusty and doesn’t have a place anymore,” stated Nebergall. “It is tried, trusted and economic. It has a lot of advantages.”

What Nebergall is talking about is fax – not the actual fax machines, but the communication protocol.

Fax Interoperability

Don’t laugh, but fax excels for healthcare interoperability in many situations. Here is one example: when the two parties looking to exchange information are on different systems and are not affiliated with each other.

In this situation there is little chance that either party is going to invest in expensive interoperability tools to connect them together. Fax solves this problem. Neither side had to spend a ton of money or have skilled interop developers on staff to make the systems talk together. Cloud fax can easily bridge to both systems.

Fax is reliable. Fax is trusted. Fax is easy to use. Fax isn’t going anywhere.

According to a survey by Consensus 56% of respondents believed fax would still be a valuable form of communication 5 years from now. The company shared the results in a presentation at HIMSS21 which I covered.

One of the keys to making fax interoperability a viable solution is eliminating the paper and the fax machines at either end of the process. With cloud-based digital fax solutions, like the one offered by Consensus, this can be easily done. Instead of printing a document, putting it into a fax machine and sending it to the recipient, with a cloud solution, the user just has to identify the recipient and press a button. The system takes care of everything else.

When used in this manner, fax becomes a protocol and is not the device that we all think of when we hear that f-word.

Adding Advanced Processing

While it is true that the fax protocol is sends information electronically from point A to point B, what is actually being sent is an image of a document vs discreet data fields.

Think of a patient intake form. When you send that via fax, the fax machine turns that form into an image, transmits it to the recipient whose fax machine reconstitutes the fax message back into a paper document that looks exactly like the original.

When you use a cloud-fax solution, you not only remove the paper and fax machines from this example, you can now apply advanced technology on the receiving end.

Natural Language Processing (NLP), for example can be applied to the inbound fax image to turn it into discrete data elements that could be directly used by an EHR. There would be no need for any user intervention. It would all happen in the background as the fax was being received.

“This is what we are working towards here at Consensus,” said Nebergall. “We want to send a fax on one side and deliver an HL7 message on the other and have the whole thing be seamless. We want to offer a platform that is completely agnostic to the communication protocol that the customer wants to use. Whether that’s DIRECT, HL7, FHIR or fax. I should be able to send a message in any of those protocols. On the receiving end, I should have the flexibility to choose the way I want that information packaged.”

The Consensus Clarity solution integrates Natural Language Processing (NLP) and AI to help healthcare organizations move unstructured EMR data and clinical content to structured, analytics-ready data. Other features include the ability to streamline prior authorizations, extract patient demographics to create a more complete longitudinal record, convert digital fax to C-CDA, de-identify PHI for population reporting and automate clinical trial management.

We Need More of This

I must admit, this sounds pretty amazing: send a fax and have it arrive as an HL7 message or even as a C-CDA? This would mean that even the smallest physician practice could interoperate with their ecosystem without the need to implement a new EHR had HL7 capabilities. If their EHR can send a fax (or print-to-fax), then that physician can move out of their silo and into the “big tent”.

That’s what we need more of.

Watch the full interview with John Nebergall and learn:

  • How Consensus smartly remains true to its fax roots while advancing interoperability
  • What Nebergall thinks of the Info Blocking rule
  • Why Nebergall is excited about healthcare policy

Learn more about Consensus Cloud Solutions: https://www.consensus.com/

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Consensus is a supporter of Healthcare IT Today

About the author

Colin Hung

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

   

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