Tackling the healthcare interoperability dilemma with artificial intelligence

Mr. Nebergall is an accomplished senior executive with over 30 years of experience in healthcare IT. John has held several executive-level positions including SVP, Client Services and Solution Adoption at Orion Health; SVP, Client Services at Allscripts; and SVP, Credit Solutions at Experian Information Services. Most recently, John served as the GM of Demandforce, driving all aspects of this business. John is also an Adjunct Professor of Clinical Informatics at the University of Illinois, Chicago.

Poor market education on available solutions is the biggest interoperability challenge facing healthcare today. Paper fax, which is not digitally exchangeable, is still highly prevalent with billions of patient records still exchanged annually through this method. According to a recent Consensus Cloud Solutions Industry Survey of more than 1,300 hospital and health system participants, 61% said they still use paper fax to send documents externally. What was even more revealing was the low prevalence of digital communication methods – for instance, 65% of respondents said they had not heard of direct secure messaging. This data suggests our industry needs to expand the understanding and use of technologies that can fuel more widespread adoption of secure, reliable, and inexpensive interoperability alternatives.

Interestingly, digital cloud fax technology (DCFT) - as opposed to paper-fax - is a very cost effective and HIPAA compliant alternative that easily fits into a paperless workflow. Over half of the survey respondents said that cloud fax will be a valuable or dominant method of communication over the next five years. So, the problem is not that cloud fax exists, but rather that cloud fax has not been accepted as a digital protocol, one capable of being integrated into EHR workflows and paperless filing solutions.

Paper fax persists as a preferred communication for no single easily addressable reason, but rather a complex multifactorial culture that prioritizes ease of use and convenience of a fax machine. But a change to this workflow is on the horizon as 68% of hospitals and health systems we surveyed indicated they plan on prioritizing solutions to improve interoperability within the next year. 

Given the burdensome cost of change and the lumbering pace of technological adoption, the key is ensuring continued backward compatibility. This will allow providers who lack financial resources or the technical acumen to keep pace with accelerating health IT advancements, while being able to effectively exchange information and deliver high-quality care. In the end, a hybrid approach consisting of digital cloud faxing technology, direct secure messaging, FHIR, and other secure digital methods is needed to move the industry off paper and into a secure, digital workflow. 

One of the most challenging aspects of interoperability proliferation is the requirement to transition unstructured documents to structured data. We have found that NLP and AI protocols are the way forward for our industry. Once you have a digital document, the task is no longer about “document” exchange – it is then “data” exchange. With technology that leverages NLP and AI advances, we can improve workflows so providers can receive documents with automatically identified information such as patient demographics and clinical information – providing a longitudinal look at that patient record. For example, a provider can convert unstructured cloud fax documents into a consolidated-clinical document architecture (C-CDA) document using NLP/AI that can be consumed more intelligently by their EHR, while still maintaining an original file that can be faxed externally. The industry is responding quite favorably to this with 90% of the respondents in the survey expressing interest in AI-enabled patient identification. In the end, the enemy of healthcare is not fax technology, but the inability to easily automate processing for efficient clinical workflows in order to move us forward so that we can improve health outcomes.

To learn more, please visit www.consensus.com