Health Information Challenges Part 3: Transport

January 11, 2019

Do you ever wonder how you can get money from any ATM and yet we can’t go from one health provider to another, even in the same town, and have them be able to access something as simple as our phone number from another clinic? Here are our insights on why that is.

  1. Variable Technology
    Medical providers have a wide range of technology in their offices. Unbelievably, some even still have paper records. And the rest have a variety of systems, some more robust than others. Some may have the technology to exchange information electronically and do not even know it. Or they know it, but their vendor has not made consumption of the data easy for the provider to see or use so they choose not to implement it. So, if your provider’s office says they “can’t” send something electronically, it is more likely that they “won’t”.
  1. Resource Availability
    Small to mid-size organizations may simply not have the resources to implement the technology and associated workflows to facilitate information exchange. Often the IT person or clinical applications lead has been trained on the job and has multiple other responsibilities to manage. With health information management technology being a newer field, it is hard to find skilled and experienced resources, especially in rural settings, that smaller organizations can afford.
  1. Security Myths
    Another excuse that may be used is that transmitting electronically is not secure. That certainly can be true, but there are methods for secure transport, including secure email. It may be more the case that it is easier just to say it is not secure rather than upgrade to the highest security safeguards. Meanwhile, offices continue to use the fax machine. I do not have a CD player on my laptop any more let alone access to a fax. That was cutting edge technology in 1990 and results in more HIPAA inadvertent disclosures (wrong number) and misdirected items (I faxed it 3 times – why can’t they find it??) than any other method of delivery. People are often also not aware that modern fax machines also retain images on the machines and must be destroyed or wiped when the machine is to be decommissioned. An interesting statistic I read from Politico eHealth says, “In 2017 there were about 170 million Direct [electronic] transactions....That's double the 2016 figure-but it's still dwarfed by the 3 billion health care faxes each year.”
  1. Cost
    The number one reason for not upgrading, engaging expert consultants, or adding the right resources will always be touted as cost. It is my experience in healthcare that budgeting and financial decisions are made in silos and for the very near term. They look at the cost of the functionality or the resource at today’s value and not the return it will provide in the future. It is harder to justify than, say, a piece of surgical equipment, that is more tangible to a clinical professional. Which leads to the final point...
  1. Culture
    Consumer expectations are driving a monumental change in the delivery of healthcare though it is a very slow boat to turn. Much of the industry is still clinging tightly to the operational workflows, and in some cases the very same photocopied forms, that were the order of the day when that first fax machine was purchased. It is a culture of wanting the new technology to fit old processes. Who knew there were so many ways to say, “we’ve always done it this way”?? To be successful in the new value driven environment healthcare needs to be more innovative and nimble.

It is because we know each of these items can be improved that we get out of bed every day. We won't stop our quest for improved exchange of information until there are no longer clinics and hospitals insisting that we fill out another set of redundant paper forms.

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