By Jonathon Swersey
The New York Times just ran an article about an unsung hero and source of both great information, and much frustration, in America’s response to the coronavirus.
The fax machine.
Is this really the issue or is our reliance on this antiquated device is a symptom of something larger? At EPAM Continuum, we believe it is a symptom of a significant affliction.
Before the early 2010s, medical information was largely kept on paper and in folders in your various physicians’ offices. Remember the wall of charts piled high behind the reception desk in your doctor’s office? Physicians would record all of their interactions with you with pen and paper. Need records shipped? Well, fax is “secure,” faster than mail, cheaper than FedEx, and rather easy to use.
But all that paper comes with a great cost—the inability to transform patients’ medical history from data into information, from bits of content to something synthesized that is helpful to providers (helping them make a right diagnosis), patients (helping them get well), and payors (helping them pay for what was done).
But translating those records into digital content? Well, that was prohibitively expensive.
So we created a program of carrots and sticks that encouraged the adoption of electronic health records (EHRs). That program was wildly successful, and drove the rapid uptake of these systems, and led to explosive growth for companies such as Epic Systems and Cerner.
The first generation of EHRs was developed with a very narrow view of who’d use these systems and how they would be used. For example, no one thought about how patients might need to access their own records. And while these systems were built with providers in mind, they were really focused on academic medical centers, organizations that faced the optimal balance of carrot and stick to encourage adoption. Providers in the public health space—well, they were left out completely—and as it turns out, their needs, when it comes to a pandemic, aren’t quite the same as a run-of-the-mill doctor’s office.
COVID-19 has exposed the inadequacies of our healthcare and insurance industries. Our dependence on fax (one example our legacy technology and processes) was never designed for the burdens being put on it today. Yes, the volume is a problem. But even more of a challenge is the intensity of the manual processes required to turn that volume of paper into something useful.
Healthcare organizations have had ample opportunity to innovate their technology and operating models but many have failed to do so effectively, if they have acted at all. Before the pandemic, inaction was masked because they were able to hide their reliance on antiquated technology by making them appear to be more modern. But just as staging a home can’t hide a leaky roof, the mold in the basement, or the cracks in the foundation that make a house inhabitable, these solutions are frail at best.
The sharp increase in COVID-related testing and its rich reimbursement are serious issues, and they’ll require holistic, human-centered solutions.
So what needs to be done?
- We need to treat healthcare as a strategic asset. If we don’t get this right, we put our nation at risk.
- Payment must move from a fee-for-service model (the test was done) to a value-based model (the test was done, and the results were captured and shared correctly).
- We must of course modernize the various systems we depend on for care.
A good first step here begins with data. The industry needs a way to collect data, automatically, that can analyze and understand it and, in doing so, help us gain some ground on the pandemic.
We believe the focus shouldn’t be on the transmission method, but the receipt of all media types (documents, fax, images, video, voice). There’s a real need to centralize and automate the ability to capture, deconstruct, and validate healthcare data.
And we can’t ignore the enrichment of the submission with additional data sources. Consumption, validation, and redirection of data, once captured, can rectify the fragmented system.
Merging all data sources across the healthcare-and-life-sciences ecosystem will move us toward a multi-layer “data hub” reporting platform. Applying such a platform would accelerate future standards and help us gain the necessary leverage needed to battle today’s pandemic and the pandemics of tomorrow.
Who will lead the charge? The solution efforts can be focused on informing the critical response of agencies involved with the pandemic. This includes labs (provider-owned and/or a consortium), public health agencies (a consortium and/or the CDC), providers, insurers, the CMS, and/or the federal government. To ensure full cooperation, it likely will focus primarily on COVID-19 labs and case data initially.
The federal government’s new directive to gather coronavirus case data could be a step in the right direction—that of a truly innovative ecosystem. This centralization can provide for higher data quality, smooth digital transactions, improved efficiency, and increased speed of insight. From this, emerging trends emerge from the existing silos in our states, laboratories, and hot zones.
We believe that enhanced data and data-driven insights for all players, along with a value-based testing model, can match the volume of cases and test results that are currently threatening to overwhelm our healthcare system. Who’s with us?
Jonathon Swersey leads the healthcare vertical at EPAM Continuum, where his recent client work has included the future of cell & gene therapies and their impact on a spectrum of healthcare participants and the future of virtual care and showing what resonates with patients.