By Bill Ho
If you watch any medical dramas on TV, you’ll notice that the doctors and nurses always have all the information about the patient readily on hand. No cut scene to the back room where the staff are trying to collect and manage patient data and no shots of a doctor entering their notes into an EMR. Obviously, not interesting enough for TV viewers. Yet this information, and the ability to store, access, and share this information is the true star of the show that helps provide great patient care.
In real life, patient information gets similar treatment. It is a necessary part of overall care but not sexy compared to the newest surgical robot or IoT wearable. But in 2009, the HITECH act put electronic patient health information on the map. From an infrastructure perspective, ePHI is the currency of healthcare, but it’s not a universal one. The inability to easily share medical information along a patient’s journey is one of the major problems still plaguing the healthcare system today.
With the current COVID-19 crisis, healthcare is being pushed to its limits in all areas, including the clinicians on the front line, and IT on the back end. Remote workers have even greater challenges now accessing information because of inadequate infrastructure, creating delays that can significantly impact patient outcomes.
It’s high time we approach health information as lingua franca. Interoperability is critical to fast and reliable information sharing when hospital systems aren’t on the same EMR platform. But that’s easier said than done. Many attempts at interoperability have been made, and health information exchanges, information highways, and other initiatives have tried to solve this problem, most with modest success. While poor adoption may seem purely technical, there are also political, cost-based, and cultural divides hampering it. Because of this, faxing patient data is often the easiest and most reliable way to send and receive ePHI.
While fax is a perfectly fine medium to share most medical information, and most health IT systems have fax capabilities built in, there are instances where additional formats and data capabilities could be useful, such as transfering DICOM images, or transmitting structured data for insertion into a specific EMR form.
Like any large platform, the network effect plays prominently and the platform only becomes valuable when enough people have signed up. With too few players agreeing to use the same system, there’s not enough critical mass to spur sufficient adoption. As more methods proliferate, the harder it becomes to agree on a standardized system of communication. It’s not just the protocol standard, it’s also about agreeing on terminology and definitions of data to ensure the accuracy and correct transmission from one system to another. If we had a magic wand that could instantly upgrade every health system to use a single agreed-upon system for information sharing, that would go a long way to solving this problem.
But that being unrealistic, perhaps a digital migration strategy is our best bet – one that can transform systems at whatever pace makes sense for each organization, yet also accommodates multiple data types. A dual path system where both ends of a conversation are capable of supporting the least common denominator (e.g. fax) and the new data types could be feasible. While this means supporting both legacy and new systems in the short term, it ensures information flows no matter what. Once enough systems support both modes of communication, you can start to phase out the old method and switch over to the new.
Information sharing is not sexy. It won’t get any air time in fast paced medical TV shows. But it’s like the air we breathe – we take it for granted until it’s not available. Healthcare is a complex beast but standardized ePHI interchange is one of the key pieces we need to get right. If we continue to push off the problem, it will only get worse, and patient care will surely suffer. It’s time ePHI has its chance to shine in the spotlight.
Bill Ho is the CEO of Biscom, a software company that helps organizations share information securely through secure fax, email, collaboration, and file sharing. Bill offers more than 30 years of cyber security experience, and under his leadership, Biscom has seen record growth, launched award-winning products, and expanded its leadership delivering solutions for regulated industries, most notably healthcare.
Prior to Biscom, Bill held leadership roles at Oracle and CNET.com before founding a company that pioneered cloud storage and secure collaboration. Bill received his BS Computer Science from Stanford, MS Computer Science from Harvard, and his MBA from MIT Sloan. Bill also serves on the President’s Council for Lahey Hospital & Medical Center.