Automating and Securing Healthcare Information Processing with Cloud-Based Fax Messaging

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1 White Paper Automating and Securing Healthcare Information Processing with Cloud-Based Fax Messaging Reduce costs while improving security, trackability and efficiency

2 Executive Summary Situation: Federal guidelines are driving healthcare providers to automate the processing of patient-related information. Government regulations are designed to protect patient privacy and encourage the adoption of functional, secure technology solutions, which will impact how healthcare providers transmit, secure, and store medical data now and in the future. These regulations are expanding the number of required forms, reports, and communications exchange, which is forcing today s healthcare providers to streamline the way this information is accessed and managed. Problem: Manual processes with traditional serverbased fax infrastructures are no longer costjustifiable. Unfortunately, many healthcare providers still depend on a combination of outdated manual processes and internal fax infrastructures to manage patient-related information. With a sharp focus on greater cost-containment policies, many organizations are determining that expenses associated with managing these processes are becoming more difficult to justify when factoring in the associated costs of maintenance, upgrades, support, and downtime. Beyond the cost issue, these procedures also present greater security risks for healthcare providers via the potential disclosure of sensitive patient information. Even with dedicated personnel and secure data rooms, any manual handling of paper-based medical information increases the possibility that sensitive patient information will be mismanaged, thus increasing the potential for regulatory compliance penalties. Solution: A cloud-based fax-messaging platform streamlines patient information processing reducing security risks while lowering operational costs. To meet regulatory and operating challenges, healthcare providers must move to a more cost-effective and secure fax messaging model that eliminates the high costs and security risks associated with maintaining an in-house fax infrastructure. EasyLink Fax as a Service comprises a series of highly scalable cloud-based solutions that accommodate peak inbound and outbound fax volumes. The solution applies business intelligence to extract data from inbound faxes while applying accepted work rules to distribute that information to update the healthcare organization s backend systems. EasyLink also maintains the highest level of compliance standards to support the delivery of secure fax communications. Result: Lower operating costs, greater information security, improved accuracy and auditability, and enhanced regulatory compliance. EasyLink Fax Services enable healthcare providers to conduct mission-critical, high-volume transactions faster and in a more cost-effective manner than less secure, manual fax processes, while eliminating the information security risks associated with maintaining an internal fax infrastructure. Healthcare providers are able to satisfy the complex requirements associated with information exchange in today s evolving healthcare industry.

3 Federal Regulations are Impacting Healthcare Information Management The healthcare industry is showing significant expansion due in large part to the ever-growing medical needs of today s population and an aging baby-boomer generation heading toward retirement. It is estimated that from 2009 to 2019, annual healthcare spending will grow by an average of 6.1 percent many times faster than the current growth rate of the entire economy (currently just over one percent for 2011). According to statistics compiled by the Centers for Medicare & Medicaid Services, national health spending is expected to rise to $4.5 trillion by 2019 and encompass 19.3 percent of the U.S. GDP. 1 While growth continues in the market, federal regulations exist to protect the healthcare consumer, and impacts how providers transmit, manage, and store patientrelated information. These regulations are increasing the number of information requirements, filings, and reports and require stiff penalties to be levied against any organization that fails to comply with these procedures. As an example, the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was designed to stimulate the adoption and meaningful use of electronic health records (EHR) and establish grants for training for the personnel required to support new health IT infrastructures. Beginning in 2011, healthcare providers have been offered financial incentives for demonstrating such implementations. In 2015, however, penalties may be levied for failing to demonstrate such use, including holding back reimbursement payments for any participating healthcare provider that fails to adhere to them. 2 Fax continues to play a significant role in healthcare communications, and with the rollout of national healthcare, fax communications are anticipated to grow at an even faster pace. Unfortunately, many healthcare providers still depend on outdated internal fax infrastructure, which exposes them up to greater security risks and the disclosure of sensitive patient information. While many large healthcare providers have moved from manual fax machines and paper forms to a network of fax servers, the rising costs associated with managing such a vast infrastructure is becoming increasingly difficult to justify at a time of severe budgetary cuts. As a result, healthcare organizations must move to a more costeffective, cloud-based fax model that eliminates the high costs and security risks associated with maintaining an in-house fax infrastructure. The goal of this white paper is twofold: First, to educate healthcare providers about the benefits of Fax as a Service for reducing the high operating costs associated with maintaining an internal fax server environment. Second, to show how cloud-based faxing can minimize patient information security risks to comply with current and future healthcare regulations. What does this mean for fax? Faxing continues to play a significant role within healthcare communications involving the physician, the patient, and the insurer and now a number of federal regulatory agencies. The number of related fax communications is anticipated to grow proportionately with the growth of this industry sector, and will be governed by the auspices of all federal guidelines and regulations. 1 Source: Centers for Medicare & Medicaid Services, National Health Expenditure Projections , Aug Source: U.S. Dept. of Health and Human Services, Rules and Regulations, Federal Register, Vol. 74, No. 209, October 30, 2009, Page 5. 2

4 Healthcare Industry Challenges of Maintaining Traditional Fax Infrastructures Today, healthcare information is considered to be a bifurcated process. In other words, there is both a frontend and a back-end component to healthcare information systems. The front-end demonstrates the significant investment in leading edge technologies dedicated to patient education, interaction, and treatment. For example, software and hardware advancements in imaging technologies and the development of mobile apps and websites represent excellent examples of how the industry has invested in the front-end of healthcare treatment and information delivery. But the back-end of many healthcare information systems shows an entirely different picture one that is, in some cases, a decade behind other commercial industries. This is especially true with regard to fax communication management. The continued use of analog phone lines, physical fax machines, and a lack of centralized records management systems point to the inadequacy of many back-end systems to meet the information needs of a rapidly changing healthcare industry. Today, there are four primary fax communication challenges facing organizations within the healthcare industry: Challenge #1: The Inability of a Weakened Infrastructure to Handle Fax Volume Spikes Many traditional fax infrastructures have been designed with a single point of failure, where a limited number of analog phone lines and/or fax servers have been implemented to support an organization s total fax needs. When peak volume spikes occur, such as pharmacies submitting prescription approvals or insurance providers sending treatment approvals, these limited fax infrastructures are unable to handle the increased load. This results in busy signals, diminished response time, and the disruption of patient healthcare and payment processing. In other words, if a single point within the infrastructure fails, the entire fax communication process grinds to a halt. The back-end of many fax systems is, in some cases, a decade behind other commercial industries that are unable to meet the information needs of a rapidly changing healthcare industry. Such fax problems persist because of the low prioritization given to infrastructure upgrades and improvements, as compared to more lucrative customer-facing projects such as advanced medical treatments or enterprise-class mobile applications. As a result of high operating costs and the low prioritization of infrastructure investments, faxrelated problems persist and result in greater downtime, slower processing, and longer patient response times. Challenge #2: Poor Fax Infrastructure Visibility and Accountability Since fax is an integral part of the healthcare communications system, any disruptions can have catastrophic results for the provider. In many circumstances, these disruptions are the result of fax systems that cannot provide sufficient details about the root causes behind the communication errors. With thousands of faxes containing sensitive medical information, a small increase in the fax error rate can translate into severe regulatory compliance penalties. Even a half of a percentage change in the fax error rate can translate into millions of dollars in penalties should such information be unaccounted for or fall into the wrong hands. Therefore, correcting fax errors becomes more important. Uncovering their root cause, however, can require extensive time and expense. Did the sender or the recipient cause the fax transmission failure? Was it due to a problem from the telecommunications provider or due to the sender hanging up? Or was it the fault of an internal fax server, telecom network, or other related desktop applications? Did a recently upgraded component cause the error? With a greater number of factors related to the fax communication process, determining the root cause of communication errors becomes more difficult to troubleshoot and more costly to resolve. 3

5 Challenge #3: A Platform-Dependent Fax Infrastructure Platform Many components of an in-house fax infrastructure have a built-in obsolescence that requires the ongoing investment of a variety of upgrades and updates to maintain a basic level of proficiency. For example, the release of a new server operating system can often require updating other associated hardware or software components, which may not always be available at the time of the upgrade. Since each component of an internal fax infrastructure is often independently managed, a small change in one key component can bring down an entire fax system, resulting in disruption of service and delays in patient response time. Related to this is the issue of cost and resource allocation. An IT employee tasked with resolving fax problems wastes the time of a valuable and costly resource that could be focused on projects that contribute to greater profitability, such as improving the delivery of patient healthcare services. There is no guarantee that the use of such dedicated resources will be any more secure or faster than traditional methods. Security is only as good as the weakest link. A rogue employee with a security clearance can easily obtain and misuse this information, resulting in the same costly liabilities as for a provider that did not employ these dedicated procedures to manage sensitive fax information. How can healthcare providers overcome these faxrelated challenges? Healthcare providers need to address these challenges by finding new ways that will easily transition them from a low priority and low availability fax model to a cloudbased, highly secure high priority and high availability fax model using more cost-effective outsourced resources. For over 20 years, EasyLink Services has provided cloud-based fax services designed to deliver a more cost-effective operational model while ensuring security, accountability, and compliance to meet the current and future regulatory requirements of the healthcare industry. Since each component of a fax infrastructure is independently managed, a small change in one key component can quickly bring down an entire fax system. Challenge #4: Ineffective and Insecure Information Management Processes Many healthcare providers address regulatory requirements, such as HIPAA, by implementing a greater number of ad-hoc manual processes that become overly complex and time-consuming. For example, many have established secure data rooms with dedicated fax machines and personnel who have the responsibility of manually processing fax messages that contain sensitive patient information. This involves devoting many man-hours to compiling patient data, determining appropriate recipients, and manually delivering faxes to their destinations. 4

6 Understanding the Advantages of a Cloud-Based Messaging Platform for Healthcare In order for any information system to improve productivity, it must be transparent to the user. The less transparent a system is, the more complex and difficult it will be to use, and the less it will be used to effectively support user needs. Cloud computing makes fax communications easier, more transparent, and more cost-effective in three distinct ways: Cloud computing moves healthcare organizations from disconnected, manual methods to enabling automated on-demand processes that populate information into enterprise applications. 1. Leveraging Economies of Scale Cloud-based fax messaging moves the traditional model of an internal fax infrastructure to a less costly, outsourced model without requiring any additional capital investment in the process. Organizations can expand services as needed without building out their infrastructure. Cloud-based fax messaging enables healthcare providers to process critical, high-volume transactions faster and more efficiently with no limitations on volume. The error-prone tasks traditionally associated with manual processes are eliminated, so users can streamline approvals to better serve patient needs. Cloud-based fax messaging also refocuses costly and limited IT resources toward more lucrative revenue-generating projects, which ultimately contributes to a more profitable bottom line. EXAMPLE: Healthcare organizations conducting clinical trials often encounter circumstances where there is high demand for multiple sets of documentation that must be delivered via fax. These faxed documents must be sent to a specific server location that has been established for the clinical trials. Fax messaging using workflow rules can distribute these documents to a designated network location with less time and cost and greater security when compared to the level of manual resources that would be required to accomplish the same task. Cloud computing moves healthcare organizations from disconnected, manual methods to enabling automated on-demand processes that populate information into enterprise applications. During this process, all medical information is safeguarded using industry-standard security and auditability controls to help organizations achieve compliance with FDA requirements. 2. Integrating Front- and Back-End Applications to Improve Service Delivery Fax as a Service integrates fax messaging directly into both frontand back-end production applications to improve the process of information delivery. When medical information arrives via fax, it is automatically routed to business applications in the most efficient manner possible. By streamlining information delivery in this fashion, healthcare providers can respond to patient needs more quickly. 3. Automatically Populating Enterprise Applications with Fax-Based Information - Production Fax messaging can be used to automatically populate enterprise applications or systems with fax information to improve productivity and shorten the amount of time to complete workflow-related tasks. 5

7 How EasyLink Fax as a Service Eliminates the Challenges of a Traditional Fax Infrastructure Today s healthcare organizations must work smarter to deliver exceptional patient services while optimizing bottom-line profitability. The EasyLink vision is to make fax communications as transparent to the user as possible. That will result in greater use and productivity for the healthcare provider. EasyLink improves fax communications in the following ways: Solving Peak Volume Problems with a Highly Scalable and Secure Fax Messaging System EasyLink fax messaging is a highly scalable solution that can easily accommodate peak fax volumes. EasyLink applies business intelligence to extract data from an inbound fax and applies work rules to distribute that information to update back-end CRM and ERP systems. EasyLink also maintains compliancy standards to automate the transmission of secure fax communications for the healthcare industry. Peak fax volume periods represent incremental impacts on total fax traffic, but even one spike beyond an organization s internal capacity can grind operations to a halt. EasyLink s cloud-based solution scales to accommodate peak fax volumes, eliminating the high cost of architecting an internal infrastructure to meet the same volume demands. EXAMPLE: A home healthcare service provider wanted to implement a solution that would decrease the time required to process prior authorizations without any service disruptions from high volume and batch processing. EasyLink provided a web-based solution that automated the exchange of prior authorization requests and subsequent approvals, shortening the authorization cycle time and dramatically improving both information and treatment delivery rates. Solving Incompatible Upgrades with a Completely Agnostic Fax Communications Service Instead of the costly problems associated with incompatible infrastructure upgrades, EasyLink continually refreshes fax technology to enable complete compatibility with ongoing enterprise application revisions for uninterrupted fax service functionality. EasyLink provides developers with a set of software APIs so that enterprise applications can be customized to ensure seamless integration and platform agnosticism. Since the service is hosted in the cloud, there is no need to worry about compatibility with hardware or software upgrades. EXAMPLE: A national home healthcare provider used Microsoft Exchange and an internal fax server for and fax messages. When a new series of fax communication errors arose, it was determined that a recent upgrade to their Exchange environment was incompatible with the existing fax server hardware. The healthcare provider had to resort to manual fax machines until an upgrade to the network fax software could resolve the problem, and no timeframe for release had been made available. Shortly thereafter, the provider transitioned to EasyLink s Fax as a Service and was fully operational within days. With EasyLink, network technologies are constantly upgraded and refreshed as needed to meet the fax messaging requirements necessary for a highly available service without requiring the customer to perform any additional desktop-level upgrades. This eliminates any downtime due to incompatible infrastructure upgrades, and is completely transparent to the user. EasyLink s cloud-based fax services scale to accommodate peak fax volumes, saving the high cost of maintaining an internal infrastructure on a full-time basis. 6

8 Solving Productivity Challenges with Highly Effective and Secure Fax Processes EasyLink cloud-based fax messaging solves the challenge of complex reporting procedures through the implementation of EasyLink Workflow Services (EWS) and EasyLink Document Capture and Management (DCM). These cloud-based services allow incoming documents, such as those required for clinical trials, to be received as electronic documents at the desktop. EasyLink EWS routes the incoming documents (e.g. adverse reaction forms) to designated work queues based on existing business rules, enabling each one to be processed and routed according to its pre-established rules. In addition, EasyLink DCM automatically extracts information from faxed forms and provides it in customer specified format to populate enterprise applications and improve data accuracy. Both of these services ensure accurate information delivery that dramatically lowers the cost of manual process management. EasyLink DCM extracts unstructured information from faxed documents and converts it to structured data to populate enterprise applications, improving data accuracy and bypassing the need for manual intervention. EXAMPLE: A global pharmaceutical distributor needed to streamline the processing of inbound prescription refills. EasyLink replaced the existing manual data entry and scanning system with EasyLink DCM, which read and populated their CRM-based enterprise prescription application, eliminated the delays associated with processing multiple claims on the same patient, and eliminated errors related to manual data entry. This implementation resulted in greater speed and accuracy, faster prescription processing, a reduction in personnel costs, and a faster time-to-revenue. Applying Business Intelligence to Solve Poor Visibility and Accountability EasyLink cloud-based fax messaging provides an intelligent real-time reporting system that gives the status of each fax message. Status can be returned directly to the application, ed or downloaded on-demand. These reports provide complete visibility and accountability for every fax transaction, ensuring support for regulatory compliance requirements. Detailed searches (such as job number, outbound fax number, or date, and time) provide evidence of when a fax was sent and received, and whether that fax was transmitted successfully. Error codes use clear, concise descriptions to describe the reason behind a failure (such as busy signal, hang up, or voice line) so that problems can be easily identified and resolved enabling subsequent messages to be successfully delivered. The Bottom Line EasyLink cloud-based fax messaging is designed to address the constantly changing needs of today s healthcare industry to lower overall healthcare costs, protect patient information, improve service delivery, and generate greater operating profitability. EasyLink s Desktop and Production Messaging Services eliminate the high costs and privacy concerns associated with an internal fax infrastructure. A secure, redundant network eliminates downtime caused by poor scalability and maintenance delays and employs greater safeguards to protect patient data, which ultimately improve productivity and faster time to patient treatment EasyLink Services International Corporation. All rights reserved. EasyLink is a registered trademark of EasyLink Services International Corporation. 7

9 Conclusion While every industry experiences change, the healthcare industry can expect to see an ongoing series of new regulations, technologies, medicines, procedures, and treatments that will be reshaping the industry for decades to come. Fax is expected to remain an integral part of industrywide communications. To meet those needs, healthcare providers should consider moving from a fax model based on more costly, resource-intensive internal infrastructures to a model that leverages more flexible, outsourced, cloud-based systems. EasyLink cloud-based fax messaging provides a secure, cost-effective solution. EasyLink improves workflow productivity, while reducing both the time and cost associated with managing fax-based healthcare information for patients, insurers, and regulatory agencies. In summary, there are four primary business advantages that can be gained by moving to EasyLink s Fax as a Service: Lower cost and higher efficiency that enable greater profitability and ROI Greater reliability that consistently provide higher information delivery rates Scalability that expands to meet volume needs, especially during peak fax periods Enhanced compliance and security with reporting to meet regulatory compliance procedures 8

10 About EasyLink Services EasyLink Services International Corporation (NasdaqCM: ESIC) is a leading global provider of on-demand cloud-based electronic messaging and transaction services that help companies optimize relationships with their partners, suppliers, customers, and other stakeholders. We provide a 100 percent outsourced solution for both on-demand business messaging and supply chain services, creating attractive economies of scale with unparalleled quality and a single point of accountability. EasyLink offers a comprehensive portfolio of any to any business messaging and transaction services that can bridge the most challenging technology gaps while creating significant cost efficiencies across an organization. Services include Desktop Fax and Production Messaging, Workflow Services, EDI, Managed File Transfer, Document Capture and Management, Notifications Services and Secure Messaging. EasyLink helps companies drive costs out of their operations. At the heart of our hosted services is the industry-leading EasyLink Business Integration Network, secure and fully redundant world-class global infrastructure that supports millions of transactions daily for our customers. With over two decades of servicing more than 30,000 customers around the globe, EasyLink has established a proven track record for providing robust, reliable outsourced communications. For more information about EasyLink s cloud-based fax messaging services for the insurance industry, please visit our website at or us at [email protected]. Corporate Headquarters International Headquarters 6025 The Corners Parkway Bishopsgate Court Suite Norton Folgate Norcross, GA London, England E16DB 1 (678) (0) (800)