Opportunity

When a patient schedules an office visit for the first time within a given health system, paperwork including a release of information consent (disclosure) and external medical records must be collected, reviewed, and filed. This process varies across clinical sites and is time consuming, cumbersome, and prone to errors when completed manually. Efficiently acquiring and processing medical records is an industry-wide challenge in health care. Despite the progress in electronic health record (EHR) interoperability and data exchange, most health systems still use fax machines to transmit patient records; Penn Medicine receives an estimated 1.3 million records via fax annually. Delays, incompleteness, or other issues with records can prevent clinical providers from preparing treatment plans in time for the visit and cause delays in care.

Intervention and Impact

We developed a suite of homegrown digital interventions to transform the records collection process, automating steps involved in identifying, requesting, and filing patient records so that intake paperwork can be assembled quickly and accurately. These solutions were designed to reduce the burden on care teams and increase operational efficiency by eliminating appointment delays due to incomplete paperwork.

Automated fax processing (eFax automation)

We built a platform called coordn8 that integrates advanced AI tools such as optical character recognition (OCR), natural language processing (NLP), and intuitive user experience design to efficiently process faxed medical records. 

coordn8 eFax reduced the average processing time for an individual fax from 3 minutes to under 40 seconds. This reduction translates to a single staff member being able to process more than triple the number of faxes in a given timeframe. As of December 2024, coordn8 had efficiently processed approximately 200,000 faxes, equating to more than 4,500 hours (2 FTEs) of staff time “saved.” Additionally, eFax automation increased staff satisfaction and reduced effort by 25 percentage points each, as measured by customer satisfaction scores (CSAT) and customer effort scores (CES), respectively.

eDisclosure consent

To obtain medical records before a visit, the health system first needs a signed form stating that the patient agrees to disclose health information. This process was previously done through email or postal mail and took almost a week on average. To make the disclosure consenting process fast and easy, we digitalized it and leveraged the text messaging capabilities of Way to Health. Patients can now sign their release of information or disclosure forms via text or email, and signed forms are automatically sent to the EHR with coordn8 once reviewed by a staff member.   

eDisclosure reduced the time to patient signature by 88 percent, which means that records collection can start 6 days earlier. This intervention increased staff satisfaction by 49 percentage points and reduced effort by 39 percentage points.

Intake SmartForm

The process of identifying records needed for an upcoming visit was highly manual and unstructured, resulting in missing or inaccurate information. Working alongside clinical users and using existing functionality within our EHR (Epic), we created an Intake SmartForm. The SmartForm serves as an algorithmic questionnaire with decision points to guide new patient coordinators gathering information from the patient during the initial phone call.  

The SmartForm improved the accuracy of intake information by 19 percentage points without increasing intake call duration.

coordn8 at scale

Through a collaborative approach with operational leaders, we’re strategically expanding the use of two coordn8 modules, eFax automation and eDisclosure consent, throughout Penn Medicine outpatient departments. Because the intake SmartForm is highly customized to meet disease-specific needs, we are not scaling it enterprise wide at this time.