An AI-powered system developed at the Penn Medicine Center for Health Care Transformation and Innovation (CHTI) in Philadelphia has tripled the speed of fax processing and cut a full week off the new patient intake process, according to a paper published in NEJM Catalyst.
Although faxing may seem old-fashioned, people who work in healthcare know it has been difficult to eliminate due to interoperability challenges and institutional inertia. At University of Pennsylvania Health System (UPHS), between 8,000 and 9,000 faxes are processed each day.
The new solution, called coordn8, automates the intake and filing of faxed documents into electronic health records and allows patients to digitally give their consent to release records instead of mailing forms.
“Reducing processing time allows staff to focus on more patient-facing activities and results in higher job satisfaction,” said Jency Daniel, D.N.P., M.S.N., R.N., a lead transformation strategist at CHTI, in a statement. “On top of that, we designed this in a way so that team members can easily cover for each other. Vacations or sick days won’t slow the process down anymore.”
During a nine-month pilot period in 2023, the CHTI team surveyed clinical staff using coordn8 and found that their satisfaction with the new patient intake process jumped from 35 to 60 percent in just two weeks. In addition, a survey of coordn8 users found the same improvement (35 to 60 percent) in their “effort score,” a measure of how staff felt about the effort required to successfully file incoming faxes into the electronic medical record.
Fax processing time under coordn8 improved from an average of two minutes to just about 40 seconds. So, for every 100,000 faxes processed (a number reached every 11 to 12 days at Penn Medicine now), staff could save 2,300 hours of time that could be devoted to other critical tasks.
The paper also details the coordn8 process for getting patients’ consent to share past health information, such as test results and scans.
At the start of every new patient intake process, many healthcare organizations require a signed release of information form, and this often means a snail-mailed piece of paper. On average, it took a week to process this at UPHS. Digitizing the consent (now called eDisclosure) reduced both the steps required from a patient and the time it took to get the actual form from UPHS to the patient and back again.
By sending the eDisclosure via text message, the coordn8 team decreased the time it took to get a patient signature by 85 percent. (Patients can still get a paper form, if they choose.)
The NEJM Catalyst paper described the initial implementation in more than 150 fax lines across many different departments across UPHS. Now coordn8 is expanding its fax processing and eDisclosure form to span outpatient services throughout Penn Medicine.
The researchers claim that in just over a year and a half of use, coordn8 has reached an average of more than 3,000 faxes per day and saved a total of 8,500 staff hours in total.
The Penn Medicine team has recommendations for other health systems looking to deploy a solution like coordin8. “For other health systems looking to apply this, it’s essential to identify the departments with the highest need and the highest willingness to participate,” said Yevgeniy Gitelman, M.D., head of Custom Software at CHTI and associate chief medical information officer at Penn Medicine, in a statement. “If others in a health system can see their colleagues thriving, it will increase buy-in and help to better expand a service like this, increasing its impact.”
The University of Pennsylvania Health System facilities include the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Chester County Hospital, Doylestown Health, Lancaster General Health, Princeton Health, and Pennsylvania Hospital.
