AI-driven system cuts fax processing time and speeds new patient onboarding in health care

An emerging artificial intelligence-powered system developed at Penn Medicine has tripled the speed of fax processing and cut a full week off the new patient intake process-freeing up thousands of staff hours. The system, called coordn8, was created by the Penn Medicine Center for Health Care Transformation and Innovation (CHTI) and is detailed in a new paper published this week in NEJM Catalyst. 

Though faxing might seem like antiquated technology, in health care it remains a vital communications tool due to challenges with interoperability and HIPAA privacy requirements. For example, at the University of Pennsylvania Health System (UPHS), between 8,000 and 9,000 faxes are processed each day. 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. 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." 

Jency Daniel, DNP, MSN, RN, lead transformation strategist at CHTI

Employees on board with efficiency 

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. 

Digital consent speeds up record gathering 

The time savings continued in a 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 health care 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-thanks to Penn Medicine's Way to Health platform-the coordn8 team decreased the time it took to get a patient signature by 85 percent. This allowed staff to get to work acquiring health information six days sooner than before, increasing staff satisfaction from 41 percent to 90 percent. Patients can still get a paper form, if they choose. 

Expansion 

While the NEJM Catalyst paper described the initial implementation in more than 150 fax lines across many different departments across UPHS, coordn8 is expanding its fax processing and eDisclosure form to span outpatient services throughout Penn Medicine. 

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. Such an expansion is likely attractive to other health systems, both large and small, looking to free up their staff. But applying it strategically will be important. 

"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, MD, head of Custom Software at CHTI and associate chief medical information officer at Penn Medicine. "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."