The Graveyard of Interoperability Initiatives in the Past & How We Can Drive the Future

The Fax Machine, Mail, and the State of Health Information Exchange Today

Despite great technological advancements, most data in healthcare is still generally exchanged by paper or fax machines. As much as 75% of all medical communications are done through fax machines, with patient and provider requests for records often arriving on paper and being sent back through fax. In other cases, records are taken from an electronic health record, printed, and then faxed, adding more paper into the equation. In the last year, within Datavant’s Ciox division, we fulfilled 15 million requests for health records that were requested via mail and fax; over 100 million pages were sent over fax. Unfortunately, the fax machine has remained supreme because attempts at interoperability have not reached the universal adoption that faxes provide.

Printing facility for Ciox, a Datavant company. In 2021, the center processed over 700 million pages of medical records.

Approaches to Health Data Exchange

So what approaches have we taken towards the exchange of health data to date?

Challenges to Health Data Exchange

Due to the complexity of the issue, there have been hundreds of attempts to make health data exchange easy– businesses, non-profits, regulations. We have tried to standardize, but now there are over 40 different standards. The following five bullets outline why complexity still remains today.

The Road Ahead

One can think of health information exchange as the highways we drive on each day. In the 1950s, cars were just starting to become an integral part of US society. Although we had roads that connected cities and towns, they were often small two-lane roads, and not all cities and towns were connected.

What Free Exchange of Healthcare Data will Unlock

Easier exchange of healthcare data will unlock a number of use cases that will ultimately improve the healthcare system in the United States and improve patient outcomes. The following section highlights three of these use cases.


Success for interoperability will require breaking through walled gardens and vanquishing the mountains of fax machines and paper. Once we build the digital connections necessary to provide the information exchange ecosystem this will lead to better health and health care. From there, we can stop talking about interoperability and instead talk about what we can do with patient information to improve health and healthcare.



Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store