Introduction
Knowing change is coming and preparing for it are two very different things.
Anyone who has lived through an EHR implementation knows that technology projects rarely succeed because of software alone. Success comes from preparation, communication, leadership, and creating workflows that people actually want to use.
The CMS deadline may feel distant, but healthcare organizations understand how quickly multi-year IT initiatives can consume calendars. Those that begin planning today will have a significant advantage over organizations that wait until compliance deadlines become urgent.
In this final installment, we’ll explore practical steps healthcare leaders can take now to prepare for a more connected, efficient, and patient-centered future.
The Transition Won’t Be Easy, But It’ll Be Worth It
Let’s be honest: this change will require real effort. You’ll need to work with EHR vendors to implement new capabilities. You’ll need to update policies and procedures throughout your organization. You’ll need to retrain staff who’ve been faxing documents the same way for years. You’ll encounter technical hiccups during initial rollout. Some vendors will be slow to update their systems. You’ll have frustrated moments wondering why you started this project.
But here’s what can be waiting on the other side:
Your billing specialist submits a claim with supporting documentation at 2 PM, and the insurance company confirms receipt and completeness by 3 PM, not two weeks later after playing phone tag. Your referral coordinator can see exactly which referred patients have scheduled appointments and which need follow-up without making dozens of phone calls. Your staff spend time on meaningful work instead of feeding paper into machines. And your patients get faster answers and better care.
The Time to Act Is Now
CMS has given healthcare organizations two years to prepare for mandatory electronic claims attachments. To prepare, you don’t need to solve everything at once. You can start with these practical steps:
This Month:
- Map your current referral and claims attachment workflows
- Identify where information gets lost or delayed
- Document how much time staff spend on manual processes
- Calculate the revenue impact of referral leakage
This Quarter:
- Schedule conversations with your EHR vendor about their compliance roadmap
- Connect with your clearinghouse about their electronic attachment capabilities
- Identify one payer partner willing to pilot electronic workflows
- Assemble a cross-functional team (clinical, administrative, IT, compliance)
This Year:
- Develop staff training programs
- Begin pilot testing
- Refine workflows based on pilot results
- Build out your full implementation plan
Remember to Treat This Like a Clinical Transformation, Not an IT Project
Something important to remember is that healthcare technology projects rarely fail because of the technology. They fail because organizations underestimate the human side of change.
To account for this, we recommend not starting by asking, “What software do we need?” But instead to start by asking, “Where would a new process create friction for patients and staff?”
You will likely need to spend time shadowing your referral coordinators, patient access representatives, nurses, and physicians regarding their current use of the fax machine. Having front-row understanding of how many times documents are typically printed, scanned, faxed, uploaded, downloaded, or manually re-entered, will be crucial. You can also ask staff where they lose time, where they become frustrated, and where patients seem to disappear from the process. This will help you understand exactly how a digitized referral system could disrupt or make life better for your patients and staff.
It will also be important to identify respected clinical and operational champions for this effort early on. Every successful transformation needs trusted physicians, nurses, referral coordinators, revenue cycle leaders, and IT professionals working together from the beginning. Change gains momentum when staff hear the benefits from colleagues who understand their daily challenges, not just from executives in boardrooms or software vendors during demonstrations.
Some additional analytics to gather that will help with gaining organizational support, and vetting different vendors, will include knowing how long does a referral take to complete? What percentage of referrals require rework? How many claims are delayed because of missing documentation? How much staff time is spent tracking down paperwork? What is the referral leakage rate?
The organizations that thrive through this transition will be the ones that combine modern tools with disciplined process improvement, engaged frontline staff, and relentless focus on the patient experience. If there’s one lesson healthcare leaders should carry forward from every major digital transformation over the past two decades, it’s this: technology is only the catalyst. People, processes, and leadership are what ultimately determine success.
Conclusion
The story of healthcare has always been one of continuous improvement.
Every major advancement, from electronic health records to minimally invasive surgery, required organizations to endure short-term disruption in exchange for long-term progress. At the time, each innovation felt complicated, expensive, and uncertain. Looking back however, most seem inevitable.
This process won’t always be smooth. There will be frustrating moments and learning curves. But on the other side is a more efficient, secure, and effective healthcare system, one that serves providers, staff, and patients better.
Imagine referrals that never disappear. Claims supported by complete documentation the first time. Prior authorizations completed in hours instead of days. Staff spending less time pushing paper and more time helping people.
The anticipated future doesn’t have to be a distant vision. In fact, for many organizations, it’s already here. Organizations that embrace the transition today will position themselves to deliver faster care, stronger financial performance, happier employees, and better patient experiences for years to come.
The fax machine had an impressive four-decade run, but now is the time to fully move healthcare information into the digital age. Your patients, your staff, your organization, and even the planet itself, will all be better for it.