Recycling makes people feel like they are protecting the planet; yet, up to 70 percent of what gets placed in recycling bins still ends up in a landfill. All the well-intentioned sorting results in waste.
Healthcare has built the same system and made the same mistake. The industry has poured billions of dollars into bins like the Trusted Exchange Framework and Common Agreement (TEFCA), interoperability mandates, and regional exchange networks that were built on the assumption that if we could get the data sorted and moved to the right place, the hard part would be complete.
Nothing could be further from reality. Healthcare is one of the largest and fastest‑growing contributors to global data volume, and as much as 97 percent of it goes unused. Compiled, exchanged, formatted, and landfilled anyway. The industry has a data waste problem.
Sorting, Not Understanding
Federal interoperability efforts have made demonstrable progress in that records actually move. TEFCA has grown from roughly 10 million patient record exchanges to more than 1 billion in a year. But moving data and understanding data are different problems, and the quiet assumption behind interoperability efforts is that if everything looks the same, it will be usable.
A 2022 study looked at 68 cancer clinics using five different medical record systems. Clinics using the same system understood each other’s data most of the time, but clinics using different systems understood each other’s data barely one in five times. And that study only looked at data that already has clear coding rules, like lab results and medications. Often, information is typed into a doctor’s notes by hand with nothing for a computer system to recognize. The record is there but might mean nothing to the next system to receive it.
Idle by Design
Most clinical data gets entered into a record without anyone thinking about how it will be used later. It is not corrupted or wrong, and it arrives clean and technically usable to its next stop, but with no downstream purpose behind it. The bins fill up more.
This is a data “actioning” problem. While interoperability moves data faster, it does not solve what to do with data once it arrives. Or the fact that data can actually be put to work with the right technologies.
An estimated 80 percent of clinical data sits in unstructured notes and scanned documents that are hard to search or act on, and that is a critical problem in transitions of care. One study found duplicate testing in 32 percent of patients transferred between hospitals within 12 hours, and a fifth of those repeat tests had no clinical reason. The same pattern shows up in medication errors, unnecessary visits, and poor handoffs. The data was unusable—and alerted no one to issues—when it mattered.
Faster transport does not help the fact that data then sits idle, if it makes it that far.
Build for Realities
The industry has proceeded as if better standards will eventually make fax and paper obsolete. This is not a reality, and for a large share of providers, never will be. Rural providers and small hospitals lean more heavily on fax and mail than their urban counterparts because they lack the IT staff and broadband access to sustain electronic exchange in the first place. TEFCA participation is voluntary, and voluntary systems tend to reach those with resources.
Many post-acute settings rely on outdated modalities just as heavily. Among nursing homes and home health agencies, 80 percent of them have adopted EHRs but rarely use them to exchange data with care partners. Fax and paper fill the gap, not because providers prefer them, but because those are what connect to everyone when you consider constrained budgets, resources, and staff.
In turn, every day, care decisions get made without the full patient story. A fax is not broken data. It is data waiting for someone, or something, to act on it. The goal must be to build systems that not only streamline data but also actions it with real-time alerts and patient insights. That is the difference between landfilling non-standard, unstructured data and composting it into something useful.
Action is the Common Denominator
Not forcing every system into data “sameness,” but, instead, building infrastructure that finds the common denominator across formats is the answer. And then putting it to work for every provider, big and small, from Epic-enabled hospitals to paper-based rural clinics.
Organizations that turn incoming data into active workflows, instead of an inbox and storage bin, close care gaps and speed follow-up without asking front-line staff to do more work.
Most health data still goes unused, and the opportunity in front of us is not sorting and transporting it faster. It is making use of what is already there, actioning it, and composting it into care that actually reaches patients.
About Effie Carlson
Effie Carlson is the CEO of Watershed Health. She brings more than 17 years of experience in healthcare leadership, policy, strategy, and business development across the provider and payer sectors, and her experience spans managed care, healthcare technology, government relations, and value-based care. Carlson founded EJC Consulting Group and has served in executive leadership positions at Modivcare, PayrHealth, Team Select, and CareCentrix. Carlson is an active advisor and board member for healthcare organizations, including the Texas e-Health Alliance, SendaRide, and the Non-Emergency Medical Transportation Accreditation Commission® (NEMTAC®).
