Medical Records' Non-Clinical Uses Overlooked by Interoperability Efforts
Medical records serve a second purpose in legal and disability claims, but interoperability frameworks largely ignore this. Only government benefits determination has a defined exchange purpose, while other uses still rely on fax and slow processes. The author argues that extending interoperability to these uses could dramatically speed up record collection.
The Social Security Administration processes roughly 2 million disability claims per year, with initial determinations sometimes exceeding 200 days and medical evidence collection costing over $500 million annually. The new Government Benefits Determination use case under TEFCA could compress record delivery from weeks to seconds for that single agency.
Beyond SSA, workers' compensation, personal injury litigation, and private disability reviews still depend on manual release-of-information queues and scanned PDF packages. Duplicate pages frequently constitute 10 to 20 percent of productions, and flattened EHRs lose encounter context, order-result links, and timestamps that reviewers need to reconstruct treatment timelines accurately.
This interoperability gap could affect millions of claimants, attorneys, and disability reviewers who depend on timely, complete medical records for non-clinical decisions. Faster record exchange may reduce claim processing times and administrative costs, but also raises privacy concerns as records move beyond clinical settings. The outcome could reshape how legal and disability determinations are made, though broader adoption and regulatory alignment remain uncertain.