Find out how automating clinical data is transforming disability claims—speeding up determinations, reducing staff strain, and restoring dignity to the process for patients.
At a Glance
- A Process Ready for Reinvention – The current disability claims system depends on slow, manual record exchanges that delay decisions, burden providers, and leave patients waiting when they need help most.
- Automation as the Game-Changer – Advances in interoperability and data exchange, powered by standards like HL7’s FHIR, are transforming how clinical data moves—reducing manual labor, cutting errors, and accelerating determinations.
- Faster, Fairer Outcomes for All – Automated data transfer allows Disability Determination Services (DDS) to receive complete, accurate records in days instead of weeks, improving both efficiency and equity for applicants.
- Tangible Benefits for Providers – Healthcare organizations adopting automation see measurable gains: reduced administrative workload, faster turnaround times, stronger financial performance, and less staff burnout.
- Technology That Makes It Possible – Interoperability standards (FHIR), AI-assisted tools, and secure frameworks like NIST and CMS Interoperability Rules form the backbone of a reliable, compliant automation ecosystem.
- Challenges and the Path Forward – To fully realize these benefits, organizations must overcome funding, technology, and cultural barriers through smart investment, leadership, and workforce engagement.
- The Future Is Here – Automation in clinical data exchange is no longer a concept—it’s an operational necessity that strengthens trust, restores efficiency, and builds a disability determination system that works faster, smarter, and more humanely.
Every year, millions of Americans apply for disability benefits. The disability determination process can feel like a relay race where the baton is dropped too often or passed too slowly, leaving everyone stuck at the starting line. Behind each application is one essential piece: the flow of medical records between healthcare providers and Disability Determination Services. It sounds straightforward, but the process is anything but simple. Manual requests, scattered systems, and long waits often slow everything down.
For patients, those delays are not just an inconvenience. They mean weeks or months of uncertainty, often when financial stability matters most. For providers, each request becomes one more task in an already full day, drawing staff away from care and into paperwork. The result is a system that weighs on everyone involved and pushes resolutions further out of reach.
At BHS Connect, our Release of Information work offers a clear vantage point of these challenges. We see how delays ripple through organizations, and we also see how forward-thinking leaders are experimenting with new tools to ease the strain. Their steps give us a glimpse of what is possible.
That glimpse points to automation. Advances in clinical data exchange now allow records to move more quickly, lighten the administrative load, and speed up disability determinations. In the discussion ahead, we share what we have learned and how healthcare organizations and agencies can use automation to create outcomes that are faster, fairer, and more efficient for patients, providers, and the public.
Within healthcare, the release of information is known as one of the most labor-intensive administrative responsibilities.
Inside Today’s Disability Claims Process
Disability Determination Services depends on accurate and timely medical records to evaluate claims. Yet in many cases, retrieving those records is still a slow, paper-based process. A claim triggers a request, the provider receives it by fax or by mail, and then begins the task of locating, reviewing, and sending the documents. Relying on fax machines to move medical records is like asking pilots to navigate with paper maps in the age of GPS. What looks simple on paper often stretches into weeks of waiting, leaving claim decisions stalled.
Within healthcare, the release of information is known as one of the most labor-intensive administrative responsibilities. The AHIMA Release of Information Toolkit makes this clear, stressing the need for policies and procedures that support compliance, efficiency, and timeliness. It also notes that staff require strong training to handle the complexity of these workflows as well as the legal requirements attached to them.
Best practices in this area, including those published in AHIMA’s Management Practices for the Release of Information, emphasize the value of tracking performance such as productivity, turnaround times, and backlogs. These are not just numbers on a report. They are indicators of how well an ROI department can hold up under pressure when requests surge.
The financial costs are harder to see, but no less significant. Providers may charge only small copying fees, yet studies show that the true expense of retrieving records, including verification, tracking, and routing, but as documented case studies show, the total cost of Release of Information can be five times or more the revenue collected when all related costs (primarily staff labor) are included. That gap is a clear signal of the inefficiencies baked into outdated processes.
The burden of this system is widely shared. Patients face delays in receiving benefits at moments when stability is needed most. Providers absorb mounting administrative demands and rising costs. DDS must navigate backlogs that slow decisions and weaken public trust in the process.
Healthcare has begun to move away from paper and manual workflows and toward secure, automated data exchange.
When Clinical Data Starts Moving on Its Own
In recent years, healthcare has begun to move away from paper and manual workflows and toward secure, automated data exchange. At the center of this shift is interoperability, the ability of electronic health record (EHR) systems and external platforms to communicate seamlessly.
One of the most important enablers of this seamless communication is the Fast Healthcare Interoperability Resources (FHIR) standard, developed by Health Level Seven International (HL7). FHIR acts like a translator at a crowded conference, making sure every system can finally speak the same language instead of talking past one another. This reduces the errors and inefficiencies that come with faxed documents, scanned PDFs, or other unstructured methods.
Research supports the impact of automation. A study published in BMC Health Services Research found that healthcare workers experienced significantly reduced workload and improved performance after adopting digital health technologies, provided there was adequate training and organizational support. At the national level, the National Coordinator for Health Information Technology (ONC) has reported steady progress in interoperability across U.S. hospitals, while also noting gaps that continue to limit efficiency. These gaps highlight the need for advanced data exchange to bridge the “last mile” between healthcare providers and government services such as Disability Determination Services (DDS).
In unison, these advances mark a pivotal shift. Instead of relying on staff to manually manage record requests, healthcare organizations now have the ability to automate the release of clinical data. The result is time saved, fewer errors, and more complete information to support disability determinations.
What Healthcare Organizations Stand to Gain
Healthcare providers sit on the front lines of disability determination. They field record requests while still trying to balance patient care and financial stability. For them, advanced data exchange and automation offer more than convenience. They bring tangible improvements across operations, finances, and workforce management.
On the operational side, automation reduces the need for constant manual intervention. A Forrester study commissioned by Waystar found that healthcare organizations using automation and AI achieved 13 to 37 percent improvements in key revenue cycle areas such as claim accuracy, denial prevention, payment speed, and staff efficiency. By cutting out repetitive tasks, providers can redirect staff toward complex needs and speed up the everyday workflows that keep the system moving. In this situation, automation is like adding an extra set of steady hands, lifting routine tasks so staff can focus on the work that truly needs their expertise.
The workforce impact may be the most compelling of all. In one real-world case, Omega Healthcare partnered with a vendor platform to automate 60 to 70 percent of its billing and documentation workflows. The shift saved more than 15,000 staff hours every month, cut documentation time by 40 percent, reduced turnaround times by half, and still maintained 99.5 percent accuracy. The effort also delivered a 30 percent return on investment.
For healthcare organizations, adopting automation in data exchange is not just about gaining efficiency. It means greater financial resilience, less burnout among staff, and faster, more accurate service for patients waiting on disability determinations.
Automation can shorten processing timelines from weeks to days...
Changes Ahead for Disability Determination Services
For Disability Determination Services, the impact of advanced data exchange can be transformative. DDS relies on receiving medical records that are complete, accurate, and timely in order to make fair decisions. Automation tackles long-standing bottlenecks that slow adjudication and fuel case backlogs.
One of the clearest benefits is speed. Automation can shorten processing timelines from weeks to days, which accelerates claim decisions and reduces the wait for applicants. Think of automation as opening a faster lane on a crowded highway, giving evaluators a clear path through the traffic of backlogged claims. We know that sometimes inefficiencies in federal disability programs create heavy backlogs, often leaving claimants waiting months or even years for resolution. Streamlined record delivery directly addresses this challenge by ensuring evaluators have the information they need without delay.
Accuracy and consistency improve as well. This approach aligns with the CMS Interoperability Framework, which urges agencies and providers to adopt standardized automation that reduce fragmentation and make information easier to use in government systems.
The Social Security Administration illustrates the scale of the task. Its SSA Annual Statistical Report on disability notes that millions of applications move through the system each year. Even modest gains such as cutting turnaround times by only a few days can mean thousands of applicants receiving decisions more quickly, with less financial strain.
For DDS, automation is not simply about speed. It is about strengthening public confidence by ensuring that disability determinations are fair, efficient, and based on the most complete information available.
Real-World Examples of Automation in Action
Real-world examples show just how powerful automation can be when it comes to medical record exchange. For healthcare providers and the agencies that rely on their data, these tools are already reshaping the process. Think of it as moving from snail mail to instant messaging. The difference in speed and clarity changes everything.
The Social Security Administration’s Health IT initiative is a strong example. By enabling providers to send records electronically, the program has cut wait times dramatically from weeks or months down to minutes or hours. The SSA reports that this speed not only accelerates determinations but also improves their accuracy, creating better outcomes for applicants and provider organizations alike.
These cases make it clear that automation is not a concept for the future. It is here now, changing how records are delivered, how agencies like SSA process disability claims, and how healthcare organizations manage their workloads.
The Tools That Power Automation
Automation runs on a set of essential tools: the standards and safeguards that keep data accurate, secure, and connected. Leading healthcare organizations already have these in their toolbox:
- Interoperability: The Fast Healthcare Interoperability Resources (FHIR) standard by HL7 provides structured formats and APIs that allow health systems, ROI platforms, and agencies to exchange information consistently without manual effort.
- Security: The National Institute of Standards and Technology (NIST) outlines protections in Special Publication 800-66 Revision 2, which guides organizations in applying the HIPAA Security Rule, safeguarding electronic Protected Health Information (ePHI), and strengthening cybersecurity controls.
- Artificial Intelligence: A JAMA Network Open study found that clinicians using an AI scribe tool spent 20 percent less time on EHR tasks and reduced after-hours “pajama time” by 30 percent. That translated into more patient interaction and improved work-life balance.
- Policy Frameworks: The CMS Interoperability and Patient Access Final Rule mandates standardized APIs, creating the infrastructure for secure and automated data flows in both patient care and disability determinations.
Together, these elements provide the backbone for fast, accurate, and protected automation in disability claim workflows.
The promise of automated clinical data exchange is clear, but putting it into practice is not always easy.
Hurdles Healthcare Must Overcome
The promise of automated clinical data exchange is clear, but putting it into practice is not always easy. Healthcare organizations and agencies face financial, technical, and cultural hurdles that can slow adoption.
Money matters most. A report from HIMSS highlights that sustainable funding models are essential. Infrastructure, training, and ongoing maintenance all require investment, and without careful planning, many organizations, especially smaller practices, struggle to afford automation.
Technology can hold things back too. Many providers still rely on legacy EHR systems that lack modern interoperability features. Upgrading or integrating these systems often requires significant time and resources. National data briefs show that smaller providers and long-term care facilities in particular continue to face gaps that limit their ability to automate data exchange.
Privacy and compliance add another layer of complexity. HIPAA requirements and state-specific privacy laws demand strong controls for consent, auditing, and data handling. Academic analyses on AI governance emphasizes that organizations need structured processes to manage these new technologies responsibly, especially when sensitive health data is involved.
Culture plays a role as well. Staff may worry about how automation will affect their jobs or feel uneasy about trusting new tools. Healthcare transformation reports repeatedly note that without strong leadership, clear communication, and proof of value, even the best technology can stall in adoption.
To unlock the benefits of automation, organizations need more than technology alone. They need financial planning, smart integration, rigorous safeguards, and leadership that can bring teams along for the journey.
The Road Ahead for Disability Determinations
The future of disability determinations will be shaped by intelligent automation, stronger data-sharing networks, and patient-centered priorities.
The Trusted Exchange Framework and Common Agreement (TEFCA), launched in 2022, is building a universal “network of networks” for health information exchange. As more providers join TEFCA, DDS will gain a greater ability to securely receive complete medical records from multiple systems, reducing reliance on fragmented manual requests.
Patients and advocates are shaping these priorities too. A National Academy of Medicine webinar, Reducing Documentation & Administrative Burden for Clinician Well-Being, underscores that reducing administrative burden is not just a technical issue but also a matter of equity and dignity. For claimants waiting on disability determinations, automation has the potential to shorten stressful delays and strengthen trust in the system.
All of these forces point toward a future where advanced data exchange supports determinations that are faster, fairer, and more humane, grounded in strong technology and designed with patient well-being at the center.
The next frontier has already arrived. The question now is how quickly leaders will choose to act, and how many lives will be improved once they do.
Final Thoughts
For years, the disability determination process has been slowed by outdated, manual systems. Providers feel the strain, and patients are left waiting at some of the hardest moments in their lives. Automation and advanced data exchange offer a different path; one that clears delays, builds confidence in decisions, and restores dignity to the process.
With interoperable standards, secure technologies, and innovative tools, healthcare organizations and agencies can finally move past the paperwork bottlenecks. For providers, that shift means lighter administrative loads and stronger financial footing. For Disability Determination Services, it means decisions that arrive with greater speed and consistency. And for patients, it means knowing the system is capable of meeting them with fairness and respect when it matters most.
The next frontier has already arrived. The question now is how quickly leaders will choose to act, and how many lives will be improved once they do.
BHS partners with leading healthcare organizations to provide a full range of no-cost Release of Information (ROI) services supporting Medical Records and Health Information Management teams.
If someone on your team would like to explore how we can support your facility, please feel free to reach out. We’d be happy to share more details and answer any questions.
