“My mission is to kill the fax.”

Charlie Rivers, CIO of Southwest Medical Imaging (SMIL) in Arizona, is adamant that the fax is an outdated, inefficient method of sharing medical data, and that it can have a detrimental impact on patient care. There may be only one other person in healthcare more committed to making the fax officially obsolete, and that’s Chris Craft, CEO of ScriptSender. Was it just a happy accident when they met at a SIIM conference a few years ago?

“With 15 sites, 48 radiologists, and a base of about 1500 referring physicians, SMIL gets thousands of inbound orders every day. Thousands—and most of those were via fax,” said Rivers. “We visited the ScriptSender booth and saw the potential for our practice immediately.”


spent on each interface build before implementing ScriptSender

“It’s high time to move on. It’s clunky and difficult to support. My mission is to kill the fax.”

— Charlie Rivers

Paper, and More Paper

SMIL was like most imaging centers: reliant on paper to process orders and using significant full-time staffing to manage the volume. The administrative labor for the front desk included following up with referrers to locate lost pages, scanning pages to create electronic copies, searching the RIS to match the order with the correct patient, and manually attaching those image files to the corresponding patient records. Managing all of that for thousands of orders per day was time-consuming—and put accuracy at risk.

SMIL could increase speed and data integrity by creating more interfaces to connect to its referring physicians. “We do receive interface requests from our referrers, and we are committed to doing everything we can to support collaboration,” said Andrew Braga, Director of Information Technology for SMIL. “But we didn’t see the logic in continuing to spend $10-20,000 on interface building and maintenance. The return on investment isn’t there, and we feel a responsibility to our patients and referrers to make smart business decisions.”

With that mindset, the solutions he saw at ScriptSender’s SIIM booth made Charlie Rivers take notice. “Here was something that solved a lot of problems for us,” said Rivers. “It’s essentially a way to have all the efficiency and accuracy of a custom interface, without the associated costs.”

ScriptSender Speed

ScriptSender enables secure, instant communication with referring providers—with no installs, no downloads, and no complex interfaces. Referrers click once in their own EHR (or any application) to send any document, such as referrals, insurance information, or clinical notes directly to SMIL.

“Before ScriptSender, we set up maybe two HL7 interfaces with referrers each year,” said Braga. “It takes months to build, test, and adapt technology on that scale, not to mention the resources to maintain it. Since we deployed ScriptSender, we average about seven or eight integrations every week. The increase has been exponential, and it’s so much easier for our referring community.”

SMIL had deployed a new RIS shortly before implementing ScriptSender, but that change had no effect on ScriptSender’s functionality. “There aren’t those typical site-to-site integration obstacles,” said Braga. “It works with our new RIS and with all the different systems run at our referring offices.”

“It’s been transformational—very easy to implement and very successful.”

— Charlie Rivers

COVID-Era Efficiency

The pandemic made SMIL’s need to solve the fax problem more urgent. “Staffing was down, because people couldn’t readily commute into the center when they had compromised relatives or childcare issues,” said Rivers. “As offices started to open back up, we were under pressure. We didn’t have the staff to process all those faxed orders manually. We were missing schedulers; we were missing front desk staff; we were missing clerks.”

ScriptSender helped SMIL offset some of those lost resources by automating much of its workflow. “The more we can automate, the less we have to deal with on the back end,” said Braga. “We’ve been able to substantially help the operations side with the automation of these electronic orders.”

ScriptSender installs are so easy that SMIL could transition to remote set-ups during the pandemic. “It changed the way we handled installations for our referrers, but not by much. What’s necessary on the referrer side takes no time at all. We were doing 7-10 installs a week at a high point, and then we simply went remote and kept up that same pace. Our referrers are ready to start sending information to us immediately,” said Braga.

The ScriptSender method of collaboration has proved very popular with SMIL’s referral base. Rivers explained: “As we were just getting under way, in May, we had about 80 orders come in. Right away that was 80 orders that we didn’t have to manually process. Our referrers were so pleased with the efficiency that we had 1000 orders come through ScriptSender in August.”

“We’ve probably integrated more providers, in the shortest amount of time, as any other organization,” said Braga. “When our referral offices started to open up, we cast a wider net and sent marketers out to explain the advantages of integrating with SMIL in this way. But our referrers already know that faxes get lost, and that more efficiency means better patient care. It was easy for our team to show them that a tiny workflow change can have a huge impact—plus it’s no cost to them. In just a few months, we’ve had 250 of our referrers agree to switch to ScriptSender.”