40 Fax vs Portal vs HIE Usage Share Statistics: Key Facts for Legal Professionals in 2026

Comprehensive data compiled from extensive research on medical record retrieval methods and healthcare data exchange for personal injury law firms

Key Takeaways

• Fax remains dominant despite digital alternatives – Between 70-90% of healthcare communication still occurs via fax, with 90% of record requests transmitted through this legacy channel, creating bottlenecks for legal case preparation
• Patient portal adoption is accelerating rapidly – Portal usage doubled from 15-34% between 2019 and 2024, with 65% of individuals now accessing their health information online, though third-party access for litigation remains limited
• HIE infrastructure is expanding but underutilized – While about three-quarters of U.S. hospitals participate in HIE networks, only 43% routinely engage in full interoperability, leaving significant retrieval gaps
• Manual processing creates substantial delays – 52% of faxed documents require manual processing, and 25% of faxed records don't arrive before critical deadlines, extending case timelines by weeks or months
• Market investment signals digital transformation – The global HIE market reached $2.27 billion in 2025 and is projected to grow at 9.75% CAGR through 2034, indicating sustained infrastructure development
• Cross-vendor challenges persist – 72% of hospitals report platform integration difficulties and 57% face patient matching issues, explaining why multi-channel retrieval strategies remain essential

For personal injury law firms, Codes Health unifies fax, portal workflows, and HIE access into one legal-focused retrieval system that delivers complete records in 10–12 days. Some competitors advertise same-day retrieval, but those requests often don’t return the full chart and require ongoing client involvement to chase missing pages/facilities—an experience that drives frustration, churn, and delays. Codes Health prioritizes completeness on a predictable flat fee.

Understanding the Foundation: Traditional Fax for Medical Records

1. Fax dominates 70-90% of healthcare communication

Healthcare organizations continue using fax as their primary communication method, with 70-90% of healthcare communication occurring through this channel. This reliance persists because fax transmission meets HIPAA compliance requirements and integrates with existing workflows that staff have used for decades.

2. 90% of medical record requests still transmit via fax

For legal professionals handling personal injury cases, this statistic matters most: 90% of record requests still transmit through traditional fax channels. This creates predictable delays when providers receive hundreds of requests daily and process them manually.

3. Global fax services market reached $3.30 billion in 2024

The fax market isn't declining—it's growing. The global fax services market reached $3.30 billion in 2024 and is projected to reach $4.47 billion by 2030, growing at 5.15% CAGR. This growth reflects healthcare's continued investment in fax infrastructure rather than wholesale abandonment.

Challenges and Limitations of Fax-Based Retrieval

4. 56% of medical referrals still transmit via fax

Beyond record requests, 56% of medical referrals continue using fax transmission. This fragmentation means legal teams must track multiple communication channels when building comprehensive case chronologies.

5. 52% of faxed documents require manual processing

Efficiency suffers because 52% of faxed documents require manual processing on the receiving end. Staff must print, review, route, and file each document individually—a process that compounds delays when handling high-volume litigation.

6. 25% of faxed records don't arrive before patient's first visit

Timing matters in both healthcare and legal contexts. Data shows 25% of faxed records don't arrive before critical deadlines. For law firms, similar delays extend case preparation timelines and postpone settlements.

Incomplete authorizations are the #1 cause of denied requests. Missing patient signatures, unclear expiration dates, or unchecked boxes for sensitive records will restart your 15-day clock. Codes Health's AI review catches these errors before submission—the system automatically flags misspellings, missing dates of service, and signature issues that would otherwise cause provider rejections and weeks of additional delays.

Patient Portals: Empowering Individuals for Record Access

7. 65% of individuals accessed patient information online in 2024

Portal engagement reached a milestone in 2024, with 65% of individuals accessing their health information electronically. This represents substantial growth from previous years and indicates increasing patient comfort with digital health tools.

8. 77% of individuals offered online access to health information

Availability continues expanding, with 77% of individuals now offered online access to their health information through provider portals. The gap between availability (77%) and usage (65%) suggests adoption barriers remain.

9. Patient portal use doubled from 15% to 34% between 2019-2024

The most significant trend shows frequent portal users (6+ times yearly) more than doubled from 15% in 2019 to 34% in 2024. This acceleration reflects both improved portal functionality and pandemic-driven digital health adoption.

10. 99% of hospitals offer electronic record viewing

Hospital adoption is nearly universal, with 99% of hospitals offering patients electronic viewing capabilities. The infrastructure exists—the challenge lies in leveraging it effectively for authorized third-party access.

11. 81% of hospitals enable patient access via apps

Mobile access continues expanding, with 81% of hospitals enabling patient access through dedicated applications. This creates opportunities for patient-initiated record sharing when properly authorized.

Security and Usability Considerations for Portals

12. 90% of portal users view laboratory test results

Portal functionality aligns with user priorities. Research shows 90% of portal users view laboratory test results, making this the most accessed feature. For legal cases involving diagnostic evidence, portal access can accelerate specific record acquisition.

13. 80% of portal users view clinical notes

Clinical documentation access is strong, with 80% of portal users reviewing their clinical notes. These notes often contain critical case details that inform breach-of-care determinations and causation analysis.

14. 79% of portal users message providers

Direct communication capabilities see significant adoption, with 79% of portal users utilizing messaging features. These message threads can contain relevant case information not captured in formal medical records.

15. 51% of caregivers had proxy portal access in 2024

Proxy access is expanding, with 51% of caregivers having portal access to their dependents' records in 2024. This more than doubled from 24% in 2020, creating additional pathways for authorized record retrieval.

Health Information Exchanges (HIEs): Interoperability and Digital Pathways

16. Global HIE market valued at $2.27 billion in 2025

Investment in HIE infrastructure continues growing, with the global HIE market reaching $2.27 billion in 2025. This substantial market size reflects healthcare's commitment to interoperability despite implementation challenges.

17. HIE market projected to reach $5.25 billion by 2034

Long-term projections indicate sustained growth, with the HIE market expected to reach $5.25 billion by 2034. This trajectory suggests digital record exchange will eventually overtake fax-based methods.

18. HIE market growing at 9.75% CAGR from 2025 to 2034

The growth rate tells the story: 9.75% CAGR significantly outpaces the fax market's 5.15% growth. Organizations investing in HIE connectivity position themselves for long-term efficiency gains.

19. U.S. HIE market valued at $730.94 million in 2025

Within the U.S., the HIE market reached $730.94 million in 2025, representing substantial domestic investment in health information infrastructure that legal professionals can leverage.

TEFCA Networks: Towards National Interoperability

20. About three-quarters of hospitals participated in HIEs in 2021

In the U.S., about three-quarters of hospitals participated in a state, regional, or local health information exchange (HIE) network in 2021. This coverage enables digital record access for most hospital-based care, though ambulatory and specialty providers show lower participation rates.

21. 90% of hospitals participate in Direct messaging protocols

Technical adoption is even higher for basic exchange, with 90% of hospitals participating in Direct messaging protocols. This standardized approach enables secure point-to-point transmission when both parties support the protocol.

22. 70% of hospitals engage in all four interoperability domains

Comprehensive interoperability is advancing, with 70% of hospitals engaging in all four interoperability domains: sending, receiving, finding, and integrating health information electronically.

23. Hospital interoperability increased 52% from 2018 to 2023

The improvement trajectory is significant—interoperability increased 52% over five years. This rapid advancement indicates that digital pathways are becoming increasingly viable for comprehensive record retrieval.

Codes Health maintains direct integrations with multiple HIEs and TEFCA networks, enabling digital record acquisition within days rather than the weeks required for fax-based retrieval. For high-volume customers, Codes Health's MIT-educated engineering team can build custom integrations with CRM platforms and other legal software, ensuring the platform constantly evolves to meet the changing demands of legal professionals. Visit Codes Health to learn how these connections accelerate your case preparation.

Comparative Analysis: Market Share and Retrieval Timeframes

24. Only 43% of hospitals routinely engage in full interoperability

Despite 70% capability, only 43% of hospitals routinely engage in all four interoperability domains. This gap between potential and practice explains why multi-channel retrieval strategies remain necessary.

25. 84% of hospitals "often send" health information electronically

Outbound electronic transmission is becoming standard, with 84% of hospitals frequently sending health information digitally. Requesters who can receive through these digital channels gain significant speed advantages.

26. FHIR app adoption reached 64% in outpatient settings

Technical standardization is progressing, with FHIR adoption reaching 64% in outpatient settings by 2024. FHIR (Fast Healthcare Interoperability Resources) enables modern app-based data exchange that bypasses traditional fax workflows.

27. FHIR adoption climbed from 49% to 64% between 2021-2024

The adoption curve shows FHIR grew significantly from 49% to 64% in just three years. This rapid uptake suggests digital record exchange will become the dominant method within the next decade.

Speed Benchmarks Across Retrieval Methods

28. 96% of hospitals adopted certified EHRs by 2021

The infrastructure foundation is in place, with 96% of hospitals using certified electronic health records. The challenge isn't EHR adoption—it's connecting these systems efficiently for authorized external access.

29. 88% of office-based physicians use EHR systems

Ambulatory adoption is similarly strong, with 88% of physicians using EHR systems. Records exist digitally at most treatment locations; the bottleneck is retrieval methodology.

Reliability and Completeness Across Retrieval Channels

30. 30% of hospitals unable to engage in full interoperability

Significant gaps remain, with 30% of hospitals unable to engage in all four interoperability domains. For these facilities, fax remains the only reliable retrieval method.

31. 72% of hospitals report cross-vendor platform challenges

Integration difficulties persist, with 72% of hospitals reporting problems exchanging data across different EHR vendors. This fragmentation requires retrieval services that can work across multiple technical environments.

32. 57% of hospitals face patient matching difficulties

Record completeness suffers when 57% of hospitals struggle with patient matching across systems. Incorrect matches result in missing records or, worse, inclusion of wrong-patient documentation in case files.

33. Only 29% of healthcare workflows fully automated

Automation gaps compound delays, with only 29% of workflows fully automated. Manual touchpoints at each stage of the retrieval process introduce delays and error opportunities.

Codes Health's Missing Record Review addresses completeness challenges by cross-referencing patient medical history to identify gaps before trial preparation concludes—ensuring no critical documentation is overlooked.

Operational Impact on Legal and Healthcare Workflows

34. 70% of routinely interoperable hospitals use external data at point of care

Hospitals that achieve routine interoperability demonstrate its value: 70% actively use external health information at the point of care. This integration proves the technology works when properly implemented.

35. 53% of system-affiliated hospitals show routine interoperability vs 22% independent

Organizational structure affects capability significantly. System-affiliated hospitals achieve 53% routine interoperability compared to just 22% for independent facilities. Legal teams must adapt retrieval strategies based on provider type.

36. 40% of rural/critical access hospitals not fully interoperable

Geographic disparities create additional challenges, with 40% of rural hospitals lacking full interoperability. Cases involving rural treatment locations often require fax-based retrieval regardless of digital capabilities elsewhere.

Optimizing Patient Intake for Clinical Decision-Making

37. 69% of chronic disease patients access EHI annually

Patient engagement varies by condition. Research shows 69% of chronic patients access their electronic health information annually, indicating higher engagement among populations with ongoing care needs.

38. 76% of cancer patients access EHI annually

Engagement is highest among serious illness populations, with 76% of cancer patients accessing records annually. For legal cases involving oncology treatment, patient-initiated sharing may accelerate specific record acquisition.

The Future Landscape: Accelerating Digital Transformation

Predicting the Evolution of Medical Record Retrieval

39. 44% cite cost concerns as automation obstacles

Barriers to digital transformation persist. Research identifies 44% citing cost, 43% identifying security, and 37% struggling with integration as primary obstacles to automation adoption.

40. 77% of portal users schedule appointments online

Digital functionality continues expanding, with 77% of portal users now scheduling appointments online. This behavioral shift indicates growing comfort with digital health tools that will accelerate portal-based record sharing.

The trajectory is clear: HIE networks will eventually dominate medical record exchange, but the transition will take years. During this period, law firms need retrieval partners who can operate effectively across all channels—fax, portal, and HIE—simultaneously.

Codes Health operates across every retrieval channel, leveraging HIE integrations and TEFCA network access for digital-ready providers while maintaining robust fax-based retrieval for facilities that haven't yet modernized. This multi-channel approach delivers complete records with average turnaround times of 10-12 days regardless of provider capabilities.

Frequently Asked Questions

What are the primary differences in speed between fax, patient portals, and HIEs for medical record retrieval?

Fax-based retrieval typically requires weeks to months due to 52% manual processing rates and 25% failure rates. Patient portals offer immediate access for patients but limited third-party retrieval capabilities. HIE networks enable near-instantaneous digital transfer when both parties are connected, though only 43% of hospitals routinely engage in full interoperability. Effective retrieval strategies must leverage all three channels simultaneously.

How does HIPAA compliance apply to each medical record exchange method?

All three methods meet HIPAA requirements when properly implemented. Fax maintains compliance through secure transmission protocols. Patient portals require proper authorization and access controls—99% of hospitals now offer compliant electronic viewing. HIE networks operate under HIPAA-compliant frameworks with additional data use agreements governing exchange.

Which retrieval method provides the most comprehensive records for legal case preparation?

No single method guarantees completeness. While about three-quarters of U.S. hospitals participate in HIE networks, 72% report challenges that create gaps. Fax retrieval can access any provider but suffers from delays and errors. Comprehensive case preparation requires multi-channel strategies that pursue records through every available pathway while cross-referencing for completeness.

General-purpose AI tools (like ChatGPT and similar assistants) aren’t designed to reliably interpret medical charts end-to-end and can miss clinical context, provenance, and document gaps. Codes Health’s purpose-built AI is designed for medical-record workflows and can analyze records with high precision inside a controlled retrieval and review process.

How are HIEs and TEFCA networks changing medical record access for litigation support?

The global HIE market is growing at 9.75% CAGR, significantly outpacing fax market growth. TEFCA establishes a national framework for trusted exchange, enabling retrieval services with proper credentials to access records digitally across participating networks. As adoption increases from current levels, digital retrieval will eventually become the primary method for most providers.

Can patient portals fully replace traditional methods for obtaining records for litigation?

Not currently. While 65% of patients accessed portals in 2024 and 81% of hospitals enable app access, portal functionality focuses on patient-initiated access rather than third-party retrieval. Portals supplement but cannot replace systematic retrieval through authorized release processes. They work best as one component within a multi-channel retrieval strategy.