PDF In-Depth

The PDF prescription for health care cost control

The PDF format encompasses documents in all their variety


In healthcare, "document" is a broad concept covering many distinct sorts of items; reports, articles, statements, charts, database records, forms (blank) and forms (filled), archives, prescriptions, invoices, labels... you get the idea. PDF can and does serve as the electronic version of each type of healthcare-related document in many settings.

So far, however, the many advanced capabilities of PDF, such as markup, interactivity, scripted forms, security, digital signatures and client-server integration, remain woefully under-utilized. Beyond the innate capabilities of the format, PDF files may include XML via the XMP (eXtensible Metadata Platform), a key mechanism to assure interoperability between diverse systems. PDF can even contain other files: XML, images, Flash animations, movies, databases, specialized medical data -- anything.

End-State: PDF provides a one size fits all solution for every type of final-form document, and can perform in dynamic document roles as well.

Bridging: As organizations learn to integrate electronic documents into their systems, PDF can meet their needs at each step of document interaction, from fillable forms to patient files, from image markup to secure distribution.

PDF is just... Portable

The central value of PDF is so obvious, it's often understated. PDF provides a consistent, reliable representation of any document, on almost any operating system, and the Reader software is free.

Adobe Systems invented the PDF format in the early 1990s and remains the preeminent desktop PDF software vendor. In 2008, PDF "went public" as ISO 32000. The format is now an international standard managed by industry volunteers, of which Adobe is but one.

The free Adobe Reader, the rapidly expanding "ecosystem" of independent PDF developers, and the body of international standards governing the technology all contribute in cementing PDF as the Portable Document Format of choice into the foreseeable future.

What Can Government Do?

  • Healthcare administration generates many metrics. Government should reward and encourage measurable progress in reducing administrative costs while improving service.
  • Drive the adoption of electronic document and digital signature technology nationwide and internationally. Many countries and states still don't accept digital signatures, and many organizations in states that do still won't take them.
  • To ensure high quality results and to set a level playing field for software developers, governments should support the development and adoption of technology solutions meeting industry standards, particularly ISO 32000 (PDF), ISO 19005 (PDF/A) and the forthcoming ISO/AWI 14289 (PDF/UA).


PDF technology is already part of healthcare administration at many levels, but often on an ad hoc basis, and almost always without taking full advantage of the format. As such, the potential for PDF technology to reduce costs and improve performance in healthcare information management has barely been tapped.

Many of the document handling requirements in healthcare are be served by the qualities that made PDF the world's de facto electronic document technology. It remains for policymakers and vendors to fashion a working consensus on moving forward. PDF, and how to leverage PDF to better serve healthcare administrative needs, should be at the core of the technology discussion.

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