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Readers Write: Tell Me Again Why Fax is Superior?

August 23, 2023 Readers Write 6 Comments

Tell Me Again Why Fax is Superior?
By Dan Wilson

Dan Wilson is founder and CEO of Moxe Health of Madison, WI.

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The “inherent security” provider argument in a recent KLAS report on digital fax is unfounded and a remnant of another era. User error is inherently possible when a process involves manual steps, and fax isn’t secure relative to more modern ways to encrypt and transact data between multiple parties. It’s also unlikely that faxing remains analog (using only a phone line), as groups are using Efax or VOIP lines with transactions going over the Internet and the fax isn’t actually encrypted. 

“Ease of use” sounds like the person who used to say that “no one will text, because it’s easier to just pick up the phone and call someone.” Faxing is easy only because finding a directory of where to send files electronically is so hard. If we solve the directory issue, the “ease of faxing” benefit is reduced.

Another way to think about ease of use is that it’s actually a tradeoff for security. Fax is easy because you send a document to a clinic’s single number. That means that the message isn’t specific to a patient or recipient. Anyone who has access to the fax machine can see the information. Rarely do you get both ease of use and security, but there’s a better set of options with digital exchange to select the right tradeoffs based on the sensitivity of the information versus just having a blunt tool.

Fax is hopelessly outdated. It creates enormous manual effort and adds cost on both ends of the transaction. A CAQH study estimates that faxing or mailing instead of using digital transfer costs $25 billion per year.

For the love of God, can we stop making doctors do a ton of work to digitize records and paying people to print them and fax them, taking those records from digital to analog and then to an even worse version of analog (an image)? And then consuming massive resources on the recipient’s end to try to reconstitute a digital copy of what started its life as a digital record? And along the way, losing fidelity of information in addition to people and compute time.

Tell me again why fax is superior?



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Currently there are "6 comments" on this Article:

    • If the segment sponsor has to take the time to say it is superior…then you know it’s not!

      • KLAS’s study was on ‘digital fax’, not paper fax. Like comparing a carrier pigeon to email for sending a message

  1. I had an issue a week or so ago when my physician’s office was faxing a STAT blood work order to the wrong fax machine at the hospital. My STAT CT Scan had to wait until this situation was resolved. Sending the order digitally would have saved 40 minutes or so. The physician office and hospital were on different EMR systems and could not communicate electronically, hence the need for the fax. The situation was not resolved until I called the office with the correct fax number. Crazy in this day and time.

    • Sadly, we here this all the time. And it is sad but true.

      The problem is EMRs won’t enable interoperable communication – so fax fills that void.

      Direct messages that go to inaccessible inboxes – terrible
      FHIR endpoints that have to be looked up and maintained – terrible

      Don’t blame the technology because someone typed in the wrong #. That could’ve happened with mis-keying a FHIR endpoint or a Direct address

  2. People are going to keep using it until there is an easier, standard, and reliable alternative. Right now we ask clinicians to send a Direct message with various attachments using their EHR’s specific workflows. They hit send and it goes into the abyss, and some time later the recipient complains they haven’t received anything.

    Did the clinician know she or her staff were supposed to check the transmission logs for errors? Does their IT team monitor the connection and move quickly when issues come up? Did the clinician know she should not try to attach more than 5 pages or any number of high resolution pages because the recipient’s system can’t handle it? Do the staff at the recipient’s office know how to check the message queue and import the documents (they’re probably going to print and re-scan them if anything).

    Eh, easier to just fax it.

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