Fax Machines + Healthcare

Last week, I live-tweeted a presentation on the future of fax in healthcare. The information and statistics I shared generated some strong reactions on Twitter. I thought it would be interesting to discuss fax technology this week on HCLDR.

Fax is Horrible for Patients

Let me start by stating unequivocally that using fax as a form of communication with patients is a horrible idea. Fax machines have never been a consumer technology and even at the height of fax popularity, it was not common for people to have a fax machine at home.

You might as well be asking a patient to send a telegraph. Its just not something that is easy, convenient or practical. I am 100% behind axing the fax for patient communications.

Fax for Provider-to-Provider Communications

For provider-to-provider communications, however, fax technology is still a viable option.

Note: I did not say FAX MACHINE. Those should all be relegated to the recycling heap…or destroyed like the copier was in Office Space.

When I say fax technology, what I mean is the protocols that underpin faxing. When you fax something, you first enter a number that uniquely identifies the recipient (a fax number). Then you press a button and the information (documents) you want to send is electronically delivered. As each “page” is sent, both the sender and receiver acknowledges receipt of the information.

In the old days, the only way to use fax technology was through a fax machine that scanned paper documents, transmitted them and a receiving fax machine would reconstitute that same piece of paper on the other side. Today, however, we can remove the fax machine from the equation and have two computer systems on either side.

This means there is no need for paper anymore AND instead of an image of a document being received, today’s technologies allow for information to be stored in database fields.

Why Stick with Fax?

Yes, fax is an old technology. HOWEVER, it remains almost ubiquitous in healthcare which means that it remains one of the cheapest and easiest ways for doctors who aren’t working off the same EHR to share information. In other words, Fax is the lowest common denominator when it comes to interoperability.

In addition, fax technology is HIPAA compliant and is written into many policies, procedures and state guidelines. One day those should be updated to remove specific technology references, but for now, fax remains there.

Lastly, faxing is secure, especially if the paper is removed. Unlike email which has to go through an intermediary, fax establishes a direct connection between sender and receiver. With email, there are numerous servers and third party providers in between. So even if you scanned a document and attached it to an email, it would not be a compliant way to deliver information.

The Challenge

One of the biggest hurdles of getting rid of faxes is the expense and complexity of the alternative – full data interoperability. That is the goal that many are striving for, but there are so many systems at hospital and physician practices – connecting them all takes time.

Can healthcare do better? Absolutely. But it’s not like they can just install an interoperability tool tomorrow and expect everything to be magically connected. It takes a lot of coding and custom development.

Standards like FHIR were supposed to make it easy, but not everyone has adopted it yet.

Instead of waiting for true interoperability, some organizations and vendors are looking to fax as a stepping stone. It’s not a perfect solution, but nothing in healthcare ever is.

The Discussion

On Tuesday August 17th at 8:30pm ET (for your local time click here), I’d like to discuss faxing in healthcare with the HCLDR community. I’m curious to hear what terrible experiences people have had with faxes in healthcare (and any good ones). I’d also love to hear about any ridiculous excuses you have been given about why paper records had to be the go-between for physicians at different healthcare organizations.

Hope to see you!

  • T1 Have you ever been asked to send/receive a fax from a healthcare organization or physician practice? How did you resolve it?
  • T2 What excuses have you been given about why your healthcare data can’t be shared/accessed by you or that it has to be faxed?
  • T3 Should government money (tax dollars) be used to help the healthcare industry axe-the-fax by implementing true interoperability tools or another modern tech? Why or why not?
  • T4 In addition to fax machines, are there any other technologies that you would like to see healthcare stop using?


Finnegan, Joanne. “Is it 1970 or 2019? 9 in 10 in healthcare industry still using fax machines, survey finds”, Fierce Healthcare, 13 November 2019, https://www.fiercehealthcare.com/practices/it-1970-or-2019-89-healthcare-industry-still-using-fax-machines-39-using-pagers-survey, accessed 16 August 2021

Spannbauer, Brad. “ Does the Fax Machine Still Have A Place in Modern Healthcare?”, HIT Consultant, 27 August 2018, https://hitconsultant.net/2018/08/27/fax-machines-modern-healthcare/#.YRtX0ohKiUl, accessed 16 August 2021

Castillo, Luis. “We Owe It To Patients To Eliminate Faxing: Here’s How To Get Started”, Forbes, 21 August 2020, https://www.forbes.com/sites/forbestechcouncil/2020/08/21/we-owe-it-to-patients-to-eliminate-faxing-heres-how-to-get-started/, accessed 16 August 2021

Minor, Lloyd. “Why Your Doctor’s Office Still Depends on a Fax Machine”, Stanford Medicine, 19 September 2019, https://med.stanford.edu/school/leadership/dean/precision-health-in-the-news/why-your-doctors-office-still-depends-on-fax.html, accessed 16 August 2021

Bush, Jonathan. “Health care must ditch its attachment to outdated software”, STAT News, 10 January 2017, https://www.statnews.com/2017/01/10/health-care-outdated-software/, accessed 16 August 2021

Acohido, Byron. “Hospitals lose $8.3 billion using old technology”, USA Today, 17 May 2013, https://www.usatoday.com/story/cybertruth/2013/05/07/healthcare-technology-cybersecurity-privacy-patient-care/2142739/, accessed 16 August 2021

Fisher, Dylan. “Why Medical Practices Stick with Outdated Technology”, Physicians Practice, 2 March 2018, https://www.physicianspractice.com/view/why-medical-practices-stick-outdated-technology, accessed 16 August 2021

Image Credit

Fax Machine

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