By Jeffrey Sullivan, Cloud Fax division of J2 Global, Inc.
The fax machine has come to represent everything that’s wrong with healthcare IT: clunky, dated, disconnected. CMS Administrator Seema Verma challenged developers at the ONC’s Interoperability Forum to help “make every doctor’s office in America a fax free zone by 2020.” Other industries jettisoned the technology decades ago, yet faxing persists in healthcare, accounting for as much as 75 percent of all medical communications.
While the fax machine has no shortage of challenges—lack of privacy, misdials and risk of confidentiality breach, throughput challenged, blurry printouts, wasteful—it also has been a tried and true workhorse. That’s why 90 percent of providers still rely on fax machines even though more secure digital platforms exist. Organizations seeking to transition to a more efficient and secure alternative will need to take pragmatic steps to assure an electronic solution works as reliably, easily, and inexpensively as the fax machine.
If It’s Not Broken
Providers don’t have their heads buried in sand, but they are faced with having to contain costs while meeting an increased demand for information from consumers, payers, and other healthcare organizations. They are required to share large volumes of sensitive data daily, such as medical records, billing, patient admissions, and discharges, prescriptions and refill requests, insurance claims, and invoices. The challenge is that emerging sending and receiving technologies differ between organizations and create barriers to ensuring these critical documents reach the intended destination. Fax remains the tool of choice for sending and receiving information between healthcare organizations for a few reasons.
Fax is ubiquitous: Regardless of alternative technologies that may exist at a given location, it is a virtual certainty that the sender and receiver both have fax technology. When a person or organization has any question about which medical records, financial, secure send, etc. system their intended receiver has, fax is a genuinely common denominator.
HIPAA compliant: Federal regulators who enforce healthcare data privacy rules have exempted fax (and certain other types of phone calls) from certain aspects of the HIPAA security rules, leading to the widespread perception that fax is more compliant than other types of electronic communication for the sending of protected healthcare information.
Secure: Traditional analog fax, relic that it is, transmits over the public telephone network and remains difficult, if not impossible, to intercept. Even the digital versions of fax transmissions are still sending the audio tones used to encode the fax image, which is inherently harder to decode for the typical bad actor. For this reason, it’s regarded as a more secure form of communication than email.
Reliable: Hospital information systems are typically proprietary, so providers generally struggle to share information with other organizations operating on different systems. Fax machines allow for interoperability because they use the same standard. This means providers can reliably send and receive faxes regardless of their system in use.
Change Is Inevitable
It’s only a matter of time before the fax machine will be phased out. Other countries have already taken the lead. The U.K.’s National Health Service is not only banned from purchasing new fax machines, but all communication and IT systems are required to meet interoperability standards to ensure systems can speak to each other in a professional network.
Director Verma is pushing for a similar change. CMS together with the ONC announced a shift in focus from the Meaningful Use of EHRs to promoting interoperability to break down information silos and improve the patient experience. This change promises end-to-end digital connectivity across platforms and even health systems.
While the intentions are good, implementing these changes will take years, not months. If providers are expected to stop using the fax machine, there needs to be a better alternative—one that doesn’t require a significant investment of time, energy, and resources, all of which are in short supply.
A Pragmatic Approach
Rather than wait, and continue to risk compliance failures and workflow disruptions, organizations should take a pragmatic approach and transition to digital fax.
Digital Cloud Fax Technology (DCFT) solutions meet providers’ demand for convenience by allowing them to send and receive faxes from anywhere without a fax machine from virtually any online channel – email, mobile app, or secure web portal. DCFT meets healthcare compliance and regulation requirements. Administrators can assign access controls and permissions to ensure only authorized personnel can view sensitive information, while end-to-end encryption ensures data remains secure during transmission and in storage. Moreover, audit trails provide details of every fax that is sent or received, by whom, and when. Sending documents to the wrong recipient is virtually eliminated since files are transmitted, not dialed, through pre-approved contacts.
In addition to greater ease and convenience, DCFT is also more cost-effective than either new technologies (HL7 FHIR and Direct) or the old fax machine. Providers only pay for the fax capacity they need, it avoids the resource waste associated with physical faxing (time spent queuing, waiting, and following up) and the expense required for paper, ink, or maintenance.
A Bridge To The Future
The answer is not to remove faxing but the source of the problem: the fax machine. Switching to DCFT enables healthcare to send and receive fax documents, and even communicate to fax machines if needed. DCFT is an essential transformational solution that allows for immediate incorporation of a secure digital technology that complements technologies like FHIR and Direct in a fully integrated digital communication strategy, and better positions healthcare organizations of all kinds for the future.
About The Author
Jeffrey Sullivan is the Chief Technology Officer of the Cloud Fax division of J2 Global, Inc.