why are fax machines still used by medical systems?
why are fax machines still used by medical systems?
I'll admit, I'm pretty frustrated right now lol. me and my doctor have been trying to submit a referral to a specialist but for the last several weeks, when i call them, they still haven't gotten it yet. they told me it's because they only have one fax machine so it refuses any incoming faxes if it's in the middle of printing a different one.
my problem is, why haven't we come up with a more modern and secure way of sending medical files?!?! am i crazy for thinking this is a super unprofessional and unnecessary barrier to care?
luckily I'm mobile enough to drive a physical copy to their location, but not everybody who needs to see this type of doctor can do that, nor should they have to.
In the eyes of the law, a fax is a secure way to send personal information. An email, even an encrypted one, is not. We need to fix the law, but lawmakers as a rule do not understand technology.
Speaking as someone who works directly in the field: this is just plain factually incorrect. Encrypted email is compliant with patient privacy regulations in the US.
The issue is entirely cultural. Faxes are embedded in many workflows across the industry and people are resistant to change in general. They use faxes because it's what they're used to. Faxes are worse in nearly every way than other regulatory-compliant means of communication outside of "this is what we're used to and already setup to do."
I am actively working on projects that involve taking fax machines away from clinicians and backend administrators. There are literally zero technical or regulatory hurdles; the difficulty is entirely political.
I work with healthcare software so I can echo most of what you're saying.
The thing is the lowest common denominator is a fax (usually a fax server that creates a PDF or TIFF of what comes over the wire), so that's what people go with. It's the interoperability between different systems that's the problem. There's no one standard...except for faxes.
"embedded in many workflows"
Key statement right there.
And once people see what that really means, and what it would take to move past it (including time, cost, and risk), they may start to understand. You're dealing with it first hand, so you know what's involved.
It became the de facto way to send stuff with high confidence it went to the right place. Then tech addressed the paper-to-paper over one phone line issue with modem banks into a fax server. So all the same fundamental comm tech (so fully backwards-compatible), but a better solution for the company with that infrastructure. Such a company has little motivation to completely change to something new, since they'd have to retain this for anyone that hasn't switched. Chicken-and-egg problem, that's slowly moving forward.
It'll be a long time before it's gone completely. Perhaps in 20 years, but I suspect fax will still be around as a fallback/compatibility.
And just try to get regular people to use email encryption. Yes, it could be signed to show that it hasn't been altered, but then most users can't even figure out where a file has been saved.
So they use faxes.Here (not US) they've tried implementing a dedicated "secure email platform" for medical professionals so that they can exchange patient data. It's both progress and kind of idiotic, but it's not very widely used (because now, they have yet another email address to manage, on top of the six they already have to use).
this makes no sense to me when patient portals exist. why isn't there a provider portal that can handle sending medical info back and forth? I can see all my medical details online already.
See, you're thinking 21st century, but this is both a healthcare management technology and a government regulation issue, so you're 2 centuries too new. We need to go back to 1843 with the electric printing telegraph, which used pendulums and electric signals to scan images and send them over telegraph wires. That's where healthcare technology regulations stopped.
because the referring physicians refuse to log into multiple systems and the providers refuse to log into multiple systems and theres no universal trusted system.
m banks into a fax server. So all the same fundamental comm tech (so fully backwards-compatible), but a better solution for the company with that infrastructure. Such a company has little motivation to completely change to something new, since they’d have to retain this for anyone that hasn’t switched. Chicken-and-egg problem, that’s slowly moving forward.
Thats the thing. Most if not all insurance companies HAVE provider portals. They cannot get rid of fax until every mom and pop clinic, dentist office, and hospital use these portals.
Example of a Provider Portal: https://www.floridablue.com/providers https://healthy.kaiserpermanente.org/northern-california/community-providers/claims
Vanilla facsimile is not secure at all.
I mean, from a technological perspective email, even encrypted, really isn't that secure. That being said neither is fax but...
Encryption would protect an email in flight and prevent interception. Faxes have no such capability and are entirely susceptible to being tapped.
Shit, they could just get a better fucking FAX machine that can put new incoming faxes into a queue. The last fax machine I used (like well over a decade ago) could at least do that.
no kidding! i have enough to deal with, without having to babysit a doctor's office that won't update their equipment.
You can even have multiple fax machines on the same phone number if you really need it.
Referrals are electronic for those running a modern EMR, like Epic. The systems exist, it’s up to both sides to implement them.
thank you, this is exactly the type of answers i was hoping for!
Where I work, the fax was a way to ensure that information could be sent in multiple ways, if one way would fail. In the medical field (at least where I live) we must have systems with backup systems in a few layers. We have a nice digital medical chart system, and I still have to print out many things and put in a binder that no one ever reads. Because the internet could stop working, or electricity could fail. We even have routines for which types of pen and paper can be used if we need to write things by hand while electricity is gone.
I have to fax docs a lot. Couple of years ago we started using stonefax so it's like an email. I wish the faxing was the worst part - most take 1-3 calls to the doc to get them sent back.
Unfolding a Xerox copy faxed over a phone line wont infect your entire network.
Opening an email, tho...
Boy do I have bad news for you https://threatpost.com/def-con-2018-critical-bug-opens-millions-of-hp-officejet-printers-to-attack/134972/
Its not the fax over phone line that was compromised, its the internet connected printer. In fact, HP even has services where you email to your own printer in order to print.
Can you pick it up and deliver it to the new office in person?
HIPAA.
i understand HIPAA. i don't understand why we are still using the technology we started using in the 60s. my question is why haven't we found a better way since then?
You can't even stop junk snail mail or end daylight savings time. Good luck.
The "modern" fax machine using telephone was invented in 1964 by Xerox, but technically the fax machine goes back to 1843. Bain patented the electric printing telegraph, which used pendulums and electric signals to scan images and send them over telegraph wires.
it's generally harder to fax to a wrong number, have that actually hit a fax machine, and have it print than to accidentally email the wrong person or something. There are things that could be implemented into certain systems to only send to certain addresses, etc., but that information also exists in multiple places that can be accessed as well. For a fax, the message exists on the sender's side (physical if any, machine memory possibly), receiver's side (same), and briefly on the wire. This is opposed to hard drive, cloud, etc. where it is always vulnerable.
Plenty of people still use landlines. That tech is much older than faxes. Internal combustion engines have been around for about as long. There have been improvements, of course, but the basic idea of spark plugs igniting fuel, which pushes down a piston is quite old.
Like many things the 1960s tech is "good enough" and the government hasn't mandated a specific standard.
For non freedoomers:
HIPPA = Health Insurance Portability and Accountability Act