I always thought email was more secure if it was encrypted. I also don't understand the difference between a virtual fax (sent as a scan, from the computer, via a phone number but literally just some kinda email like thing) or from a low tech low res scan over the phone line that likely is a voip line anyway. I don't even know the finer details of how those work, but the differences seem pretty minute to someone just staring at the parts.
Yes, email isn't actually less transparent. If you're using webmail over HTTPS it's harder for a small adversary to intercept, but that's it. Fax is way less efficient, though, while having no advantages I can think of.
Everyone even tangentially related to healthcare is terrified of violating HIPAA in a way that leaves evidence that can be traced back to them. So the corps force dumb shit like this, while the employees are perfectly happy to tell all kinds of private health information to anyone who will listen. Especially if it's funny or gross.
Because it works. Every part needed to run those machines, even line of code, every possible cause of failure is well documented and there are layers and layers of redundant protocol to ensure that if something does go wrong downtime is minimal.
The entire purpose of these machines are designed to run for as long as they’re needed. They’re not replaced or upgraded because they were never meant to be. A lot of effort went into this being the case.