Photo of fax machine with X over it

A Different Vowel for “Fax”


Of course we mean “fix.”

Another vowel may be appropriate for faxing’s effect on healthcare, though. A recent article in the mainstream press points out just how bad the situation is.

“It’s 2017. Why does American medicine still run on fax machines?” asks Sarah Kliff, writing for the news and information site. “By one private firm’s estimate, the fax accounts for about 75 percent of all medical communication.”

We previously pointed out that faxing isn’t designed to easily integrate with core applications. There are errors. It’s usually not secure. It requires a lot of manual intervention, making it expensive, and faxing isn’t designed to handle critical, repetitive volume.

The article is far more harsh — and it’s spreading. More than 300 other websites have linked to it. In healthcare we’re used to this sort of talk in our own trade publications and blogs, but now the public is weighing in.

“In the medical sector, the fax is as dominant as ever,” writes Kliff, a senior editor at Vox, a 12-year-old media outlet founded by Washington Post alumni. “It is the cockroach of American medicine: hated by doctors and medical professionals but able to survive — even thrive — in a hostile environment. “

As part of her research, Kliff visited the Arlington Women’s Center. Its physicians and certified nurse midwives serve the Washington, D.C. area. The center offers comprehensive obstetrics and gynecology services in what the reporter describes as a “high-income suburb.”

The center has digitized its own medical records, but — no surprise — it has trouble connecting with other clinics. As a result, it generally receives medical records by fax. “Sometimes they’re mailed. They almost never come by any other route,” observes Amanda Rohn, M.D., a fellow of The American Congress of Obstetricians and Gynecologists.

Among her complaints, “The pages get jammed up so you end up with half-pages that come out at the other end, or you get blank pages that don’t actually have the information you need.” And that’s the least of the issues.

The problem extends to a radiology office in the same building, one floor down. It also has digital medical records. And the two firms have different EHRs, these systems won’t ‘speak’ to each other.

“So they use a Rube Goldberg-esque analog method for sharing data,” writes Kliff. “Print out pages of one record, fax it, and then scan those pages into the other digital system.”

The center’s medical records department hand-sorts faxes for physicians’ paper file folders. To share important information among themselves, physicians hand-deliver files personally. Files too often get misplaced otherwise.

Time that could have been spent delivering care is instead used for chasing around paperwork.

The occasional wrong fax number might be funny, if breaches weren’t so serious. Kliff quotes the experience of a staff member who was faxing at a different firm. “The FBI called about a half-hour later and asked how I got the number,” he recalled. “I told them that I was faxing Minnesota. They told me I had faxed NASA.”

The article credits the Obama administration with moving healthcare providers to digital recordkeeping, but criticizes it for “badly misread[ing] the economics of American health care,” creating a small but well-defined technology desert in which faxing survives.

Besides government and EHRs, Kliff blames healthcare organizations. After all, she writes, a shared medical record “makes it easier to see a different doctor. A walled garden — where records only get traded within one health system — can encourage patients to stick with those providers.”

We strongly doubt that devious motivation. We’ve never encountered a physician so small-minded. Quite the opposite — if only patients were that savvy about their medical records!

But as attention like this from the mainstream press grows, patients will hardly be reassured. We’ve argued for automation, such as our own clinical data clearinghouse solutions. The article suggests forms of government intervention. Whatever the answer or answers, something clearly needs to be done.

Meanwhile, we still have the fax and its effects. As Kliff summarizes, “It frustrates doctors, nurses, researchers, and entire hospitals.”   And certainly patients.

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