The role of the fax in the future of healthcare

Advancements in healthcare technology hold the promise of improving efficiency, security, and quality of care while reducing costs.

Yet adoption has been slow across many organizations due to legacy communication systems – including fax, which remains a commonly used communication tool in healthcare. In response to this slow adoption, CMS Administrator Seema Verma told ONC’s Interoperability Forum, “If I could challenge developers on a mission, it’s to help make doctors’ offices a fax free zone by 2020.” This line was greeted with significant applause, while fax is quick and reliable, it creates paper which can be costly and less secure than electronic communication.

Many healthcare organizations are moving to more efficient and secure ways to share information, such as electronic communications. While this shift is a noble goal, many healthcare organizations are not yet ready to make the leap as 75 percent of US medical communication today happen via fax machine. As a result, they must make a decision: make their fax machines more secure and efficient, or find an electronic fax solution that will help them achieve the goals set by Verma.

Healthcare organizations should consider the following when exploring their options:

Paper-based messaging remains a critical form of communication for physicians.
Fax communication is still commonplace in hospitals because it allows physicians to quickly transfer patient-specific information to one another at the point of care. However, there are opportunities healthcare leaders should consider to better manage faxing and reduce risks, such as breaches in protected health information (PHI).

Here are a few examples:
• Provide staff with the ability to fax information directly from their computers, eliminating the need to print paper files to scan.
• Implement security controls so the right fax goes to the right person, eliminating potential security threats and HIPAA breaches.
• Enable faxes to be sent in multiple formats, according to a physician’s needs at the time of receipt, meaning faxes don’t need to be re-sent, costing employees more time.

Audit trails of messages sent by fax are difficult to capture — and it’s one area where compliance may be at risk.
Consider that the speed-dial functions on many fax machines are manually programmed by staff. What happens when a physician moves to another office and their fax number changes? What if the phone number hasn’t been corrected in the fax machine, and the information is sent to the wrong office? And what happens when staff misdials a fax number and the information is accidentally sent to the wrong location? Would your organization know that these potential security threats had occurred?

A typical hospital uses at least 100 fax machines and sometimes as many as 1,000. Keeping that many fax numbers straight, especially if care providers change offices or leave, can prove difficult, potentially creating issues that are easy to miss for even the most dedicated and thorough of compliance officers. However, by implementing technology that delivers information directly to the EMR or relevant portal, these potential breaches can be avoided. Furthermore, advanced fax alternatives can create a single audit trail for all fax machines in your organization – in a central location with a central administrator – making it significantly easier to track down and address workflow and security issues if they do arise.

If your healthcare organization is ready to move beyond fax, consider the following:

What comes after fax, and how does it fit with my processes?
Direct messaging – which allows providers to securely share information with each other and with providers at other systems, such as notifications of transitions in care – is a cost-effective, secure fax alternative. Direct messaging eliminates the risks of paper, which can let sensitive information sit, unprotected, on output trays for long stretches at a time. It also leverages secure, streamlined connectivity with other systems and workflows care providers use every day, helping to keep patient information safe while helping to improve record-keeping and aid interoperability.

Direct messaging, a secure way to fulfill Verma’s fax-free vision, requires very little training to start using. Furthermore, it doesn’t require universal buy-in among partners to work, so even if partner organizations are slow to leave fax behind, yours can move forward as soon as it’s ready. Direct messaging essentially reroutes an outgoing fax as an electronic message delivered through the recipient’s health information service provider (HISP). Inbound messages, meanwhile, are converted from faxes into searchable PDFs. The direct messaging program scans the PDF and cross-references it with the recipient’s EMR’s patient data, automatically ingesting the information and adding it to the appropriate patient file. It’s fast, reliable, and the end-point user experience for those sending a fax is functionally the same – just with all of the security and cost-saving benefits of skipping the paper step of faxing and getting information directly where it’s needed, in the format it’s needed.

A prescription for change
The challenges associated with fax, paper, and interoperability in healthcare can be significant, but they are not insurmountable. Healthcare leaders and IT specialists who take the time to understand what an organization’s clinical workflows around fax are and why they exist will be better able to diagnose areas where technology can enhance value — and better prescribe and implement a solution that works seamlessly with current workflows.

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