The Evolving Role of Fax in Interoperability in Healthcare

The following is a guest article by Doug Clayton from WestFax.

The origin of the modern fax machine dates back to the 1960’s. From that analog origin to enterprise-scale cloud fax, we have seen the evolution of fax from simple point to point document exchange to something extremely powerful and capable. 

Some pundits see fax as standing in the way of forward progress, but the truth is that HIPAA secure fax is evolving and already providing interoperability and automation capabilities now. 

For healthcare organizations, one of the biggest obstacles in the interoperability race has been the industry’s lack of clear data standards. While these new standards evolve, fax is the workhorse doing the heavily lifting. With the recent release of FHIR v4 we now have a standard that is normative as all future versions of FHIR must be backward compatible with V4. While some herald it as the golden child of Interoperability, it still faces challenges with adoption and issues with two way communications among stakeholders. 

Many EHRs only allow read-only access and even if they do enable bi-directional information exchange, many health providers are hesitant to allow outside data into their systems without validation. They have modern tool sets but their data sharing practices are still rooted in the past. In time this will change but FHIR can’t solve the non-technical behavioral issues.

Transitioning from analog to digital

Digital cloud fax technology is inexpensive, faster, and more secure than ever. The era of expensive racks of modems in a server room have passed. HIPAA secure cloud fax is the new norm. Migration to cloud fax is relatively painless and fast, as we have seen a large number of healthcare providers move from analog fax to the cloud due to the COVID-19 crisis. They can’t get into the office to get their faxes and we can immediately transition them into cloud fax. The pandemic has effectively killed the physical fax machine which is a good thing for modernization.

The next evolution of Fax

The advent of OCR / barcode / automation technology has changed everything. A fax is no longer a dead document that has to be picked up in the fax bin. It can be digitally downloaded, converted to structured data (xml/json), processed, and automated without any manual intervention. Modern fax APIs allow healthcare organizations to send, receive and process fax data without needing to print anything.

An entire industry of document automation and document management vendors have embraced cloud fax and it’s capabilities. The ubiquitous presence of fax, with regards to healthcare, has given it an advantage over the developing standards and frameworks. Interoperability is being realized now while organizations struggle to retool and implement FHIR. 

Right now fax is here, doing the job every day, and it is evolving with each challenge. HIPAA compliant fax is not fading out to some new shinier thing. It is the reliable engine we know well, and it just works. As technology companies add value and capabilities, the goal of 100% interoperability can be realized today.

About Doug Clayton

Doug works as a Senior Analyst for WestFax, Inc, a Colorado based cloud fax provider specializing in HIPAA secure fax. Doug started his long career helping the DoD convert legacy logistics software from mainframes to modern stacks. He also worked on currency conversion systems at the World Bank in Washington DC and consulted for many leading non-profits based in the DC area. At WestFax he wears many hats ranging from devops, sales, engineering to developer relations. You can find Doug on LinkedIn.

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  • Evolution? The fax? While I’m not opposed to cloud faxing, using it maybe half a dozen times a year, I don’t see it being the future of shared documentation. If fact, I prefer to load a document into Google docs, work on it with the receiver of the document, and conclude the transaction in real time. More productive, time saving, and evolutionary.

  • Hi Shereese – It’s likely your shared Google docs transfer is not HIPAA compliant. It is incredibly important to maintain security of ePHI. Fax still accounts for over 70% of secure medical document transport with a very high percentage of that total being digital cloud fax technology. It’s time to think about fax in a whole new light.

  • “Many EHRs only allow read-only access and even if they do enable bi-directional information exchange, many health providers are hesitant to allow outside data into their systems without validation. They have modern tool sets but their data sharing practices are still rooted in the past.”

    It’s really not that easy and certainly not fair to claim that they live in the past. We talk about sensible medical information as well as hard requirements regarding validity, data safety and consistence – every vendor has to proof that his system is reliable in that sense. If you open up write-access to your data, you have limited control of what is happening to your data. Furthermore FHIR, from what I understand so far, leaves serveral cruicial questions unspecified. Imagine a data set is available in system A and in system B. The same data set is modified in both systems A and B at the same time, who has the truth? How to handle conflicts? So as long as these and similar questions are not clear I can understand every vendor for denying write access to his data as they don’t want to jeopardize their medical device regulation certification.

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