For Many Hospitals, the Fax Machine Is Still the Dominant Information Sharing Tech

By Scott E. Rupp via Multibriefs

The fax machine has not gone anywhere in medicine. This so-called “ancient relic” is still operational and is considered a simple, yet powerful tool for those in healthcare, despite the other more modern modalities of exchanging information. According to newly released federal data, almost three-quarters of nonfederal acute care hospitals routinely use faxes to receive summary of care records from providers outside their system, according to the data released by the Office of the National Coordinator (ONC) for Health IT.

Receiving records via fax is the most popular form of use for the fax machine use. For example, more than 40 percent of the health systems measured said they “often” use fax. Only 27 percent of the same folks said the same about using a stand-alone health information service provider.

The industry’s preference for fax likely has a lot to do with the Health Insurance Portability and Accountability Act (HIPAA), passed by Congress in 1996. The law set the creation of privacy standards for health information and required healthcare providers to take “reasonable safeguards” when sharing patient data between labs, hospitals, specialists and insurers.

The Department of Health and Human Services (HHS) names the fax as an acceptable method of transmission of medical records, test results, instructions and treatment regimens. Email use, on the other hand, is considered too insecure a medium for the sharing of medical records. Emails can be encrypted, but faxing information remains the simpler process.

Even though this is considered the case, Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma continues to push for the adoption of electronic methods for data exchange, calling on developers help “make every doctor’s office in America a fax free zone by 2020.”

This is particularly difficult for small, rural hospitals and practices. “These types of hospitals were about half as likely to routinely send and receive summary of care records using only electronic methods compared to their counterparts,” authors of the data brief wrote. “Instead, they largely relied on paper-based methods to routinely send and receive summary of care records with outside organizations.”

About 80 percent of hospitals used more than one electronic method to send records in 2017, but more than 25 percent of hospitals are not receiving records electronically at all. The number of methods used is a detriment to health systems, ONC says.

“The number of exchange methods hospitals need to ensure that they have information electronically available and subsequently used, contributes to the complexity and costs of exchange,” the agency wrote. “These complexities and increased costs are often cited as barriers to interoperability. Efforts, such as the Trusted Exchange Framework, might help to simplify the exchange of health information through the use of health information networks.”

Faxes, though, just tend to be more convenient to use when dealing with physical patient files, especially in environments that until quite recently relied upon paper records. For example, scanning and sending an attachment can be done in one step and they could easily have been placed into the file.

Another challenge for electronic health records is that they often do not speak to one another. Fax machines, despite the brand or maker, easily connect and communicate with other fax machines. In the world of healthcare interoperability, fax machines still seem to have a leg up on electronic record sharing solutions. But, younger providers and caregivers don’t understand how to use fax technology, and are often baffled by it.

Producers of vinyl records might once have felt similarly to those who use fax technology. Why replace what some consider the best medium to express a message?

Scott E. Rupp is a writer and an award-winning journalist focused on healthcare technology. He has worked as a public relations executive for a major electronic health record/practice management vendor, and he currently manages his own agency, millerrupp. In addition to writing for a variety of publications, Scott also offers his insights on healthcare technology and its leaders on his site, Electronic Health Reporter.