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The Facts About Faxes

February 14, 2018

The Facts About Faxes

The fax is medicine's cockroach: hated and prehistoric, but still thriving in a hostile environment. Medicine is one of the only major industries still using faxes. The story of fax survival starts with the 2009 HITECH economic stimulus package. HITECH was intended to incentivize healthcare providers to adopt digital records, using the lure of a $30 billion fund. Providers had to meet "meaningful use" benchmarks to receive the incentive money.

HITECH worked. Electronic medical record (EMR) use jumped by double digits. But HITECH did not exterminate faxes for one simple reason: HITECH did not include any incentives to encourage different electronic medical record systems to talk to one another.

The developers considered their EMR systems proprietary, and didn't want to share. That is understandable on the surface; it wouldn't make sense for Trader Joes to make it easy for its customers to go to Whole Foods. More significantly, selling a particular EMR system to a hospital meant cross-selling to all the providers communicating with the hospital, emphasizing convenience. In that competitive atmosphere, faxes lived on.  

Interoperability

Still mired in 1990s technology, healthcare providers have tolerated the fax's busy signals, paper costs, and smeared printouts because they had little choice. "I think if we want to kill the fax, we need to schedule a funeral," said Donald Rucker, M.D. of the National Coordinator for Health Information Technology office, the government office tasked with promoting health information exchange to improve healthcare.  

Now a new law, the 21st Century Cures Act, may be the start of stomping out the fax machine in medicine. It requires developers to design EMR interoperability to exchange health records "without special effort on the part of the users." No one yet knows what "without special effort" precisely means, but the legal definition will be sorted out by the regulatory agencies in the future. Look for which EMR vendors get fined, and for what.

The EMR companies are paying attention, mostly because they have to. The Cures Act also creates an EHR Reporting Program which requires the EMR vendors to report back to the government on interoperability. Vendors can't just say they are interoperable; they now have to prove it.

The new regulations will take time to filter down to the provider level. Eventually, medicine will evolve and the fax, like household pests, will skitter away.

Contact your local LAMMICO Risk Management and Patient Safety representative or dial 504.841.5211 for consultation or additional information.

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