How Fax Machines Hinder EMR (And How to Solve It)

Want to see if time-travel is real? Simply walk into any doctor’s office or a hospital and ask to use their fax machine. 

This everyday device, whose heyday was back in the late 1980s, is still lumbering along in a world of telemedicine, medical computers, and artificial intelligence. Nearly 90 percent of healthcare organizations use fax machines with an estimated 75 percent for communications purposes alone. While reasons range from comfortable familiarity to doctors’ distaste for electronic medical records (EMR), this post, instead, will cover why it’s time for the fax machine to join the likes of the Walkman, VHS tapes, and the fanny pack. 

Waste of Time and Money

According to the Council for Affordable Quality Healthcare, the manual processing of medical information through phone calls, fax, etc., costs the healthcare industry more than $9 billion annually.

Such processes cost $6 to $11 more per piece of information than through EMR. Professional services firm PricewaterhouseCoopers (PwC) agrees, pegging the labor cost for medical providers alone at $20 for each paper document. 

The use of fax machines costs time as well. Healthcare staff must spend their limited work hours physically retrieving, integrating (i.e., data entry or input), and destroying any confidential documents per HIPAA. And the PwC study shows providers filling out an average of 20,000 forms a year. Filling and faxing those forms, along with any phone calls, can take an average of 8 minutes per piece, with some requiring as high as 30 minutes. All these chip away at time better spent on patient care.

Support staff, like healthcare IT, is similarly affected. Fax equipment, from new machines to legacy, must be maintained. This costs time and money for the technicians, which could have been utilized on securing the hospital network to the purchase of needed medical tablets for ICU.   

Paper Jams Can Cost Lives and Money

Missing or jammed pages, busy signals, and blurry printouts are well-known issues with fax machines. Normally they’re just an annoyance to the average consumer or business. For medical groups and hospitals, fax issues take a different tone since those printouts can be a matter of life or death. As CareAlign CEO Subha Airan-Javia vividly illustrates: “Just last week we received faxed medical records for a patient that made a stack two inches thick. And it came in two or three different faxes, because they ran out of paper half-way through, and it was all disorganized, and there were missing sheets. It was a mess.

“And there I was, trying to put all this information together, it was like sorting through a year’s worth of credit card information for 20 different cards, and being expected to immediately balance your checkbook and know how much money you have in every account, right now. It’s just about impossible.”

And also expensive. Using the tragedy above as an example, the PwC pegs the average healthcare organization would spend over $200 to recreate each missing record alone, in addition to $120 in labor cost for each piece of paper. 

Cybersecurity on Paper

Here’s some surprising ﹘ and ﹘ unpleasant news. Fax machines are not covered by HIPAA rules on the encryption of data. That is because the information to be faxed was not digital in its original, paper form. 

Fax printouts with patient information, however, are under HIPAA rules. Healthcare organizations are thus responsible if the printout is not promptly picked up by authorized staff, left alone, lost or, worse, taken by unauthorized personnel. (Newer technology uses RFID or badge scanning features to verify identity, while fax machines just sit in hallways.) And if the information is faxed to the wrong number? The health group is still responsible as per this 2017 Texas case. 

Finally, fax machines are vulnerable to cyberattacks like Faxploit, which allows hackers to access any and all IT attached networks.

Solutions are Coming. Slowly.

EMR systems resolve the above issues especially in cutting costs and in cybersecurity. So why haven’t medical groups tossed out their fax machines?

One word: interoperability.  

When the Obama administration in 2009 provided funds to private healthcare organizations to switch to EMRs, there were no requirements for such systems to be able to communicate with each other, i.e., interoperability. A study published in 2013 showed only 41 percent of hospitals in the US were able to exchange patient medical records with other systems. Fax machines, phone calls, and even physical mail, had to be used to deal with this lack of interoperability. 

Solutions are coming, though. The private sector developed health information exchanges (HIEs) where healthcare organizations can share patient information without breaking HIPAA confidential rules. Unfortunately, HIEs are limited to select geographical locations like within states. 

The government, realizing its mistake in 2009, looks to encourage interoperability between healthcare groups on a national scale as well as get rid of fax machines. Said Seema Verma, administrator for the Centers for Medicare and Medicaid Services in 2018: “If I could challenge developers on a mission, it’s to help make doctors’ offices a fax free zone by 2020.”

Closing Thoughts

Fax machines in medical offices are a throwback to an earlier time and need to go out like cathode ray tube tv sets. EMRs effectively solve their big shortcomings like costs, paper jams, and lack of cybersecurity.  Contact an expert at Cybernet if you’re looking to move from faxing to modern systems. Also follow Cybernet on Facebook, Twitter, and Linkedin to stay up to date on this and other relevant topics.