Nikhil Krishnan’s Post

What about small rural hospitals that don't have the infrastructure, the funding or that staff to upgrade to fully electronic methods of sending information?

Axe the fax has precedent in other countries Wrote about it here https://healthapiguy.substack.com/p/chasms-and-fires

Fax is still used as a backup to send orders during a system or network downtime. It certainly shouldn't be the primary method anymore, but it still has use cases today. For example, hospitals have downtime procedures they follow in the event of an outage (i.e. unexpected ransomware attack, or a planned downtime for maintenance) which often include fax as a backup communication method.

Old school faxes are not HIPAA compliant: 1. They're analog, so they're not encrypted in transit 2. Fax inboxes don't have validated recipients, so you cannot enforce/audit PHI access Yet nobody cares because EHR vendors offered no alternative way to export/send records... until Dec 2023. We're 1 class action lawsuit away from CIOs prioritizing a switch.

I was told that they use fax coz it cannot be hacked 😂

Back in 2012, I started as COO of a large independent pharmacy business. (I ran a biotech and med device company prior to that.) On my first day, someone mentioned something about the fax queue. I said surprisingly "you still use fax?" They looked at me like I was crazy. Fast forward to 2024 and pharmacy and healthcare still relies on fax. And to say that no inexpensive, secure, electronic transmission methods exist is total BS. I have my conspiracy theories about why we still use fax but I won't share them on a public forum. 😉

Nikhil Krishnan you see, I do sympathise with the sentiment, I really do, but it’s just too facile to say forced interoperability needs to happen and expect only postivies from that motion. The new infrastructure brings cost, it also actually ironically brings additional security liabilities vs. fax. Ultimately if it’s forced, the patient pays. Maybe it’s worthwhile maybe not. Furthermore, we often conflagate matters- what saves lives is timely information exchange. Interoperability mainly saves administrative resources and can but is not necessarily compulsory for the former. Now I actually support an enforced common standard, but mostly for adminstrative reasons, and fully controlled by the patient. And it’s just a simple indictment of how under-resourced many healthcare facilities truely are.

I’m almost convinced there’s a fax lobby out there in DC.

Couldn't agree more... so many issues with fax. Here in Saskatchewan, we've had multiple privacy incidents as a result (https://regina.ctvnews.ca/sask-medical-info-leaked-because-three-doctors-share-the-same-last-name-1.6756259) and this is like the 4th time in the last decade or so smh...

the only reason facsimile still exists is because of the the US healthcare system.