In this next post in our series, we talk about faxing. It's apparently been around since 1964, and, stepping back for a moment, it's absolutely unbelievable that over 50 years later, much of the Canadian medical community still communicates largely by fax.

In our view, it's unreliable, expensive, results in poor image quality, and does not adequately protect patient privacy. That being said, it's the only practical way of communicating with a very large majority of other health care professionals and so we're forced to hold our nose and use this protocol, and why, in a typical month, we send and receive over 5000 pages of faxes.

Accepting that we need to be able to send and receive faxes, how best to go about it?

The traditional approach is to have a fax machine attached to a dedicated landline. Send a fax by putting physical pieces of paper into the fax machine's paper tray, punch the destination fax number, and wait 30 seconds per page or so before getting a confirmation of receipt back. What surprises us is how frequently we see other health care professionals still using this method - we know this is what they're doing because the fax comes to us upside down (which is a whole other frustration). It works the same in reverse; the machine picks up incoming calls, and prints out a paper copy of the incoming fax.

One step above would be network attached physical fax machines. Most importantly, these fax machines can be configured to save incoming faxes to PDF form on a network drive (and presumably, can be configured to send outgoing faxes from PDFs as well). This option still requires dedicated landlines though, and there's a scalability problem since the line will be busy whenever a fax communication is in progress. It's also an option to set up a software based fax server, such as HylaFax.

Our approach has been to use internet based faxing instead, in line with our philosophy of using cloud-based technology where possible in order to let specialized professionals handle our IT needs. In essence, we outsource all of the nitty gritty of faxing to a third-party, namely, SRFAX, so that we simply send and receive PDFs from them via any number of methods (e.g. REST API, email, web).

There are a number of specific reasons why we took this approach:

It was important to us that our fax line was never "busy". We see how often other fax lines are busy, and that impacts the timeliness and reliability of our patient related correspondence.
We can easily have multiple fax numbers. For example, each of our physicians have their own fax number in order to streamline our internal processes and to reduce misdirected correspondence.
We wanted exceptional error handling. In particular, we need to know when faxes aren't received or sent properly, and internet fax services make this easy.
We wanted our fax service to be always available. Since we're in a retail space, we lose power on a semi-regular basis. We wanted our fax hardware to be in a commercial data centre, not our server closet.
We can send faxes via multiple methods. This is important to us since there's a lot of different scenarios where we need to send faxes - it's not always easy to send a fax via a locally hosted fax server.

This isn't the cheapest approach (e.g. using internet faxing is more expensive that running our own fax server), but we think it's the right approach in our situation since reliable fax communication helps us provide excellent patient care, and we couldn't recommend a better provider than SRFAX.