Did you know the first telephone fax device was introduced to the market in 1964?
Did you know that 70% of all healthcare communication is still conducted through fax and can be as high as 90% when you take into consideration faxes flowing into and out of EHR applications?
In an industry so reliant on fax for bi-directional communication with other healthcare facilities – as well as revenue-generating opportunities such as referrals – it is essential that your organization has the correct technology to meet demand. Requirements such as responsiveness, reliability and capacity are important to support patient care and increase revenues.
Despite the antiquity of fax technology, it still plays an important role in healthcare. Fax is imbedded deeply into healthcare’s workflow processes by both clinicians and admin workers. However, fax has shown to be an ineffective communication medium for certain applications. So the question is, how can we utilize fax technology more effectively?
Here is an example of ineffective use of fax in Healthcare:
EHR systems provide electronic referral systems, however, 56% of referrals continue to be faxed. The primary reason for this is if the referring facility uses a different EHR than the receiving facility, the two EHR’s can’t communicate with each other. Hence, fax is often the only alternative to deliver information in that situation. Unfortunately, this can be a slow process, often resulting in a slow ability to respond, which can result in the loss of a new patient to another facility.
A slow response can also result in lost revenue for existing patients. When a patient does not continue treatment within a healthcare system – what is also referred to as leakage – it poses a serious problem for all healthcare institutions. According to GetReferredMD.com, if 55-65% of revenue is lost due to leakage, then a hospital is losing between $821K to $971K on average, per physician, per year. That means for a hospital with 100 affiliated providers, total leakage costs can add up to between $78M to $97M per year.
Facts about Fax
Eclipsed by modern email, fax is kept on life-support due to the necessity of transmitting paper documents, and heavily used by the healthcare industry as a recognized HIPAA-compliant means of communication to share medical information containing PHI. This is true as long as the information is sent to the correct number, which unfortunately is not always the case. History has shown that faxes are often sent to incorrect numbers, exposing patient information and opening the facility up to violations and potential penalties. And although the tech industry has created steady improvement of fax machines, including G3 fax and later greater compression ratios like JBIG and JBIG 2 to help to speed large faxes along, faxing can be a slow process. But the facts about fax remain, it relies heavily on copper POTS lines that are an expensive and aging infrastructure.
The storm clouds are brewing
In 2019, the Centers for Medicare and Medicaid (CMS) called for the end of faxing in healthcare by 2020. While this didn’t happen – likely due to the pressures the pandemic placed on healthcare – here are the numbers:
Given that fax is still an integral part of workflow process in 2025 how do we make fax better?
If you told someone in 1957, when 75% of households in the United States had a telephone, that one day they would be cutting the cord, it would have seemed like an absurd idea. But a US Centers for Disease Control and Prevention 2022 survey found that only approximately 29% of U.S. adults lived in a house with a landline phone, down from more than 90% in 2004.
Mature Fax Strategy
With no real end in sight, where could we make possible improvements? When you consider that traditional telephone infrastructure is fading, and the recent deregulation of fax lines is pushing prices 300 to 400% higher post deregulation, it makes sense to consider alternatives.
On Premise Fax Servers: These types of devices have been in use by health systems for quite some time and provide greater control, capacity and routing features. However, fax servers require careful calculation related to fax volumes and channels necessary to support capacity. Additionally, they still rely on POTS lines (Plain Old Telephone Service) or expensive bonded T1, which is the same infrastructure where fiber may not be an option. There are also ongoing maintenance costs to consider, and costs associated with adding additional channels. With the on-premise server, additional costs could include long-distance charges.
Hybrid Fax Servers: This type of fax server uses an on-premise server but does not require an array of POTS lines to support communication. Instead, it uses a faster, more reliable internet service provider (ISP). When a fax is sent or received, documents are either scanned and sent or sent from the desktop. And instead of using POTS lines, you will be accessing the never-busy cloud. Senders and receivers of faxes, into and out of the health system, will never know the difference, but compliance officers will, as this enables an audit trail for fax communication. In this instance, expected costs relate to the number of faxed pages, the number of channels and the ongoing maintenance costs, avoiding potential long-distance charges and busy signals.
Cloud Fax: Unlike on-premise or hybrid fax servers, cloud faxing does not require a physical server or additional telephony, but operates in a Fee as a Service (FaaS) environment. It can be utilized as either an embedded application or web portal. This type of capability transitions all fax activity to the cloud. Like the hybrid fax server, all telephony is cloud-based, and still enables senders and receivers to interact much the same as traditional fax. This option provides tremendous value by eliminating expensive infrastructure and maintenance. It fits very well into the enterprise and SMB healthcare market and does not rely on outdated POTS technology.
Smart Routing: In today’s healthcare environment, plain paper faxes spew from the device, making it necessary to sift through volumes of paper to find your documents. This is typically the beginning of your workflow process. However, it is no longer necessary to have a complex telephony infrastructure or multiple lines to deliver faxes across the healthcare organization. Instead, smart routing applications can deliver faxes directly to devices, email inboxes and network folders. This eliminates the need for a fax number to a dedicated copper line to reduce infrastructure costs. If someone or a department moves, the fax routing follows them. Workflow applications can also be implemented to capture incoming faxes, converting the information into structured data and routing these directly to your EHR. The applicable data will then be populated into the correct fields, effectively eliminating the need for manual keying or scanning.
While fax technology may seem outdated, it remains a critical component of healthcare communication. By adopting more modern fax solutions, healthcare organizations can enhance the efficiency and reliability of their communication processes. These advancements not only support better patient care but also help mitigate revenue loss due to communication inefficiencies. Embracing these technologies ensures that fax continues to play a vital role in the healthcare industry, even as we move towards more integrated and digital communication systems.
