Ask HN: It's 2022, who still uses faxes?
Today I went to a business where they wouldn't take my order over email -- fax only. The year is 2022 for Pete's sake!! HN: what's the craziest surviving fax-only situation that you've had to deal with?
28 comments
In my scientific business in the 1990's I would select my fax machine according to the maximum length of paper it would send & receive. IIRC the best was about 8.5 x 39 inches or about a meter length of A4 width paper.
We still had research instruments using similar thermal paper rolls themselves which plotted real-time data and that could be a few feet of paper if you were printing for more than an hour or so.
Clients loved it when I could fax the whole thing, even if their poor fax machine broke it up into smaller pages.
Then about the time of W9x I would fax it from the fax machine to a PC's analog modem to get it into a single Windows file using the Windows faxing routine.
Interestingly, in the cargo business we had them much earlier when they were still called telecopiers. You would generally have a dedicated operator at each end (of the world, one of which was always likely to be called out after-hours for the "emergency" paperwork transmission) for the duration of the not-fully-reliable 300 baud session.
Once the technology became a bit more user-friendly then attorneys began to wish they could use it but since the legal paperwork itself physically was not actually issued by their office it was no go. Our clients pay well for expedited paperwork and agreed in advance to accept it. Once the attorneys got the name changed from telecopier to "facsimile" machine they were fine after that.
We still had research instruments using similar thermal paper rolls themselves which plotted real-time data and that could be a few feet of paper if you were printing for more than an hour or so.
Clients loved it when I could fax the whole thing, even if their poor fax machine broke it up into smaller pages.
Then about the time of W9x I would fax it from the fax machine to a PC's analog modem to get it into a single Windows file using the Windows faxing routine.
Interestingly, in the cargo business we had them much earlier when they were still called telecopiers. You would generally have a dedicated operator at each end (of the world, one of which was always likely to be called out after-hours for the "emergency" paperwork transmission) for the duration of the not-fully-reliable 300 baud session.
Once the technology became a bit more user-friendly then attorneys began to wish they could use it but since the legal paperwork itself physically was not actually issued by their office it was no go. Our clients pay well for expedited paperwork and agreed in advance to accept it. Once the attorneys got the name changed from telecopier to "facsimile" machine they were fine after that.
Most Hospitals
If you need records transferred from one institution to an out-of-network provider, they usually need the request by fax and the data is sent by fax.
Varies by institution of course
If you need records transferred from one institution to an out-of-network provider, they usually need the request by fax and the data is sent by fax.
Varies by institution of course
> If you need records transferred from one institution to an out-of-network provider, they usually need the request by fax and the data is sent by fax.
Note that this is a regulatory hack because of the interpretation of HIPAA that fax transmissions are not “electronic media”, and therefore their use between HIPAA covered entities is not covered by the standardized format requirements and special security requirements associated with transactions conducted via electronic media.
Note that this is a regulatory hack because of the interpretation of HIPAA that fax transmissions are not “electronic media”, and therefore their use between HIPAA covered entities is not covered by the standardized format requirements and special security requirements associated with transactions conducted via electronic media.
It's funny because faxes are wildly insecure compared to email.
I've seen the same thing at a very "security conscious" organization where email and slack were heavily restricted, so people just texted eachother.
I've seen the same thing at a very "security conscious" organization where email and slack were heavily restricted, so people just texted eachother.
I’ve heard a lot of doctors are still using pagers because mobile phones are banned and considered to intervene with medical equipment
Phones probably don't interfere with medical equipment--patients use phones all the time with no issues. Not to mention most medical equipment is subject not only to the usual FCC electronics regulations on electromagnetic interference but additional regulations. A quick google search suggests the reason is likely more related to super long battery life, and the un-ignorable nature of the alerts (a text message or call is easy to ignore or fade into the background).
I actually think Fax is pretty damn good precisely because no one is using it. So all you get from Fax are signals. And mostly better signals because people make an effort to fax you.
I used to hate Fax, thinking it is some old technology that should die. Along with Pager. But I have now grown to appreciate these technologies.
I used to hate Fax, thinking it is some old technology that should die. Along with Pager. But I have now grown to appreciate these technologies.
Work in a doctor's office. We still use it daily to get documents from hospitals.
In BC government services that require confidentiality tend to use faxes: healthcare, child welfare, that sort of thing.
I work at a library. We rarely use our fax machine internally, but we send faxes for patrons at $1 per page. This may sound steep, but it's because we really don't like dealing with the fax machine either. If they have a lot of pages, we try to confirm with them, "are you sure you can't send an email? We can help you with that too!", but there are still some weird cases where people just need to send a fax, so it's still there.
Most doctor's offices.
Fax is considered to be HIPAA compliant if done properly, so it is still the defacto method of sending orders etc...
For a small non-technical health practice, in many cases it's the only option.
Fax is considered to be HIPAA compliant if done properly, so it is still the defacto method of sending orders etc...
For a small non-technical health practice, in many cases it's the only option.
> Fax is considered to be HIPAA compliant if done properly
This is a misleading description of the rationale.
Fax is not considered “electronic media” under HIPAA and therefore has a lot weaker requirements, both as to format (the standard data formats and contents required of electronic media under the TCS rule don't apply) and security (the encryption and other electronic media requirements the Security Rule, and the definitions of “unsecured” PHI under the HITECH breach notification rule don't apply) than most other non-paper mechanisms.
This is a misleading description of the rationale.
Fax is not considered “electronic media” under HIPAA and therefore has a lot weaker requirements, both as to format (the standard data formats and contents required of electronic media under the TCS rule don't apply) and security (the encryption and other electronic media requirements the Security Rule, and the definitions of “unsecured” PHI under the HITECH breach notification rule don't apply) than most other non-paper mechanisms.
Not really.
Most implementations of faxes are "soft" (efax) and have an encryption requirement. They'll generally have a configuration where the fax arrives as a secure link in an email, or as an actual attachment to an email, or is accessed through a portal depending on the email security configuration.
It's also fairly common for slightly more sophisticated practices to have faxes go directly into the EHR.
This all falls squarely under the HIPAA Security Rule.
I don't see very many practices printing faxes anymore. Same way you don't see many practices that still have paper medical records, though they still exist.
Electronic faxes are also commonly used for sending documents, most EHRs have this capability. This is to avoid transmission of documents over email, and also falls squarely within the Security Rule.
Eventually we'll get to the point where we all use HL7/FHIR for this stuff, but until then "soft" faxes will remain the primary means of Healthcare document transmission.
Most implementations of faxes are "soft" (efax) and have an encryption requirement. They'll generally have a configuration where the fax arrives as a secure link in an email, or as an actual attachment to an email, or is accessed through a portal depending on the email security configuration.
It's also fairly common for slightly more sophisticated practices to have faxes go directly into the EHR.
This all falls squarely under the HIPAA Security Rule.
I don't see very many practices printing faxes anymore. Same way you don't see many practices that still have paper medical records, though they still exist.
Electronic faxes are also commonly used for sending documents, most EHRs have this capability. This is to avoid transmission of documents over email, and also falls squarely within the Security Rule.
Eventually we'll get to the point where we all use HL7/FHIR for this stuff, but until then "soft" faxes will remain the primary means of Healthcare document transmission.
> Most implementations of faxes are "soft" (efax) and have an encryption requirement.
The transaction is not considered electronic when it is by fax, even if both sides happen to use eFax, so the pieces that involve the partner-to-partner communication aren't covered by the standard transaction set requirements of the Transaction and Code Sets rule, when performing functions for which there is a specified standard; I personally know major state Medicaid agencies whose use of fax has been largely for special (out of the regular automated flow) communications that fit functions for which there is a standard transaction, as a TCS rule hack. And it supports communication with partners using hard fax as an even more comprehensive regulatory back, which may be a minority but still exist.
But, yes, with soft fax the internal toolchain is covered by electronic-specific provisions of the various HIPAA rules.
The transaction is not considered electronic when it is by fax, even if both sides happen to use eFax, so the pieces that involve the partner-to-partner communication aren't covered by the standard transaction set requirements of the Transaction and Code Sets rule, when performing functions for which there is a specified standard; I personally know major state Medicaid agencies whose use of fax has been largely for special (out of the regular automated flow) communications that fit functions for which there is a standard transaction, as a TCS rule hack. And it supports communication with partners using hard fax as an even more comprehensive regulatory back, which may be a minority but still exist.
But, yes, with soft fax the internal toolchain is covered by electronic-specific provisions of the various HIPAA rules.
I went to an optician, and they had to call my insurance. The insurance sent them a fax as a form of 2FA to make sure they were talking to the right store.
Manufacturing, finance, health care, and government.
Older people are very familiar with fax machines and nowadays you can send digital fax via e-mail to fax machine. Company IT is still often in relatively dysfunctional state and people lack skills. Multi-function printers are often worse quality and harder to use than fax machines.
Machine that does only one thing can be preferred for these reasons.
Fax machines also print confirmation receipts.
Older people are very familiar with fax machines and nowadays you can send digital fax via e-mail to fax machine. Company IT is still often in relatively dysfunctional state and people lack skills. Multi-function printers are often worse quality and harder to use than fax machines.
Machine that does only one thing can be preferred for these reasons.
Fax machines also print confirmation receipts.
Wells Fargo brokerage. They rehire you to fax documents to them. Thank god they do t require me to burn a CD like the FDA!
Fax is faster than opening an email, downloading, finding correct file, try to print it, printer warms up and then prints.... Vs automatically prints without bothering anything.
Why would you want to do business with such a business? If they are that stuck in their ways, they probably don't care about customers anyway.
At the wife's office there is a fax machine which spews a daily sermon in curled paper onto the floor of their little kitchen.
I think I read that a great deal of regional health offices handling vaccination rates and infection rates during the Covid pandemic in Germany, sent their data back to higher (federal) offices with fax.
Germans
Chargeback investigators
Healthcare. Lawyers.
Japanese
Military