Fax machines should not be banned, as they work and are useful as a back-up system that clinics and hospitals already own and know how to use. That's not saying we should just stick with the fax machine, as there are modern, easier to use options that exist, but banning fax machines shouldn't be necessary to move forward.
First place to stop sending and receiving faxes is CMS. If they are serious about promoting interoperability they will not be requiring clinicians to fax anything to them.
Yes...but not only the medical industry. Last week I had to request a with drawl from an investment account from a major US firm and I was told to fill out their PDF form, print it out, then fax the signed request to them. I told them I did not have a fax machine or land line, but could electronically sign the PDF? They said 'No', you need to go to our web site, print out the PDF form, fill it in, sign it, scan it, then email (or snail mail) it. That's only half a step better than sending a fax.
The continued use of fax machines in the EHR era may in part be due poor EHR designs which are error-prone or difficult or impossible to use, Thus, continued use of faxing for transmission of data may function as an expedient work-around.
First it will be necessary to address the various government agencies that refuse to accept anything other than paper or fax. We would love to get rid of our fax machines but in our state it's almost impossible to work with Medicaid (almost as bad for Medicare) without faxing. Also, fax technology can be problematic in this day of VoIP with some faxing systems not as compatible as you might think.
It’s a chicken vs the egg question. Until all potential communications can occur via Secure electronic communications, then I don’t see it being possible to outlaw faxes. Unfortunately, there are still many mental health providers who don’t have electronic records because the incentives didn’t apply and because many don’t accept Medicaid, Medicare or insurance. So it won’t work to outlaw faxes only for hospitals before all providers have mandatory secure electronic communication (perhaps tied to licensing).
There also needs to be appropriate infrastructure set up to receive information from non-providers related to referrals. For example, we often have students referred by schools for emergency psych evaluations and the school personnel fax us information that would not be easy to receive otherwise.
Even within our electronic record, transmission of information electronically is not straightforward. Some elements can be sent but others are difficult if not impossible to attach to an electronic message. So improvements are also needed to EHRs to facilitate rapid seamless information transfer.
Outlawing “insecure” PHI transmissions would also prevent patients from communicating with providers through their preferred modes of communication. Of my current outpatients, about 80% have used the portal to send messages at least once. The rest say they don’t want to use the portal or they don’t have or don’t use a computer. Of the ones with a portal account, more than half prefer to communicate by regular email or regular text message about issues like scheduling appointments, getting med refills or asking for a return phone call. They just don’t like all the extra steps of fooling with a poorly designed portal and they know I check my email frequently but don’t get alerted easily to portal messages. (The phone app for our EHR doesn’t display face-up if you have new messages and the portal can’t send an automated email to the provider saying login to see a new message.)
I would however be in favor of outlawing faxes from pharmacies, particularly in states like NY with mandatory e-prescribing. This practice leads to much confusion and potential for errors and the pharmacies refuse to turn this “feature” off, even when providers ask them to cut it out.
OCR should crackdown on insecure transmission of PHI, and set guidance to confirm recipients prior to sending. Maybe that will entice organizations to implement something better.