When J.D. Whitlock told physicians who refer patients to Mercy Health that the Cincinnati-based system's providers would be required to start sending patient information digitally, rather than by fax, some of those physicians said to go right ahead—they'd just start referring their patients to a competitor. Ditching the fax would mean the referring physicians' practice would have had to log into a secure site to get patient test results, said Whitlock, who at the time was vice president of enterprise intelligence at Mercy. “It's not completely crazy from their perspective that they're not excited about this.”
So while a lot of people in healthcare want faxing to go away, many doctors draw a line in the sand in front of their fax machines, and hospital executives don't want to cross it. “Hospitals can't stand on principle in opposition to faxing if their business is going to go away,” said Whitlock, who's now chief information officer of Dayton (Ohio) Children's Hospital.
The problem is that for physicians, faxing works, but for healthcare as a whole, it doesn't. Sending patient data and other health information digitally would result in more complete patient records. Those records would contain more information that could be analyzed by machine-learning tools. And providers, in turn, would cut costs by doing less repeat work, reading the same things on screens that they've already read on paper. They'd also lose the big risk that what they're sending will go to the wrong recipient.
“The irritating thing is I'm getting as much faxed paperwork as I did a decade or two ago,” said Dr. Thomas Lee, chief medical officer of Press Ganey Associates. As a practicing physician, Lee gets faxes mostly related to signing off on physical therapist treatment, prescription renewals and insurance company notifications about potential gaps in care. “I don't particularly want someone to send me faxes telling me everything that's happened, because there's no way I can absorb all that information.”
Now the chorus of faxing opponents includes not only large health systems but also federal regulators. CMS Administrator Seema Verma called on developers at the Office of the National Coordinator for Health Information Technology's Interoperability Forum to help make doctors' offices “a fax-free zone by 2020.” And Steven Posnack, executive director of the ONC's Office of Technology, mostly seriously declared Oct. 12 No Fax Friday.
Those may sound like good ideas, but to some, they also sound like wishful thinking. “I told (Verma) to keep dreaming,” said Rush University Medical Center CIO Shafiq Rab. Nevertheless, he said, the end is in sight (he predicts it will come by 2022).
In order for that to happen, hospitals and clinics will have to just say no to faxing, slowly phasing it out until it's truly a relic of the past. Until then, as providers seek greater interoperability, they must contend with workarounds and accept that they'll duplicate information in some cases and miss it in others.