Just the fax, Ma’am

According to Wikipedia, fax machines have existed, in various forms, since the 19thcentury, but the modern fax became feasible in the mid-1970s due to advances in technology. Sending a fax can be a very convenient way to deliver hand-written information over large distances quickly, but it’s not a good way to send PHI (protected health information).

NEMT IT Magician Andrew Clarke

Although it’s still acceptable to send PHI via fax according to HIPAA, I expect the regulations to catch up with another technological advance soon – fax by email. In the past, all faxes were sent to devices attached to phone lines using a series of tones. This technology required a process called handshaking at the beginning of the transmission so that both devices communicated at the same speed, so it was difficult, if not impossible, to intercept a fax.

Today faxes are often sent via email and email is extremely insecure since the documents are stored online for extended periods of time and can easily be retrieved by anyone who has the email username and password.

Many of us know someone who has had their email hacked due to malware, a computer virus or a friend with a big mouth. Unfortunately, there is no way for you to know if the fax you’re sending is going to a physical fax machine or an e-fax inbox.

My recommendation is to stop using faxes to send PHI and start using other forms of technology like web portals. Web portals require the end user to login, then allows them to download documents securely using the same encryption technology used by the banking industry and credit card companies. If you must send PHI via fax, use the same precautions you would if you were sending it via email:

  • Do not send Social Security numbers
  • Do not send patient names and medical record numbers together
  • Black out any sensitive information thoroughly

You should also verify you have the correct fax number by sending a test fax first. The local gas station may be only one digit off …

It’s up to all of us to protect our patients’ PHI. Identity theft is on the rise, and none of us wants to end up on the six o’clock news for this reason.


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