It was not that long ago that fax machines were the hot new technology for business and medical practice. Instead of mail and hand delivery, documents could be moved around securely by fax. With the adoption of EMRs, the deluge of faxed diagnostic results, referral requests, and consultation reports may have slowed slightly; however, we still live and work in a predominantly paper world. Without a mechanism to easily digitize these paper documents, a staff member needs to scan previously mailed or faxed reports, save them in a folder, and attach them into an individual patient's electronic charts. A software application called a Fax Server is designed to take over (to a large degree) the functions of your standalone fax machine. For a more detailed description of fax servers, click here (Source: Wikipedia).
Fax servers can send and receive documents, although you may not want to completely retire your traditional fax machine. Because the fax server functions as an application through a desktop computer (unless you have a very efficient scanner), sending multi-page documents such as referral requests through your fax server may be disruptive to staff. Keeping the traditional fax machine for some outgoing documents is a good strategy. If you are able to generate referrals through your EMR, these can often be sent directly using the fax server to a destination fax.
Another form of fax server is "Fax over IP" or Internet fax. Using one of these services, you can easily receive faxes via the Internet that are then delivered to you as documents attached to an email. Although not as easily usable as a fax server that runs directly off your laptop or desktop computer, these services provide great convenience, particularly if you are mobile and like to have access to your faxes from multiple locations. A popular service is MyFax.com, although there are many others. Prices are reasonable and usually volume based, and it is also a cost-effective way to obtain a toll-free fax number.
Document management is a critical part of the day-to-day work in a medical practice. As a result, you should have a detailed conversation about fax server software with a potential EMR vendor as part of the selection process. Different vendors may have different approaches, and it is important to understand the implications to your staff's workflow if the fax server is directly integrated with the EMR vs. a standalone service on the desktop computer. There are a number of steps in order to electronically receive and attach a document in an EMR. One step that deserves additional discussion with your EMR vendor is how the documents are named when they are received using the fax server. The fax server software may automatically generate a unique ID for each document received. It is then up to your staff to open the document, identify the patient name and contents, and then rename the document prior to attaching in the patient's chart. Your vendor may have a creative approach to managing this mundane and time consuming task.
If you are currently using an EMR and do not have a fax server, or if you are considering an EMR, the fax server is a simple, cost-effective tool that makes document management easier and more efficient.
When considering a fax server it is important to recognize that most modems out there are not going to be very reliable for fax use despite their claims of fax support. Few modem manufacturers are dedicated to fax support. As for online fax services, if you care about reliability be careful that the service uses true PSTN circuits and not VoIP or T.38 (and this can affect pricing as the latter are cheaper).
Posted by: Lee Howard | March 19, 2012 at 11:24 AM
I currently have a set up similar to what is described above. I use the MyFax Internet fax service and find it works very nicely. I do find that the MyFax web portal is somewhat clunky so I have chosen not to use it and rather have each incoming fax sent via e-mail to me, so my Gmail account acts as the day to day interface rather than the MyFax webpage. My question is how secure is Gmail? I do have an HTTPS connection at all times, but beyond that I do not know for certain if I am meeting whatever guidelines apply in this case.
Posted by: David Bridgeo | April 11, 2012 at 06:04 PM
As a software engineer, I'm not aware of the regulatory guidelines you're subject to, but email by its very nature is inherently insecure. It is a public channel and subject to eavesdropping.
That being said, you are right to enable HTTPS for gmail, it reduces the exposure and ensures the message is encrypted between google's servers and your device. The problem is that the email is travelling unencrypted from MyFax to Gmail. In all practicality, its unlikely to be a problem, but the potential is there.
Posted by: Drazen | May 22, 2012 at 10:19 PM