Why the Canadian healthcare industry is still stuck in the ’80s when it comes to the fax machine

It’s a dark and rainy Thursday night near the end of 2021, but for Steven Marji, it might as well be 1991.

You’re coming back from a repair job, fixing an essential piece of technology your customer just can’t live without: the fax machine.

This time the employer was an 85-year-old semi-retired realtor. But while printers and copiers make up the majority of her business, Marji finds that there is a sector, other than retirees, where she can always find them.

“I’m somewhat in awe of the medical field that they still rely on,” he told the Star as he drove home from his most recent job.

“It keeps us going.”

While most offices dumped their faxes a long time ago (the provincial government plans to phase out traditional fax machines in public service by the end of the year), they remain a constant fixture in hospitals, pharmacies, and doctors across the world. country.

Many doctors have newer digital models that integrate the fax into a printer or scanner, but frustrations persist amid calls to bring the industry into the 21st century and overcome an archaic system uncovered by the pandemic.

During the early days of COVID-19 in Toronto, test results had to be faxed from labs, leading to “long delays” in processing and reporting, according to a Toronto Public Health Report May 2020.

As a result of these difficulties, the agency instituted a new case and contact management system, which reduced reliance on faxing.

There were other prominent examples from around the world, the BBC reported that in Austin, Texas, the testing system was quickly overwhelmed in June 2021, due in part to the need to fax results. Health officials in the Netherlands faced a similar problem.

But despite some improvements made during the pandemic, the fax remains a critical step in the transfer of patient information in healthcare.

In a October Report, The Ontario Medical Association, which represents doctors in the province, reported that nine out of 10 doctors must rely on faxes to share patient information. Thirty percent of physicians surveyed said that linking health care record systems to reduce reliance on faxes would save them between one and five hours a week.

“You know that dial-up modem sound? That’s really what’s going on in the back of my mind as we go and click, ”said Dr. Miriam Hanna, a Burlington-based pediatric allergy specialist.

All of her patients need a referral to see her, and about “99 percent” of them arrive by fax, she said. They are part of “every day, and each encounter is related in some way to the use of a fax machine.”

This means that information can be “easily lost”. Sometimes the fax is not sent or is sent to the wrong number. They can also appear blurry or staff are simply given a blank page.

“It’s archaic, that’s what we do,” he said.

“Doctors have been using faxes forever, for better or for worse.”

Dr. Rashaad Bhyat, a family physician in Brampton who works part-time with Canada Health Infoway, a federally funded nonprofit that promotes digital health solutions, said stories of fax confusion, such as the of the pandemic, they are just the “tip” of the iceberg. ”In his office, he uses electronic medical records, but the system still ends up in faxes, because they need to fax documents to other offices, hospitals and pharmacies.

“Fax is very unreliable, very insecure as a technology and very difficult to eliminate,” Bhyat said.

“We often have what we call a fax etiquette, going back and forth between our office and the specialist’s offices, or our office and the hospitals.”

The information “ends up in a barrage of roundtrip faxes, which end up taking a day or two to resolve.” He compares faxing to “throwing something into the ether, it’s a black box.” This often results in a “significant delay” that can affect people receiving their medications and “causes a lot of inconvenience for patients and a lot of stress for everyone involved.”

Of course, the fax machine was not always a symbol of outdated technology. It took decades for them to figure out (Scottish scientist Alexander Bain is credited with inventing the first fax in the 1840s), but by the late 20th century, “what is your fax number?” was the question that was asked in every business meeting.

“The machine converts text or images into a dot pattern and sends signals. Somewhere on the other end of a phone line, another fax machine receives the signals and translates them into the proper dot pattern, Star reporter Alison Cunliffe wrote in a July 1988 article.

“Science fiction.”

They were becoming so popular, he reflected, that they might one day be in every living room, alongside the “computer and video recorder.”

What if your friends needed directions to your house? No problem, “just fax a map to your guests.”

Needless to say, the fax did not live up to expectations.

So why are they still so ubiquitous in healthcare?

“It’s inertia,” said Sachin Aggarwal, CEO of healthcare technology company Think Research.

“This is something that everyone can assume, it has to come from the top down, there have to be some mandates, but the technology already exists.”

Michael Green, President and CEO of Canada Health Infoway said there must be a “concerted effort” between health authorities, ministries of health and health professionals to make change.

“The thing about health care, it’s a pretty conservative field and I think it takes a while to change practices,” he said.

Some of this can be done by laws or some combination of carrots and sticks. But it’s complicated by the fact that in Ontario, most doctors are independent contractors, billing the government for services, rather than receiving salaries.

The roughly 1,300 traditional fax lines in the Ontario Public Service are spread “across all ministries,” said Kyle Richardson, manager of affairs, media and correspondence for the Ontario Treasury Board Secretary, in an email. “Of them, more than 90 percent will be eliminated or migrated to digital alternatives.”

The health sector includes other agencies and organizations that are not within the scope of this modernization project, he added.

One extreme idea is to simply ban faxes, making it illegal to fax medical information, Green said. Incentives could also be offered to physicians to make investments to replace them.

“There is still a way to go, unfortunately,” he said.

Meanwhile, in his car, the occasional fax machine repairman, Marji, is philosophical. Over a decades-long career, you’ve seen different technologies fall out of style.

But somehow they have a way of never really disappearing. Besides faxes, he still does some repairs on his passion, typewriters.

“They said typewriters were going to be obsolete, but it never really happened,” he said.

“Twenty or thirty years from now, you will still see some people using the fax … it will always be there.”


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