4 ms·

> It's the lack of a universal API. This sort of thing is exactly why the healthcare industry still uses faxes, even going electronic charts -> pdf -> fax -> p

> It's the lack of a universal API. This sort of thing is exactly why the healthcare industry still uses faxes, even going electronic charts -> pdf -> fax -> pdf -> electronic charts in some cases.

dragonwriter 8y ago
Healthcare uses faxes mostly because HIPAA rules particular to format and security of electronic communications don't apply to faxes; it's a compliance hack.
- Lorkki 8y ago
  That sounds a bit too juicy to be true. Any citations?
  - dragonwriter 8y ago
    I've literally been in the room when legal and compliance offices gave the advice on both the construction of the relevant regulations and industry practices on which a payer relied on in deciding to use a process that created paper documents then faxed them for certain purposes, but, no, there's nothing published I can link to as to that being the reason industry players make that decision. I can, however, point you to the relevant section of HIPAA regulations on which it rests, the definition of “electronic media” at 45 CFR § 160.103, specifically this bit: “Certain transmissions, including of paper, via facsimile, and of voice, via telephone, are not considered to be transmissions via electronic media if the information being exchanged did not exist in electronic form immediately before the transmission.”
    - cm2187 8y ago
      And in a way it is justified, you need a warrant to wiretap a phone line but no such constraint on eavesdropping on TCP/IP communication.
    - dx034 8y ago
      > if the information being exchanged did not exist in electronic form immediately before the transmission So you need to print them out before faxing? PDF->Fax wouldn't work with that definition.
zeta0134 8y ago
This is even more fun because in the modern age, what very often ends up happening is: electronic charts -> pdf -> fax -> fax machine as a service -> unsecured email -> pdf -> electronic charts Compliance can sometimes help, but ultimately the data needs to flow, and people will do whatever it takes to make that happen. Until security is so easy that it's the default, these little loopholes will continue to be abused.
- bm1362 8y ago
  To be fair, you’ll notice if 150 million faxes start going off rather than someone breaking abusing your API.
- rabidonrails 8y ago
  Phaxio co-founder here. We do a _ton_ of heathcare faxing and we're starting to see a shift away from the "unsecure email" in applications. Granted, we can't see what our users are doing at all times but being HIPAA compliant ourselves, we often work with our users to understand their systems and guide them towards compliance. >> Until security is so easy that it's the default, these little loopholes will continue to be abused. The simple way to think about this is that the government is more worried about unsecure email/email spoofing than it is about wiretapping.

> It's the lack of a universal API. This sort of thing is exactly why the healthcare industry still uses faxes, even going electronic charts -> pdf -> fax -> pdf -> electronic charts in some cases.

dragonwriter 8y ago

Healthcare uses faxes mostly because HIPAA rules particular to format and security of electronic communications don't apply to faxes; it's a compliance hack.

Lorkki 8y ago
That sounds a bit too juicy to be true. Any citations?
- dragonwriter 8y ago
  I've literally been in the room when legal and compliance offices gave the advice on both the construction of the relevant regulations and industry practices on which a payer relied on in deciding to use a process that created paper documents then faxed them for certain purposes, but, no, there's nothing published I can link to as to that being the reason industry players make that decision. I can, however, point you to the relevant section of HIPAA regulations on which it rests, the definition of “electronic media” at 45 CFR § 160.103, specifically this bit: “Certain transmissions, including of paper, via facsimile, and of voice, via telephone, are not considered to be transmissions via electronic media if the information being exchanged did not exist in electronic form immediately before the transmission.”
  - cm2187 8y ago
    And in a way it is justified, you need a warrant to wiretap a phone line but no such constraint on eavesdropping on TCP/IP communication.
  - dx034 8y ago
    > if the information being exchanged did not exist in electronic form immediately before the transmission So you need to print them out before faxing? PDF->Fax wouldn't work with that definition.

zeta0134 8y ago

This is even more fun because in the modern age, what very often ends up happening is: electronic charts -> pdf -> fax -> fax machine as a service -> unsecured email -> pdf -> electronic charts Compliance can sometimes help, but ultimately the data needs to flow, and people will do whatever it takes to make that happen. Until security is so easy that it's the default, these little loopholes will continue to be abused.

bm1362 8y ago
To be fair, you’ll notice if 150 million faxes start going off rather than someone breaking abusing your API.
rabidonrails 8y ago
Phaxio co-founder here. We do a _ton_ of heathcare faxing and we're starting to see a shift away from the "unsecure email" in applications. Granted, we can't see what our users are doing at all times but being HIPAA compliant ourselves, we often work with our users to understand their systems and guide them towards compliance. >> Until security is so easy that it's the default, these little loopholes will continue to be abused. The simple way to think about this is that the government is more worried about unsecure email/email spoofing than it is about wiretapping.