3 ms·

Meanwhile in Germany doctors are still using fax machines and dot matrix printers heavily, as there's no good solution for digital signatures and some paperwork

by mhd 7y ago

Meanwhile in Germany doctors are still using fax machines and dot matrix printers heavily, as there's no good solution for digital signatures and some paperwork still needs physical carbon copies. Also, in the few years since this was written I got the feeling that some genres are actually bringing cassette tapes back. Mostly out of nostalgia, of course (so totally different from the vinyl craze).

nosianu 7y ago
I think it was just last week that I saw a headline here in Germany that after a ransomware attack on computers the only thing that still worked was fax [0]. As an administrator I would leave that old technology in place if it doesn't cost much, just in case, in addition to any of the other arguments about politics or issues around laws. Just as a backup if - or when - computers/Internet are down or unusable. Of course, this does not explain why it is being used regularly. From my subjective point of view, having worked in the IT industry and as freelancer in various big customer projects for two decades, IT solutions don't look nearly as great as they appear to be in theory. Riddled with bugs and often brittle, completely different interfaces depending on what software you use (much of it custom-made), bad interoperability, expensive, long-term questions about what will happen 10 years later (usually needs to be solved with even more money for new software and data migration and lots of new issues). I'm a lot more wary of shiny software solutions in practice, because I think the process of creating big and especially custom niche software for special use cases seems way too political to me now and not enough interested in actually finding a good technical solution. I laugh a lot less now about people and businesses using "ancient" tech like paper. [0] It might have been this court in Berlin: https://www.berlin.de/gerichte/kammergericht/kontakt/artikel.851552.php https://www.berlin.de/gerichte/kammergericht/kontakt/artikel... (TL;DR "we are offline, only phone and fax work") -- but it could also have been something else, that's not the only case when something like this happened.
rjzzleep 7y ago
I worked in that environment and you're wrong. The reason why it's done the way it is isn't because there isn't a better solution. Plenty of countries have better solutions. The reason why it is that way is that there is one company printing out prescription paper and distributing it to doctors based on their estimated usage(the estimate is based on the previous year). Actually the distribution doesn't happen to the doctors directly it is sent to the Kassenaerztliche Vereinigung which then distributes it. For alternatives see Denmark for example. The reason why they use fax machines is purely political. The Kassenaerztliche Vereigigungs lawyers decided against using PGP and still sends fax and physical CD's for two reasons. Legally if you send a letter the burden of proof is on the receiving party. It's called "Rechtssicher" in lawspeak. So even if you send a data with corrupt data, it's not technically your problem. The Government basically set in stone / law that the only digital way to transmit information while maintaining the burden of proof in the same fashion is by using De-Mail (a previously failed standard that was riddled with problems). Institutions however don't want to use De-Mail because it's tied to a few organizations like the Deutsche Telekom, and they feel like they're giving away control of their data if they can only use Telekom infrastructure(not to mention that it's pretty terrible). As for why doctors still send fax here's a little history. The KVSH (Schleswig Holstein) had a mail communication solution that they offered royalty free, but other KV's in the other states didn't want to use it because they felt it would make the KVSH too "whatever(i actually don't know)" but they were concerned about something. As an alternative the KBV(the federal level institution) created KV-Mail(I think it was called). That piece of software is built by a third party which is famous for their horrible code. As it turns out when you decompile it, it's just a really terrible s/MIME implementation based on the demo code. However, not only is it riddled with problems with messages sometimes disappearing, it's also not royalty free and it implements a decentralized system s/MIME and turns it into a royalty based solution with the KV as the man in the middle. My information is a bit outdated so anything might not be valid anymore. By the way, the move to a digital submission format for legal documents has been riddled with issues look at this review of BeA > This software requires communication with bealocalhost.de (which resolves to a server running on localhost). To enable TLS(https) for this connection the software brought its own Certificate signed by a regular Certificate Authority (TeleSec), but also included the private-key. Therefore TeleSec revoked this certificate in accordance with general CA regulations. https://blog.timmeey.de/2017-12-27-German-lawyers-are-required-to-install-a-crypto-backdoor/ https://blog.timmeey.de/2017-12-27-German-lawyers-are-requir...

by mhd 7y ago

nosianu 7y ago

I think it was just last week that I saw a headline here in Germany that after a ransomware attack on computers the only thing that still worked was fax [0]. As an administrator I would leave that old technology in place if it doesn't cost much, just in case, in addition to any of the other arguments about politics or issues around laws. Just as a backup if - or when - computers/Internet are down or unusable. Of course, this does not explain why it is being used regularly. From my subjective point of view, having worked in the IT industry and as freelancer in various big customer projects for two decades, IT solutions don't look nearly as great as they appear to be in theory. Riddled with bugs and often brittle, completely different interfaces depending on what software you use (much of it custom-made), bad interoperability, expensive, long-term questions about what will happen 10 years later (usually needs to be solved with even more money for new software and data migration and lots of new issues). I'm a lot more wary of shiny software solutions in practice, because I think the process of creating big and especially custom niche software for special use cases seems way too political to me now and not enough interested in actually finding a good technical solution. I laugh a lot less now about people and businesses using "ancient" tech like paper. [0] It might have been this court in Berlin: https://www.berlin.de/gerichte/kammergericht/kontakt/artikel.851552.php https://www.berlin.de/gerichte/kammergericht/kontakt/artikel... (TL;DR "we are offline, only phone and fax work") -- but it could also have been something else, that's not the only case when something like this happened.

rjzzleep 7y ago

I worked in that environment and you're wrong. The reason why it's done the way it is isn't because there isn't a better solution. Plenty of countries have better solutions. The reason why it is that way is that there is one company printing out prescription paper and distributing it to doctors based on their estimated usage(the estimate is based on the previous year). Actually the distribution doesn't happen to the doctors directly it is sent to the Kassenaerztliche Vereinigung which then distributes it. For alternatives see Denmark for example. The reason why they use fax machines is purely political. The Kassenaerztliche Vereigigungs lawyers decided against using PGP and still sends fax and physical CD's for two reasons. Legally if you send a letter the burden of proof is on the receiving party. It's called "Rechtssicher" in lawspeak. So even if you send a data with corrupt data, it's not technically your problem. The Government basically set in stone / law that the only digital way to transmit information while maintaining the burden of proof in the same fashion is by using De-Mail (a previously failed standard that was riddled with problems). Institutions however don't want to use De-Mail because it's tied to a few organizations like the Deutsche Telekom, and they feel like they're giving away control of their data if they can only use Telekom infrastructure(not to mention that it's pretty terrible). As for why doctors still send fax here's a little history. The KVSH (Schleswig Holstein) had a mail communication solution that they offered royalty free, but other KV's in the other states didn't want to use it because they felt it would make the KVSH too "whatever(i actually don't know)" but they were concerned about something. As an alternative the KBV(the federal level institution) created KV-Mail(I think it was called). That piece of software is built by a third party which is famous for their horrible code. As it turns out when you decompile it, it's just a really terrible s/MIME implementation based on the demo code. However, not only is it riddled with problems with messages sometimes disappearing, it's also not royalty free and it implements a decentralized system s/MIME and turns it into a royalty based solution with the KV as the man in the middle. My information is a bit outdated so anything might not be valid anymore. By the way, the move to a digital submission format for legal documents has been riddled with issues look at this review of BeA > This software requires communication with bealocalhost.de (which resolves to a server running on localhost). To enable TLS(https) for this connection the software brought its own Certificate signed by a regular Certificate Authority (TeleSec), but also included the private-key. Therefore TeleSec revoked this certificate in accordance with general CA regulations. https://blog.timmeey.de/2017-12-27-German-lawyers-are-required-to-install-a-crypto-backdoor/ https://blog.timmeey.de/2017-12-27-German-lawyers-are-requir...