Leeds hospital launches campaign to 'axe the fax'

Leeds hospital is bragging about a major IT project that would set it apart from the wider NHS – it plans to "axe the fax" by the new year. A report from the Royal College of Surgeons earlier this year found there were more than 8,000 fax machines loitering in NHS trusts across the UK. Reg readers were aghast. Leeds Teaching …

[Anonymous Coward]

Dangerous

"Health secretary and former Minster of Fun Matt Hancock ... recently backed calls to ditch fax machines, saying they were "downright dangerous"."

Insecure maybe, but I don't see how fax machines are dangerous unless they hide on top of doors and drop on people like drop bears do?

[Aladdin Sane]

Re: Dangerous

That comment needs a trigger warning. Drop bears are downright savage, I barely escaped with my life.

[AMBxx]

Re: Dangerous

Most hospitals won't even confirm receipt of a fax. If you're trying to refer a patient, that's dangerous.

Fax machines are kept in unmonitored rooms - that's dangerous.

Fax machine numbers change without notice - that's dangerous.

[Anonymous Coward]

Re: Dangerous

Most hospitals won't even confirm receipt of a fax. If you're trying to refer a patient, that's dangerous. The fax machine isn't dangerous. If a hospital refuses to acknowledge an email then you have the same situation. This is bad process.

Fax machines are kept in unmonitored rooms - that's dangerous. A security risk yes, but how is an unmonitored fax machine dangerous? A fax is effectively a low resolution printer with a phone line.

Fax machine numbers change without notice - that's dangerous. Fax machines don't just change numbers. Someone has to move it to a different phone line or arrange for the number to be changed. I'm not aware of any fax machine having the ability to spontaneously send a fax to BT asking for its number to be changed - not until AI is rolled out.

[Little Mouse]

Re: Dangerous

"Most hospitals won't even confirm receipt of a fax. If you're trying to refer a patient, that's dangerous."

*This*

Been a victim of this myself, 5 years ago. Couldn't believe that a) they were still using (and relying on) faxes and b) that there was no checking whatsoever that the fax had been received. No formal handover of the patient's notes at all.

I eventually got my heart scan months later after a second, successful, referral attempt (which only happened after I actively chased it down) and it came back good news. It still concerns me now that others may not have been so lucky, and for such a stupid reason.

[S Betts]

Re: Dangerous

From my experience earlier this year the process is now something like: referral is sent to NHS fax and a confirmation of receipt received. Referral is lost. Referral is re-sent, confirmation received, and immediately followed up by a phone call to ensure someone has picked the fax up off the machine. Confirmation of receipt verbally obtained.

Fax is then scanned into NHS systems......

[DropBear]

Re: Dangerous

"Drop bears are downright savage, I barely escaped with my life."

...it's so nice to feel respected...

[Prst. V.Jeltz]

fax facts-based tale of tech support terror?

Yes , ive dealt with a few hundred fax machine calls 99% of the time nothing is broken.

People dont know its a phone - you can ring it to check if its awake.

"I didnt recive a fax" - 99% of the time - they didnt send it

"I cant send a fax" 99% of the time , you are sending to wrong number , oir recipient has swithced off machine

[DuncanLarge]

Re: Dangerous

"Insecure maybe"

How are they insecure?

Intercepting a FAX is vastly more difficult these days than intercepting an email, or grabbing the entire mail server with access to all emails ever sent and received.

I'd have to tap into phone lines, digital multiplexed ones at that. Back in the day it was easier when phone lines were analogue and phreakers could commandeer a line by blowing a special kazoo made from a comb and paper.

I've always been concerned with people thinking that email replaces fax. Lol, how cant it? Its not used because people are lazy. Its used because email was never designed to replace fax, is terribly insecure and unreliable. Today I WOULD NOT email a scan, certainly a colour one of any of my ID documents to a solicitor. I once had to, and it was crazy I had to.

The only thing that can replace fax is a fully implemented GPG/PGP email system with a correctly set up web of trust. This is why GPG/PGP was created, to implement just that.

People have to understand that Email is as secure as using a postcard, and was never designed to be more secure as that. So I really hope for everyone's medical privacy that the nhs.net system that will be used to replace the fax machines has been designed to do so i.e uses some form of email encryption with signatures.

[Charlie Spalton]

Re: Dangerous

Email security is actually much worse than a postcard. It's like a postcard where at every step through the postal system it is a copy of the postcard that is sent to the next step in the chain, and the only assurance that you have that each stage isn't retaining a copy for itself is a gentleman's agreement, or a promise to not "be evil", which is utterly meaningless in this instance.

[hammarbtyp]

Re: Dangerous

"Intercepting a FAX is vastly more difficult these days than intercepting an email, or grabbing the entire mail server with access to all emails ever sent and received."

I've rarely see an email left in plain site because no one has looked at the email server for a week

[J.G.Harston]

Re: Dangerous

That's why they're moving to emails within nhs.net, so they're never seen or processed by the outside world. Any flaws in the email process are then entirely internal.

[Daniel von Asmuth]

Re: Dangerous

"but we simply cannot afford to continue living in the dark ages," said chief digital and information officer Richard Corbridge.

If fax machines are dangerous, then what about the danger of hospitals not being able to share information?

Presumably, the fax machines being but small fry, Britain simply cannot afford public health care anymore. Is that because all the money they spend on IT?

[Anonymous Coward]

Re: Dangerous

Presumably, the fax machines being but small fry, Britain simply cannot afford public health care anymore. Is that because all the money they spend on IT?

No, it's because we have a free health service, a population that is both rising fast and ageing, because the medical supply chain have come up with a panoply of (often) very good technologies and therapies that they wish to be paid for, and because successive governments of all persuasions have chosen not to raise taxes to pay for it.

[Nick Kew]

@Ledswinger

... and because we have a monumentally bureaucratic and inefficient system. Not to mention one whose priorities are horribly warped (no link because story of victim killed by NHS warped process has no writeup available).

[martinusher]

Re: Dangerous

Faxes might be old, slow and clunky but combined with an old fashioned POTS system they're at least secure.

[Allan George Dyer]

Re: Dangerous

@martinusher - Secure? Hardly, they are unencrypted and can be intercepted anywhere along the POTS wires. Someone with the motivation could hook up a small device to record every incoming and outgoing fax.

In comparison with plain email, then you're only exposed to attackers who can access the wires, not everyone on the internet. In comparison to end-to-end encrypted email, then the email is a lot more resistant to attack.

[Happy_Jack]

Re: Dangerous

He was probably thinking of shredders. They are easily confused with fax machines. It's easy to see the dangers of trying to send bum pics by sitting on a shredder.

[TRT]

But... but...

How do they expect to transfer clinical data in and out of the trust?

[katrinab]

Re: But... but...

Print out the document

Scan to email

Forward the email to the recipient's secretary

It gets printed out and placed on the recipient's desk

[DuncanLarge]

Re: But... but...

"Print out the document

Scan to email

Forward the email to the recipient's secretary

It gets printed out and placed on the recipient's desk"

You missed a critical step: before forwarding the email, encrypt it and then sign it using the recipents public key. You were going to encrypt the very secret and personal scanned copy of a patients data wernt you?

[LeahroyNake]

Re: But... but...

Modern copiers with a fax can usually forward received fax to email. The sender gets a delivery receipt and the receiver doesn't have to print all the spam.

Sending a fax with a decent copier without printing it first, install the fax driver click print enter the phone number click ok done. You get a delivery report etc.

Saves paper I spose :) hope the phone lines are not too expensive.

[katrinab]

Re: But... but...

The sender and recipient are on the same Exchange Server. Is that going to make any practical difference?

[Mark 85]

Re: But... but...

In the distant past it was print and snail mail or print and courier. We've traded speed for security. Speed is faster, security not as good.

[Anonymous Coward]

Easy for internal

Instead of faxing a document, simply scan it in and print it to a remote printer.

You no longer need a phone book, but do have a list of 340 printers to choose from each time you print.

[AMBxx]

Re: Easy for internal

And who confirms receipt? How do you know there's paper? what happens when they move the printer?

[Primus Secundus Tertius]

Re: Easy for internal

It is fairly certain that a fax has reached the destination machine. The feedback is instantaneous, whereas an email bounce can take days.

What is not so certain is where it goes after it has reached the far machine.

[Cynic_999]

Re: Easy for internal

"

And who confirms receipt? How do you know there's paper? what happens when they move the printer?

"

You could say exactly the same about emails sent to a staff member who is on extended holiday or has left the NHS.

It boils down to exactly the same thing - having a procedure in place that ensures that such things are dealt with appropriately.

[katrinab]

Re: Easy for internal

Way more than 340. There's 9000 in hospitals alone, then you have all the GP surgeries and so on. The NHS is the world's largest purchaser of fax machines.

[Mark 85]

Re: Easy for internal

A good solution and one of many in the comments. Doctors are not techies. Many can barely use a computer much less anything else tech related. Change for them is hard in this area even if they're keeping abreast of the latest medical publications (which they prefer to be paper based). It's going to take the profession another decade or two before they catch up with the rest of the world.

[martinusher]

Re: Easy for internal

>Doctors are not techies. Many can barely use a computer....

Nah....in my world all the doctors' offices, pharmacies, hospitals and what-have-you are linked. Every office has a computer and patient records are updated in real time. (Personnel log into the system using their ID badge, the one that acts as a door key &tc.) X-rays turn up in consulting rooms faster than it takes to limp down the corridor between the departments, prescriptions are ready before you get to the pharmacy -- yes, it really is possible.

This isn't the UK, though, but it could be -- I use a large HMO which is vertically integrated like the NHS. The UK will probably spend a few billions doing their own system, finding out it doesn't work, doing another system and so on rather than borrowing/licensing someone elses' code.)

The real reason why doctors don't use general purpose computers is -- in the US -- called "HIPPA". There's probably an English equivalent. We've come a long way from those halcyon days of the mid-80s where I was given a pile of floppies with database information to test some software -- live patient information (that was the UK). This data's supposed to be confidential.

[Shadow Systems]

Is this fake news?

Or have we been given just the fax, the whole fax, & nothing but the fax?

I'll get my coat... =-)p

[Ochib]

So have the NHS found another way of sending signed documents, with a method of proving that they have been send and received, to any number of third parties

[AMBxx]

Um, digital signatures for the last 20 years?

[Ochib]

The Electronic Signatures Directive (99/93/EC)

An electronic signature must be:

•uniquely linked to the signatory;

•capable of identifying the signatory;

•created using means that the signatory can maintain under his sole control;

•linked to the data in such a manner that any subsequent change of the data is detectable.

The most common methods of achieving this are to use cryptography (symmetric or asymmetric) technology .

So you will need a encryption system that all the parties agree to and can use. Or you use a fax

[Spazturtle]

"So you will need a encryption system that all the parties agree to and can use. "

You know you can sign emails with a digital certificate right?

"Or you use a fax"

And ensure the other person never sees the record all together as it gets lost?

[Allan George Dyer]

Ochib - "So you will need a encryption system that all the parties agree to and can use. Or you use a fax"

Yes, fax is so good at doing signatures. My standard method, when someone insists on me faxing a signed document, is to prepare the document in my wordprocessor, paste in my signature image and fax using my fax server. No-one has objected.

Fax fails on the 3rd and 4th requirements for electronic signatures that you quote. As soon as I have ever faxed a signed document to anyone, I no longer have sole control of the image. Image files are easily edited.

[Terry 6]

That being said, while I used fax a lot till recently, I used a scan of my signature on both media. (Faxes were more often than not documents printed on my MFD to fax and ma never have seen any paper)

[Anonymous Coward]

You have three options:

1. Place document on fax machine, type in extension number, send. ... Get receipt.

2. Place document on scanner, type in email address, send. ... Phone to check they got document (and confirm that pea-soup pdf filename from scanner's pea-soup email address is not Wannacry18).

3. Place document on scanner, scan. Walk to PC, open email, write "here's attached docs you asked for", remember not to click send, browse to network, attempt to find correct document with pea-soup filename on today's random network folder, now send. Delete file on network drive so not everyone can read it.

Yes, I'd pick #1 any day of the week, or night of the weekend for that matter.

[ButlerInstitute]

4. Walk to scanner/copier.

Use your Id card to log-in to it.

Put physical documents in scanner and hit Scan button.

Take physical documents off scanner.

Go back to your desk and find that the scans have been emailed to you.

No network drives involved. Scans have come straight to you (could have been encrypted if so configured). Activity may have been recorded in a log somewhere.

[Spazturtle]

1) Take digital x-ray, print it out and the fax it, ring up in 2 weeks time to check they actually looked at it..

2} Take digital x-ray, it's automatically added to the patients digital records, if anything looks odd the x-ray technician can add a flag to notify the doctor.

Yeah I'd pick #2 any day of the week.

Most of what is being faxed is already on the computers.

[tin 2]

nobody faxes digital x-rays. They are too low resolution after faxing to be of any use.

[Fred Dibnah]

The radiography department's Christmas party might generate a few.

[Spazturtle]

It being usable or not is a moot point, if fax is the tool provided and somebody is told to send an x-ray to a doctor in another hospital then it will get faxed over and the person can say that they sent it over. When I moved from down south my old hospital faxed over my medical records including OCT scans, which are completely un-usable so the doctors at the hospital I now go to had to do all the scans again.

[bazza]

nobody faxes digital x-rays. They are too low resolution after faxing to be of any use.

That depends. I reckon that'd be fine for me, there's not much inner detail to see... Funny bone? Check. Brain absent? Check. Especially on Mondays. Summary? Nearly functional human being. Prescription: tea. Lots of it.

[Terry 6]

No. No one says you don't have email as well or that you shouldn't replace fax machines over time. as they fail. Images from high tech devices get emailed or transferred electronically. Letters to a named person get faxed. Perhaps from a printer. But while the fax works, is secure and the information pops up on someone's desk it may be better than being in a list of 500+ email messages about everything from trust directives about the latest changes in curtain material to arrangements for Doreen's hen night.

But to spend money replacing functioning fax machines wholesale is a different matter.

The newest and latest tech doesn't have to be adopted immediately just because you can.

[tin 2]

and on the recieving end...

(1) walk into office, jobs are on the printer tray of the fax, in a pile, no matter what time of day they were sent, take the next one, go do.

(2) walk into office, boot computer, sign in to any number of systems, open email, identify job emails, print each one via whatever convoluted how to find the printer system, then start from above.

[SkippyBing]

Re: and on the recieving end...

'(2) walk into office, boot computer, sign in to any number of systems, open email, identify job emails, print each one via whatever convoluted how to find the printer system, then start from above.'

Why do you have to find the printer? My work computer remembers which printers I've used from one day to the next.

[vtcodger]

"Yes, I'd pick #1 any day of the week, or night of the weekend for that matter."

Not anymore you won't, Luddite trash!!!

We don't take kindly to your sort in this century.

Take your outdated technology and get the hence. ... And don't come back.

(Actually we scrapped our fax machine a couple of years ago. If wasn't working very well. ... But I have a USB fax modem stashed in a drawer just in case.)

[SkippyBing]

'1. Place document on fax machine, type in extension number, send. ... Get receipt.'

You've got a receipt saying a fax machine has received your fax. Brilliant. It's now sat in a tray with whatever anyone else has sent to that number. With an email delivery/read receipt you have a receipt saying the right person has your message and even if they've read it.

[Anonymous Coward]

Not a chance!

I have delivery / read receipts turned off. They’re simply unnecessary network noise.

[hammarbtyp]

"1. Place document on fax machine, type in extension number, send. ... Get receipt."

Put document on fax, send

Realize that you put the document in the wrong way

Send again - phone engaged, realise you have sent it to the wrong number

Send again - fax stops halfway

Send again - get receipt

Fax fails to to get received because toner/paper out

Send again - fax sits on receiver in try until cleaner comes and throws it in the bin

Send again - fax gets picked up, but internal mail goes to HR rather than finance

Put in envelope and send it by snail mail

"Yes, I'd pick #1 any day of the week, or night of the weekend for that "

[Anonymous Coward]

We have two fax machines

They are connected to their own dedicated phone lines (not even via the internal phone system). It's been like this for at least 5 years, I don't think I've seen either of them used.

They are there as a contingency as part of our civil contingency requirements.

It's all well and good to scoff about it, but frankly if e-mail or the network goes down and we need a list of medication/allergies/medication personally I'd rather they had some way of doing it quickly than none at all because "security".

I'm not saying they should be common, but to completely remove them may be a step too far.

[katrinab]

Re: We have two fax machines

We have a big fax / scanner / copier thing. About a year ago, the phb asked for it to be moved to the other side of his office door. Since then, it has not been plugged into the phone socket, and nobody has noticed.

[Anonymous Coward]

Re: We have two fax machines

Is there not an issue with the loss of the older analogue phones here? I didn't think the the more modern IP based phone network functioned for civil contingencies.

[vtcodger]

Re: We have two fax machines

It depends? We have dsl at our house and fax did work. For that matter I tried a 32K analog modem connection over the phone line with the dsl filters in place just to see if it would work. Rather to my surprise, it did.

[Anonymous Coward]

@vtcodger

The DSL filters don't affect the ability of an analog landline to work exactly like it always has, and given that your 32K modem worked fine I'm assuming you still have a traditional landline to go with your DSL.

What he was talking about was VOIP technologies, most of which won't pass a fax. Some can recognize a fax/modem connection and change to a different format that will allow it, others can be set to a higher bit rate with less/no compression.

[vtcodger]

Re: @vtcodger

You're correct, it's twisted pair all the way to the house. I know because the street construction guys severed it -- twice -- while rebuilding the street a couple of years ago. I had reason to look into how the US POTS telephone network works once. Robbed Bit Signaling and stuff like that. I'm amazed that the system works at all, much less well. But for the most part if does seem to work pretty well except for some pathological cases.

[Anonymous Coward]

Re: We have two fax machines

Is there not an issue with the loss of the older analogue phones here? I didn't think the the more modern IP based phone network functioned for civil contingencies

It depends. Some countries class their telephone and data networks as critical national infrastructure, and demand companies have engineering plans to suit all contingencies up to and possibly to some extent including nuclear attack.

[SGJ]

I do some work for a local football club and during a recent audit of their telephone lines queried the presence of a fax machine which had been used twice in the last three months. I was told that having a fax machine was a Football League requirment as certain documents had to be faxed (plus multiple copies sent by post)!

[Anonymous Coward]

Remember that the only reason David de Gea is still at ManU and didn't move to Real Madrid 3-4 years ago was that 10 minutes before the trasnsfer deadline they discovered that their fax machine didn't work and they couldn't get the transfer registered

[Aladdin Sane]

Damn it feels good

to be a gangsta.

[SminkyBazzA]

Re: Damn it feels good

That was a printer wasn't it?

[Aladdin Sane]

Re: Damn it feels good

What was a printer?

[Anonymous Coward]

digital signatures

A person wishing to have a digital signature may register with one of a number of regulated providers of advanced signature services. The registration process requires passport and driving license details to be inserted and an annual fee to be paid (in the region of £50). This generates a certificate, which is recognized by software such as Adobe and Outlook, that a signatory can insert into a document digitally in preference to physically signing it.

So to work out how much this will cost, you need to multiply the number of NHS staff who need to send a signed document by £50 for the each year

There are approx. 106,430 doctors and 21,597 midwives employed by the NHS, so a back of the fag packet calculation that's a cost of £6,401,350 per year, that not counting the lab staff etc who also send faxes out

[Spazturtle]

Re: digital signatures

OR the NHS can just provision their own certificates like any medium - large business would do.

[katrinab]

Re: digital signatures

The NHS could set up their own certification authority, and the probably already have.

[TechDrone]

Re: digital signatures

Or free if all you want is a certificate for a given email. Any organization can set up a certified email solution for not a huge amount of money, or buy it in as a managed service. Even Exchange could handle it the last time I looked.

My guess is you'll probably spend more in the first year training staff how to use it and making sure they can read email on all authorised devices than the cost of the certs themselves.

Maybe if the NHS did go for certified email by default it might help the idea catch on?

[hammarbtyp]

Time travel optional?

Soliciter - "Can you fax the document"

Me "faxes don't work here"

Soliciter "Why where are you?"

Me "In 2018"

[JimmyPage]

One word missing from the entire article.

And that's "patient".

As an NHS patient, I'd rather have the option to have EVERYTHING emailed to me, (would certainly help when they misplace my records) way before this tomfoolery.

[Anonymous Coward]

Re: One word missing from the entire article.

Here in the USA, my health provider (Kaiser Permanente) sends me emails that consist essentially of a https:// link to the place on their secure website (user handle and password required) where the referenced data or message resides. I can print it or download it if I choose to.

That is one way to make email secure.

All my lab tests, images and scans, and doctors' notes of exams for the last 10 years or so are online (password protected), for me and the doctors and nurses to look at.

[Allan George Dyer]

Re: One word missing from the entire article.

@AC - "sends me emails that consist essentially of a https:// link to the place on their secure website (user handle and password required)"

This explains the amount of phishing emails containing links to fake login pages.

"online (password protected)" - We all know how good people are at choosing and remembering passwords.

"Axe the Fax" focusses on a symptom, not the problem of efficient, secure communication.

[DarkLordofSurrey]

The use of nhs.net is far more secure and safe than the use of faxes.

Hmm how many wannacry problems were caused by fax machines?

[fedoraman]

.....and in 2020, we're rolling out

Prestel!

[Primus Secundus Tertius]

Patient use

In her later years my mother was very deaf, and the telephone therefore useless (she could not even hear it ring). She was too old to adapt to computers, although as a young civil servant she had been the only one in the office who could operate the telex machine.

A fax machine worked brilliantly for her, to keep in touch with family, the doctor's surgery, and the social services.

[Jeffrey Nonken]

Re: Patient use

efax.com

[spold]

Therapeutic

I'm sure a real axe could be very therapeutic in this exercise.

I worked with a client that would lock all the old hard drives up in a safe and then once a year take the security team out for a beer and then let them loose on the hard drives with some hammers. Makes secure destruction much more fun (de-gauss them first if you want just don't tell anyone - makes them feel useful).

I'me sure fax works similarly - hammers/axes out - yell "you are so faxing ****ed" <bang> <bang> <bang>".

[Anonymous Coward]

Oh dear

We're all laughing about the fax machines in use, but it will mean things are worse.

I'm getting great treatment from the Leeds Teaching Hospitals at the moment, but all of the medical staff are hampered by crap tools and processes.

I've had my diagnosis, and the hospital wanted my GP to know as its fairly serious. The consultant dictated a letter, this letter was then in the typing queue for about 8 weeks, which was then POSTED to my GP surgery, who put it in their scanning queue for two weeks, then scanned it. All my GP sees is that there is a scanned letter there, and has to open it and read it in front of me.

Basically 11 weeks to get the critical information from my consultant to the GP.

This is Leeds Teaching Hospital process if you don't have a fax number...

[Anonymous Coward]

Re: Oh dear

Your NHS Trust needs a few kicks where it hurts.

My one seems to be miles ahead of yours.

My GP sees all my records from the Hospital (in remission from the big C) and vice versa. Saves a lot of time, effort and money (no duplicate Blood Tests.

[Mark 85]

Re: Oh dear

Here in the States, my doctors use the tech. Patient records are in a central repository (mychart, I think). Yet, every office has a fax machine because some doctors don't use the computer and hand over their chart notes to a secretary. When he/she gets around to it, the chart notes get entered. The nice part is that patients and medical staff have access when needed.

[DuncanLarge]

So they managed to figure out how to replace a fax machine properly? I hope so

I've always been concerned with people thinking that email replaces fax. Lol, how cant it? Its not used because people are lazy. Its used because email was never designed to replace fax, is terribly insecure and unreliable. Today I WOULD NOT email a scan, certainly a colour one of any of my ID documents to a solicitor. I once had to, and it was crazy I had to.

The only thing that can replace fax is a fully implemented GPG/PGP email system with a correctly set up web of trust. This is why GPG/PGP was created, to implement just that.

People have to understand that Email is as secure as using a postcard, and was never designed to be more secure as that. So I really hope for everyone's medical privacy that the nhs.net system that will be used to replace the fax machines has been designed to do so i.e uses some form of email encryption with signatures.

[jms222]

It's all true

I've had to get my G.P. to fax a referral through to the hospital before. The system is shit.

Similarly the "electronic" prescription service seems to delay prescriptions by whole days.

Where the surgery have emailed me letters _they_ sent they are scans of prints.

In order to get a prescription waiver card you get a form from the chemist, take it to the G.P. (who actually issues the prescriptions to the chemist) then send it off then get a card through the post which you take back to the chemist. It's as if they're on a mission to waste as much taxpayers' money as possible.

[Cynic_999]

Fax machines are inherently more secure that t'internet

It is highly difficult to hack into a fax machine (you have to physically cut the line - you cannot "T" into a fax communication because it's bidirectional with the same frequencies used on both sides so you usually have to insert a hybrid in-line to separate Tx from Rx), and it is impossible to do so from outside the country.

And if you do manage to hack the machine, you'll only get the real-time faxes sent to & from that particular machine from that time on, not a database of the past 10 years' email correspondence from all users on the server.

All the security and reliability issues mentioned are due to failings in the way faxes are used and is no different to Internet based communications. Yes, an unattended fax machine is a security risk. So is an unattended logged-in terminal, or an unattended printer or an unattended filing cabinet. And if the fax does not get to the person it is supposed to get to, that's a failing of the way it is managed, not the fax. Exactly the same can happen to an email (or snail-mail) - e.g. when the recipient has left or away on holiday, or when they delete your email without reading because it's buried amongst last night's spam, or when it is sent to the wrong email address and not forwarded to the correct person. Or when the email server crashes after receiving the email and gets restored using last weeks' backups.

The fax machine sends back confirmation that the fax was correctly received and printed which works 99% of the time (if it is out of paper or has a mechanical jam it will send back an error to the originating machine, but a few other failures can occur that result in an "OK" response with nothing printed). It cannot confirm that anyone bothered reading the fax, any more than your email receipt confirmation means that anyone actually read the contents of your email rather than e.g. the confirmation being automatically generated by a computer running an email client behind an empty desk (which like the fax, would be a problem with the configuration and/or policy, not emails in general).

[Alan Hope]

Fax or Whatsapp?

Fax or Whatsapp ... which is best for sending a copy of an ECG when a copy is requested as part of an urgent referral to specialists at another NHS hospital? Hard copy by drone? Scanned photo as email attachment? Before you brag about "axing the fax" define the alternatives and tell us all why a fax is any worse / less secure / less reliable.

[Anonymous Coward]

The basics

The basic facts are that fax is insecure and unreliable.

Forget about intercepting the transmission, it's the fact that an open to view hard copy document automatically prints out in a room where anyone could see it.

It's no different to throwing your patient notes in through an open window.

Or do you have the fax in a secure room that only authorised staff have access to? Good use of estate there.

Fax needs to die.

Anything it does can be replaced by email, including signatures.

[Alan Hope]

Re: The basics

Hard copy ECG to be sent.

1. Fax in Drs Office, to Fax in receiving Drs Office

2. Scanner in Drs office, into computer in Drs office, image attached to email message, sent to receiving Drs office, printed on printer in receiving Drs Office.

Ah, yes, that's so much better!

[Peter Clarke 1]

Faxes- the Truth

If you think faxes aren't dangerous wait until you get your tie caught in the roller

[Dante Alighieri]

I find the article a little odd.

It is as though Leeds is the first hospital in the UK to think of doing this.

Mine a bit further north has already ripped them all out. perhaps Leeds should ask for advice rather than pretend to be an authority.

We accept radiology referrals from consultant NHS.net accounts - it is an electronic signature in its own right, for those based outside our organisation. Internally we have a request system which you can use or be told to resubmit your scrap of paper electronically. Almost completely paperless referrals now.

Re fax ct scans etc - you can email/scan/fax a report - the images not so much.

It's my day job.

[Herby]

Scanning??

You might want to be careful here. Some scanners attempt to do OCR on the text to make things "better" and screw it up sometimes.

This was documented in a story a while ago (1-2 years?). I think the brand was Xerox, but I'm not sure.

Somehow the "paperless" office is a long way off.

I will admit that they are getting closer. My MD has a computer in the exam room to do all the silly stuff (record vitals, enter prescriptions). I get emails telling me to log in and read the "secure" messages. Still paper is a fact of life!

[Winkypop]

Hey guys!

Can any of you with a fax machine fax me over a few blank pages, I'm running low on paper.....

[mark l 2]

Where as the widespread use of fax machines seems inefficient within the NHS, do do feel that some of the fax machines need to be kept in place for contingency. As if they get any other wannacy style outbreak that downs their IT infrastructure. I would rather then were still able to send hard copy of documents using faxes than go back to relying on snail mail.

What I haven't got my head around with faxes is the amount of people who still require something to be printed out, signed and faxed back to them. (or scanned and emailed).

I don't get how a signature that hasn't be notarized or even witness by someone and is then sent through fax or email could every hold up in court as actually being officially agreed to. Heck no two of my signatures ever look alike as I hardly ever need to sign my name any more and I forget what I did it like the previous time.

[GingerOne]

Courts

Courts in the UK will only accept documents via fax, not email.

Fax is more secure than email. Fax is not 'dangerous' (although processes maybe).

As others have said, a modern multifunction device with a modern fax system means the process is entirely paperless and very secure.

[Jame_s]

delivery

i was staying in a hotel for a nearby convention. the hotel desk delivered a printed out fax in an envelope to my room that turned out to be patient notes for a doctor with the same name in another room.

so much for HIPAA.

[Toni the terrible]

FAx?

I dont know, last time a bought a multifunction A3 printer scanner it had a fax function built in. Just in case you see, for contacting solicitors/doctors - never used the function in years.