Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Why does American medicine still run on fax machines?

vox.com

Post reply on HN
Print view View original

41–50 of 53 posts

Re: Why does American medicine still run on fax machines?

#41

Post by dx034 »

tryingagainbro wrote: post #33
Taniwha wrote: post #8

And so insecure too, my fax machine's number used to be 1 digit off from a pharmacy's .... I used to get more faxes of other people's private prescriptions than genuine faxes intended for me

Point taken, but given the hacks I'm almost certain that while fax machines are insecure, at least the damage is very limited /targeted. Now just imagine an EquiHealth hack...AIDs diagnoses, other STD, infertility, etc etc records out there--forever.

You're being downvoted but I think you have a point. A lot of the old tech is not secure per-se but doesn't concentrate data in one system. Most newer systems have a single point from where you can access all data. If Equifax had been based on paper and Fax, no one would've been able to steal 150mn records.

Re: Why does American medicine still run on fax machines?

#42

Post by lostboys67 »

alkonaut wrote: post #38
mamon wrote: post #35

Earlier quoted context omitted.

America's infrastructure is behind other developed countries because once upon a time it was AHEAD of it's time. When you have a legacy infrastructure that is good enough it is harder to justify the cost of replacing it with something else. African countries, or Eastern European ones didn't have this dillema because they didn't have a legacy infrastructure to deal with.

All western countries had faxes, magnetic strip cards, paper check payments, etc. And most of them have no traces of that. I think there must be some other element to it as well, and it's probably not only "well US is big". I think one is the diversity of states and companies. Having tons of systems and businesses communicating over several state borders with varying regulations, it's very easy to just settle with th…

Chip and pin was also about pushing the liability onto the consumer

Re: Why does American medicine still run on fax machines?

#43

Post by lostboys67 »

mcpherrinm wrote: post #11
interfixus wrote: post #9

> The clinic has digitized its own patient data. But its electronic system can’t connect with other clinics’ records. So when doctors want to retrieve records from another office — an ultrasound for a pregnant patient, for example — they have to turn to the fax Haven't these people at least heard of email?

They've heard of it, but aren't going to use it. Email is generally not encrypted when stored at rest in many hops along the way, which should be considered insecure. While fax is unencrypted, it's generally not stored in any intermediate systems and has established history of being considered HIPAA compliant.

And set up properly Fax's can provide proof of delivery

Re: Why does American medicine still run on fax machines?

#44

Post by alkonaut »

lostboys67 wrote: post #42
alkonaut wrote: post #38

Earlier quoted context omitted.

All western countries had faxes, magnetic strip cards, paper check payments, etc. And most of them have no traces of that. I think there must be some other element to it as well, and it's probably not only "well US is big". I think one is the diversity of states and companies. Having tons of systems and businesses communicating over several state borders with varying regulations, it's very easy to just settle with th…

Chip and pin was also about pushing the liability onto the consumer

I never heard any discussion about liability difference in the EU.

Now: before chip + pin the cards were magnetic strip + pin. I never had a pin-less card. Perhaps that is a difference?

Re: Why does American medicine still run on fax machines?

#45

Post by lostboys67 »

interfixus wrote: post #10
frik wrote: post #6

What should they use instead? Email isn't secure enough. Email got not forced TLS/GPG upgrade (compared to the web's HTTPS)

Email is roughly as secure as you care to make it. Better than stupid phone lines at least.

Much easier to hack say the DCI's mail account than say tap his phone line eh :-)

Re: Why does American medicine still run on fax machines?

#46

Post by lloeki »

mamon wrote: post #35
grecy wrote: post #34

America's infrastructure is behind in many ways. Bank transfers are arcane, no chip n pin, fax machines, etc. etc. I'm moving through West Africa, where these problems have been solved 2+ years ago.

America's infrastructure is behind other developed countries because once upon a time it was AHEAD of it's time. When you have a legacy infrastructure that is good enough it is harder to justify the cost of replacing it with something else. African countries, or Eastern European ones didn't have this dillema because they didn't have a legacy infrastructure to deal with.

> America's infrastructure is behind other developed countries because once upon a time it was AHEAD of it's time

This is ludicrous. Look at this timeline[0]:

    2008 SEPA pan-European payment instruments become operational (parallel to domestic instruments)
    2010 SEPA payments become dominant form of electronic payments
    2011 SEPA payments replace national payments in the Eurozone
    2014 SEPA becomes fully operational in all Eurozone countries.
    2017 Instant SEPA payments of up to 15,000 euros within 10 seconds, starting 21 November
And that's not counting national norms like RIB[1] that have allowed for trivial domestic next-day transfers since even before I opened my first bank account like 20 years ago. Same goes for chip and pin, which was basically ubiquitous even then. Now NFC payment terminals have basically been deployed everywhere over here across a couple of years, which means things like Apple Pay just works (and Android Pay if Google cared enough about non-US/UK/Canada/Australia markets).

So the argument is "US was so advanced multiple decades ago that it rather stood still despite massive inconveniences to the end user". Breaking news: it wasn't ahead of its time at all even 20 years ago, and free market competition didn't do squat to make the situation change; policies enacted in the interest of the consumer do.

[0]: https://en.wikipedia.org/wiki/Single_Euro_Payments_Area

[1]: https://fr.wikipedia.org/wiki/Basic_Bank_Account_Number#Le_t...

Re: Why does American medicine still run on fax machines?

#47

Post by PragmaticPost »

Most modern copiers have the ability to encrypt PDF files. The password is the problem. There are also some email providers who serve healthcare that offer security that abides by HIPAA rules. The solution is there. It's mandating a standard that facilitates the flow of data that is not.

Re: Why does American medicine still run on fax machines?

#48

Post by chaz6 »

forapurpose wrote: post #4

How else would they be transferred? E-mail isn't secure enough. Perhaps a partial answer to the question is, 'because the IT industry hasn't provided the world with a secure, widespread, public communication medium" (by public, I mean one not controlled by a private company). The IT industry gets a lot of praise, but there are a lot of gaps in performance that we have become accustomed to overlooking.

A common method used in the UK is EDI (electronic data interchange).

Re: Why does American medicine still run on fax machines?

#49

Post by tryingagainbro »

dx034 wrote: post #41
tryingagainbro wrote: post #33

Earlier quoted context omitted.

Point taken, but given the hacks I'm almost certain that while fax machines are insecure, at least the damage is very limited /targeted. Now just imagine an EquiHealth hack...AIDs diagnoses, other STD, infertility, etc etc records out there--forever.

You're being downvoted but I think you have a point. A lot of the old tech is not secure per-se but doesn't concentrate data in one system. Most newer systems have a single point from where you can access all data. If Equifax had been based on paper and Fax, no one would've been able to steal 150mn records.

I don't care about downvotes. Most of the time I don't write a lot so most is left to be processed. So, many times, even if I'm right, I could downvotes for that ;).

But yeah, since we can't secure anything connected to the internet (a lot of big boys got hacked) or to a central db, we have to go to plan B.

Post reply on HN