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The Fax Is Not Yet Obsolete

theatlantic.com

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Re: The Fax Is Not Yet Obsolete

#61

Post by askvictor »

cknight wrote: post #49

IT Manager of a large medical centre in Australia here. I've been spending quite a lot of time trying to minimise the number of faxes we send and receive but there's only so far I can go. Email and fax-to-email services are generally frowned upon by the relevant medical accreditation boards, as they consider these to be insecure unless PGP is used. Email addresses have the ease of use and interoperability that fax nu…

I wonder how this squares with the NBN, given that, once activated, the traditional phone line ceases to exist, and you use VoIP instead. And that the POTS will be entirely deactivated (in theory) once rollout is complete.

Re: The Fax Is Not Yet Obsolete

#62

Post by Zak »

Spooky23 wrote: post #47
codingdave wrote: post #24

Back when I first started working in tech, in the early 90s, up to when I left enterprise IT in 2011, email-to-fax gateways were a thing. You just emailed a specific address format, something like: 999-999-9999@your.fax.gateway, and the email server would send an image of the email and attached documents to that number, via a connected fax machine. Likewise, incoming faxes to your number were received as images in an…

Inane bureaucracy and primadonna users make change difficult. Doctors can’t be bothered doing anything differently, and they often don’t work for the place they are providing service at, and don’t have reliable access to email. As doctors get swallowed up by medical networks/cartels, fax will shift to EMRs and patient portals that will leave you wishing for a fax machine.

> Doctors often don’t have reliable access to email.

Why? It would be very unusual for a doctor in a wealthy country not to have a smartphone with service, or the ability to get one.

Re: The Fax Is Not Yet Obsolete

#63

Post by Zak »

mrweasel wrote: post #53

If someone was to build a device that could clamp on to the phone line and listen for incoming faxes and copy the signal and sent it of to a remote server, would that force us to rethink the use of faxes? Sadly I think the answer is no. One argument that could be made for the fax is the lack of availability. Some government office in Denmark have been known to email sensitive information to wrong email addresses, bec…

Another user in this thread has a phone number one digit off from the fax number of a medical service provider and does, in fact get confidential information faxed by mistake on a regular basis.

https://news.ycombinator.com/item?id=18483673

Re: The Fax Is Not Yet Obsolete

#64

Post by walterbell »

Zak wrote: post #60
walterbell wrote: post #56

Earlier quoted context omitted.

IETF is working on a protocol for interoperable E2E encrypted messaging, https://datatracker.ietf.org/wg/mls/about/

That's cool and all, but it seems to me this is more a problem of user adoption than technology. PGP provided a pretty good solution for end-to-end encrypted messaging, and a whole bunch of people who should really be adopting that solution are using fax machines.

Cisco, Google, Facebook, Apple and others are participating in MLS. The scale of messenger adoption is already much larger than PGP ever achieved, but they are not yet interoperable (like fax) with strong E2E encryption.

Re: The Fax Is Not Yet Obsolete

#65

Post by epochwolf »

Zak wrote: post #62
Spooky23 wrote: post #47

Earlier quoted context omitted.

Inane bureaucracy and primadonna users make change difficult. Doctors can’t be bothered doing anything differently, and they often don’t work for the place they are providing service at, and don’t have reliable access to email. As doctors get swallowed up by medical networks/cartels, fax will shift to EMRs and patient portals that will leave you wishing for a fax machine.

> Doctors often don’t have reliable access to email. Why? It would be very unusual for a doctor in a wealthy country not to have a smartphone with service, or the ability to get one.

HIPAA requires any email with patient data be encrypted. That kills any attempt to receive email on a smart phone.

Re: The Fax Is Not Yet Obsolete

#66

Post by Zak »

walterbell wrote: post #64
Zak wrote: post #60

Earlier quoted context omitted.

That's cool and all, but it seems to me this is more a problem of user adoption than technology. PGP provided a pretty good solution for end-to-end encrypted messaging, and a whole bunch of people who should really be adopting that solution are using fax machines.

Cisco, Google, Facebook, Apple and others are participating in MLS. The scale of messenger adoption is already much larger than PGP ever achieved, but they are not yet interoperable (like fax) with strong E2E encryption.

Participating in the creation of a standard doesn't always lead to integration into end-user products, but we can hope.

Re: The Fax Is Not Yet Obsolete

#67

Post by cknight »

askvictor wrote: post #61
cknight wrote: post #49

IT Manager of a large medical centre in Australia here. I've been spending quite a lot of time trying to minimise the number of faxes we send and receive but there's only so far I can go. Email and fax-to-email services are generally frowned upon by the relevant medical accreditation boards, as they consider these to be insecure unless PGP is used. Email addresses have the ease of use and interoperability that fax nu…

I wonder how this squares with the NBN, given that, once activated, the traditional phone line ceases to exist, and you use VoIP instead. And that the POTS will be entirely deactivated (in theory) once rollout is complete.

All our fax machines are already using Cisco ATAs to connect to our VoIP system anyway. Only problem I've ever had with that aspect was a dud ATA.

I know many practices use eFax though, even though it uses email and hence is against accreditation standards. Small one- or two-practitioner clinics don't have the means to trudge through the RACGP's information security standards like we do.

I did trial a local Australian eFax competitor who offered a fax-to-my-server-via-SFTP method, and was accredited with several government health agencies. The PDF image quality sucked so badly though, I couldn't run with it. Illegible. Even if it worked well though, it's still just faxes as image files, which is painful. OCR doesn't look like it'd help much, even before you think about doctors handwriting.

I've got 30 practitioners and I need incoming messages to be directed to their respective inboxes in the practice management system so we don't all go crazy.

Re: The Fax Is Not Yet Obsolete

#68

Post by Zak »

epochwolf wrote: post #65
Zak wrote: post #62

Earlier quoted context omitted.

> Doctors often don’t have reliable access to email. Why? It would be very unusual for a doctor in a wealthy country not to have a smartphone with service, or the ability to get one.

HIPAA requires any email with patient data be encrypted. That kills any attempt to receive email on a smart phone.

[Repeat rant about people not adopting PGP when we've had it for 27 years]

Nothing about a smartphone prevents email from being encrypted. The fact that nobody's sending encrypted email does, but that's a user adoption problem rather than a technical problem. The technical problem is solved, solved well, and has been solved for decades.

Re: The Fax Is Not Yet Obsolete

#69

Post by viraptor »

cknight wrote: post #49

IT Manager of a large medical centre in Australia here. I've been spending quite a lot of time trying to minimise the number of faxes we send and receive but there's only so far I can go. Email and fax-to-email services are generally frowned upon by the relevant medical accreditation boards, as they consider these to be insecure unless PGP is used. Email addresses have the ease of use and interoperability that fax nu…

Doesn't Medical Objects try to end this insanity without email or fax involved? Or are they the ones with email+PGP in the background?

Re: The Fax Is Not Yet Obsolete

#70

Post by walterbell »

Zak wrote: post #66
walterbell wrote: post #64

Earlier quoted context omitted.

Cisco, Google, Facebook, Apple and others are participating in MLS. The scale of messenger adoption is already much larger than PGP ever achieved, but they are not yet interoperable (like fax) with strong E2E encryption.

Participating in the creation of a standard doesn't always lead to integration into end-user products, but we can hope.

Ubiquity is a goal, similar to WebRTC.

Both protocol availability and support in widely deployed messengers will be necessary. Key/identity management will need to pass regulatory/legal scrutiny, but once we have interoperable, multi-vendor encrypted messaging that is usable by mere mortals and globally available at low cost, various groups can start lobbying for regulations that encourage migration to MLS-enabled communication.

The other issue with digital messaging is endpoint security and message archives, after the message has been transported. A pile of faxes is not easily accessed remotely, unlike a disk with message archives.

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