FHIR Chat · Can FHIR fix this fax insanity? · social

Stream: social

Topic: Can FHIR fix this fax insanity?

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Dave deBronkart (Jul 13 2020 at 21:35):

New York Times today: Bottleneck for U.S. Coronavirus Response: The Fax Machine

Serious question: can we do anything about this? SANER / @Keith Boone ?

Grahame Grieve (Jul 13 2020 at 22:27):

actually, this is about case reporting rather than capacity reporting, and we already have the relevant standards pretty much in place. What this article is about is that adoption of the standards is lagging

Grahame Grieve (Jul 13 2020 at 22:28):

“There are standards that exist out there, but with the onslaught and the drastic increase in volume and the increase in the number of tests, they’re struggling to keep up,”

Grahame Grieve (Jul 13 2020 at 22:29):

Fun to see CDC play the 'no national identifier' card, as though that were the problem. I mean, it is a problem and a contributing factor but not the only one

Grahame Grieve (Jul 13 2020 at 22:31):

OTOH, since that's quoting Dr Frieden, and I know how the process works, he probably said exactly the right thing, and the reporting got it wrong, driven by (a) journalist not grasping the details (b) editorial staff wanting a simpler story and (c) underlying political messaging agendas around national identifiers

Keith Boone (Jul 14 2020 at 00:54):

image.png https://pbs.twimg.com/media/Ec2COD6XYAEJ13u?format=png&name=900x900

Brendan Keeler (Jul 14 2020 at 04:57):

@Grahame Grieve curious what fax usage is like in Australia.

From some brief googling, definitely seems like other countries struggle with it too

https://twitter.com/healthbjk/status/1282739649115381760?s=19

Grahame Grieve (Jul 14 2020 at 04:58):

yeah. we're up there too. the healthcare system still runs on faxing. It's insane at several levels, but it is what it is

Peter Jordan (Jul 14 2020 at 05:23):

The NZ Health & Disability Sector is aiming to phase out analogue fax machines by the end of 2020. Easier said than done, of course, and I'm not sure if COVID-19 will hasten their demise or not.

Dave deBronkart (Jul 14 2020 at 10:09):

Keith Boone said:

Maybe you should just use FHIR

LOL do I detect a wee bit of image editing there?

Dave deBronkart (Jul 14 2020 at 10:10):

Grahame Grieve said:

OTOH, since that's quoting Dr Frieden, and I know how the process works, he probably said exactly the right thing, and the reporting got it wrong, driven by (a) journalist not grasping the details (b) editorial staff wanting a simpler story and (c) underlying political messaging agendas around national identifiers

Ugh.

David Pyke (Jul 14 2020 at 13:02):

The electronic Case Reporting standard has been around for a long time, using Direct as the primary method of transfer. Recently Careconnect released their adoption of it so it is now able to be used more broadly (as soon as it's implemented). But as bad as faxing seems, it works, even if it requires retyping.

Brendan Keeler (Jul 17 2020 at 00:53):

The reliability of a ubiquitous solution beats the functional advantages of a technically superior one

Grahame Grieve (Jul 17 2020 at 01:28):

we should call that 'keeler's rule'

Dave deBronkart (Jul 17 2020 at 14:16):

Brendan Keeler said:

The reliability of a ubiquitous solution beats the functional advantages of a technically superior one

Careful what you mean by "reliability," eh? :slight_smile: Fax is SO undependable in so many ways.

I remember hearing last year about an auto repair shop that kept getting 30-page dumps of some patient's record because some fool had entered a speed-dial wrong and had never checked it before putting the number to use. Of course the actual doctor's office that WANTED the record kept calling and saying "We didn't get it" and so the fool just kept sending it again, instead of troubleshooting. And the auto repair shop obviously didn't appreciate it, but THEIR calls went unheeded.

Brendan Keeler (Jul 20 2020 at 04:38):

I can reliably assume that the fax is present in a doctor's office because of its ubiquity as a solution. The same cannot be said for technologically superior solutions today (Direct is widespread but not as widespread as fax)

Josh Mandel (Jul 20 2020 at 15:15):

And regular people aren't "trusted" to send a message via Direct; anyone can send a fax.

Josh Mandel (Jul 20 2020 at 15:16):

(This IMHO is us shooting ourselves in the foot with trust frameworks.)

Kevin Mayfield (Jul 20 2020 at 15:42):

Optimistic we will get significant change in the UK. We've lacked central standards for several things, we're seeing initial standardisation on a couple of them (as FHIR).... Hoping it's going to lead to a domino effect, fingers crossed.

Paul Church (Jul 20 2020 at 15:47):

Tell them that the EU wants everyone to use faxes :innocent:

John Moehrke (Jul 20 2020 at 16:55):

Josh Mandel said:

And regular people aren't "trusted" to send a message via Direct; anyone can send a fax.

I was going to say similar. The reason fax still survives is that it has no trust model to hold it back... and as soon as you take a small step toward trust model, you must do a complete job. Half trust is no better than no trust.
Note a no trust model that is better than FAX is simple e-mail... And there are use of e-mail. but no one is going to mention that because they will get hit with the "you use non secure email?" which should be seen as them trying harder than fax, but is seen as a step not far enough.

Grahame Grieve (Jul 20 2020 at 18:58):

I have been advocating that we can use email if we require standard SMTP security features from senders these days - way more secure than fax. It's not like the email of old. But people have learnt 'email is not reliable where as fax is' and facts won't get in the way of that

Lloyd McKenzie (Jul 20 2020 at 20:47):

There's also a perception that email can be hacked while fax can't. In some ways, that's actually true, but in other ways completely false.

David Hay (Jul 20 2020 at 22:34):

as well as it's association with phishing attacks...

Grahame Grieve (Jul 20 2020 at 22:37):

hmm. there's a challenge for faxing...

Grahame Grieve (Jul 20 2020 at 22:38):

https://www.bankinfosecurity.com/beware-phishing-via-fax-a-2796

Michael Lawley (Jul 22 2020 at 02:02):

Also relevant is the recent data breach of pager (!) messages; apparently pagers were being used rather than SMS (I'm not going to touch on relative security here) because "SMS delivery cannot be guaranteed".

Richard Townley-O'Neill (Jul 22 2020 at 05:50):

My wife often gets SMSs a day after they are sent. Sometimes a week after they are sent.

Dave deBronkart (Jul 22 2020 at 12:01):

Richard Townley-O'Neill said:

My wife often gets SMSs a day after they are sent. Sometimes a week after they are sent.

Where are you located, and which carrier?

We've been having trouble with minutes of delay (Verizon, Boston area) and on occasions through the years there have been delays of hours to a day. I speculated that it was due to installation of new snooping technology around the country to divert and copy all messages but I never had any evidence for it. The delays always ended in a day or two, which I speculated was a result of tuning the new stuff.

Richard Townley-O'Neill (Jul 23 2020 at 07:28):

In Australia. In Brisbane, a state capital. She is with Telstra, the largest telecom with coverage over a much wider land area than any of the others.

Richard Townley-O'Neill (Jul 23 2020 at 07:29):

:sad:

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Last updated: Apr 12 2022 at 19:14 UTC