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UK's national health service still relies on fax machines

By midian182 · 11 replies
Jul 12, 2018
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  1. The 1980s and 1990s saw a fax machine in most offices around the world. They allow the sending of a scanned image from one number to another using audio frequency tones via the telephone system. In the 21st century, their use started to decline drastically, mostly due to the rise of emails, the internet, smartphones, and other tech. But the NHS is not only “stubbornly attached” to the machines, it is also the world’s biggest buyer of faxes.

    A report by the Royal College of Surgeons (RCS) found there are at least 9000 fax machine in use across all NHS services, with one trust alone using 603 of them. The professional body has called the medical service’s reliance on the obsolete technology “farcical.”

    The Telegraph reports that frustration with faxing has resulted in many doctors sending sensitive information using unofficial means, including messaging services such as WhatsApp. “The NHS cannot continue to rely on a technology most other organizations scrapped in the early 2000s,” said Richard Kerr, chair of the Royal College’s commission into the future of surgery.

    The revelations follow a report by DeepMind Health last year that named the NHS as the largest purchaser of fax machines in the world.

    Back in 2016, it was reported that many US agencies also still use ancient technology, including IBM Series-1 computers complete with 8-inch floppy discs for nuclear weapon systems. A lawsuit later claimed the FBI deliberately employs these decades-old computers to hinder public requests made under the US Freedom of Information Act (Foia).

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  2. TomSEA

    TomSEA TechSpot Chancellor Posts: 3,092   +1,542

    This article is a little misleading. FAX machines are still in use by medical professionals in several countries for HIPPA (Health Insurance Portability and Accountability Act) compliance, and in the judicial field (attorney/client and courts use) for various privacy laws.

    Everyone knows that e-mails and other media can be easily compromised, and the courts still don't trust encryption. So until someone figures out a better way to immediately transmit confidential forms with 100% assurance, FAX machines are going to be around for a while.
  3. VitalyT

    VitalyT Russ-Puss Posts: 4,360   +2,865

  4. Vulcanproject

    Vulcanproject TS Evangelist Posts: 691   +945

    This was going to be fixed. This was all going to be modernised, until it wasn't.

    The NHS has had difficulty effectively replacing their old systems for a long time now. An integrated nationwide I.T network was contracted over 15 years ago. It was going to be the world's largest civilian network, but it was nothing short of a disaster, with epic costs and long lists of procurement failures before being canned 6/7 years ago.

    Today the situation is pretty bleak. After such a huge waste of money from the previous project there is a reluctance for anyone to stick their neck out and try again. Politically it's probably a bit of a no go. Despite the obvious need for better I.T efficiency this is how it is going to be for the forseeable future.

    But then what do you expect when you put the government in charge of an operation like that.
    Last edited: Jul 12, 2018
    Godel likes this.
  5. BSim500

    BSim500 TS Evangelist Posts: 598   +1,201

    Don't understand the "outrage". Stuff like sending urgent prescriptions from doctor's surgery to pharmacy (a different business who don't usually have access to internal health records) in real time without getting held up on an e-mail server down for maintenance or misplaced into the "Spam" folder are precisely fax machines strength.
    senketsu and Godel like this.
  6. Silvernine

    Silvernine TS Enthusiast Posts: 44   +36

    I don't know... when you have people lives on your hand, changing technology can be hard. Especially when using faxes hasn't really killed anyone yet unlike the possible higher possibility of having an e-mail server compromised, communication end-to-end compromised, accounts compromised, and more which seems to be rather common these days especially when companies don't seem to give a damn about protecting sensitive digital information.

    IAMTHESTIG TS Evangelist Posts: 1,682   +773

    Funny thing is fax isn't secure by any means, it just has to be deliberately compromised. It wouldn't be hard or require much equipment to tap into telephone lines at clinics and record the faxes. Later showing up to download them, or even employing a micro computer with an app to record, translate, and transmit copies of all faxes over a connected cellular or WiFi network. Identity information could then be retrieved which could then be sold or used for identity theft.

    In the end though nothing is 100% secure and if information is worth stealing then criminals will find a way to do it. Even physical paper mail is stolen and used for identity theft crimes and that mail obviously never was in electronic format during transit.
  8. Scott Barnes

    Scott Barnes TS Rookie

    I'm based in Newfoundland Canada and we have rather similar legal privacy measures to what the NHS has to deal with via the MCP system. It specifically factors into what I do as I am a sole proprietor business owner who operates a specialized "courier/transport" service. By volume ~80% of my clients are medical in nature (whether that be MD's, Pharmacies, the local med school, etc...) while the other ~20% are legal firms. Long story short certain documents are required by law to be physically in front of an individual to be signed, these documents may not be altered or reproduced via any electronic means.

    The fax issue is a little different in my neck of the woods as the law is a bit greyer regarding what can be faxed, usually an MD can fax a prescription to a pharmacy though even that may vary depending on the specific pathology of the patient in question (such as mental health issues where a breach of information privacy may be considered seriously damaging to the patients public image). Honestly this system may seem hilariously antiquated but with the ridiculously insecure state of common digital transmission means it probably isn't going anywhere in the near term unless there is a real paradigm shift at he federal governmental policy level. As a side note a lot of law firms I contract with actually prefer the hand delivery method as it keeps the pace of things at a manageable level, we're already at a point these days where a "successful" personal injury attorney is pushing 70hrs a week, the average successful pharmacy owner in my home city works at least 6 days a week and close to 70hrs a week as well. Personally I did the 70-80hr a week thing in transport for nearly 3 years till I pinched a nerve in my cervical spine from repetitive stress, when you're 32 and a former national level athlete who still swims and runs regularly that kind of injury has you start asking questions like "maybe we all need more down time and maybe society is moving a lil too fast for all of our own good?".
  9. kapital98

    kapital98 TS Maniac Posts: 321   +246

    I'll echo the sentiment of several commentators. I'm an attorney and the quickest, most reliable method of service is fax. The courts in NY, especially outside of NYC, are very slow to adopt electronic filing (essentially email on a centralized server). With rare exception, everything is still done through physically serving someone (say, by person or mail) or faxing them.

    Email is expressly not allowed unless done by prior consent of the parties -- Something I don't know a single attorney allowing without knowing the other person really well. Lawyers hate to make service easy. It gives them another way to get out of missing a deadline or just to beat the other side.

    This is unlikely to completely change in states like NY because we have a system of numerous courts. Most of which do not have attorneys as judges and lack funding to barely even stay open (most are part-time courts).

    Fax is likely to continue to be the fastest way to serve documents on government agencies and courts for a long time in the US.

    P.S. Knowing how to work a fax machine can be a huge plus among younger attorneys who have no idea how they work. It's not necessarily something employers expect you to know -- but it's something you should know. Discarding it as 'outdated' and something that should be ignored is a bad career move for attorneys.
  10. I'm also in Canada, when I require a prescription refill and there isn't one, the pharmacy faxes my doctor who faxes the prescription back. Doc is in private practice so no access to the electronic medical records system that hospitals use. My prescriptions all appear on that system and I have no idea how that transfer is taking place. The system has served me well
  11. nismo91

    nismo91 TS Evangelist Posts: 987   +65

    Yes fax machine is outdated. but the latest iteration works quite well and is far from floppy disks in terms of operation, even today.

    my cheap 5yo brother AIO printing machine has a built-in fax machine and doc feeder. I can just put stacks of A4 paper in the feeder and dial a number, it will do the rest.

    no printers? few years ago on windows 7 I even tried using the windows fax & scan on my core2duo laptop which has built-in RJ11 port. similar interface to the old outlook express, it's easy to use and it keeps everything digitally. you don't even have to scan the documents again if you want to forward it to another number. yeah sure you can't easily send a fax from a smartphone, but keeping up with people who only receive fax are not that hard.
  12. flipp3r

    flipp3r TS Member

    It's not just in the UK. Fax is cheap & reliable.
    Just look at a typical pathology lab. They are scattered everywhere. Imagine the cost & headaches of setting up PC's/tablets/internet. Reliability & servicing, not to mention insurance on the countless units that will go missing...

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