$$ - Smarter Faxing


Precursors to modern fax machines predated the first working telephones and were in use as early as the 1860s. One notable early adopter of fax technology was an ageing Charles Louis Napoleon Bonaparte (Napoleon III), the last Emperor of France.

Fast-forward a hundred and fifty years and fax machines are amongst the most widely adopted technologies in Australian medical practices. Despite convergence with photocopiers and scanners, underlying fax technology has changed little in the past few decades.

For many years however, computer-based fax solutions have been available, promising to reduce the amount of paper used in the process, and more importantly reduce costs and increase efficiency. These computer-based solutions can be divided into two categories:

  1. Internet Fax Solutions (aka eFax)
  2. Modem Fax Solutions


Despite differences in the underlying technology used to transport computer-based faxes, both of these solutions promise to deliver the following benefits:

  • Both clinicians and practice staff can send and receive faxes from any computer without having to relocate to a traditional fax machine.
  • Incoming faxes arrive electronically, negating the need for these to be scanned or filed at a later date.
  • Any printable document can be faxed directly from the computer, negating the need for documents to be printed, faxed and then stored or shredded.
  • An audit trail of incoming and outgoing faxes can be automatically generated, which assists with cost control and reduces the chance of faxes going missing.
  • Both incoming and outgoing faxes tend to arrive as higher quality images than those processed with traditional fax machines.
  • “Spam” faxes can be filtered and discarded without wasting paper and toner.
  • A physical fax machine may not be required, reducing both upfront and ongoing costs.

Internet Faxing (eFax)

Like voice telephony, fax solutions that leverage the power of the Internet emerged several years ago, creating new possibilities for businesses that rely heavily on the fax machine as a communication device. These services essentially act as a bridge between the Internet and the traditional phone network, converting documents back and forward between the two formats as required.


When sending a fax via an Internet service, the user transports their “fax” to the service provider using any one of the following methods:

  1. As an email or email attachment.
  2. Via a web portal.
  3. By “printing” to a special fax driver.
  4. Using software provided by the Internet fax service.


With the exception of the printer driver approach, incoming faxes can be received using the same methods as when sending faxes.

Practices would typically either have a staff member distribute incoming faxes to the relevant practitioner electronically, or store it in a holding folder ready for collection.


In addition to the benefits outlined earlier, Internet-based solutions offer other advantages over traditional fax solutions:

  • As faxes leave and enter the practice via the Internet, no dedicated fax line is required, which can save approximately $30 per month in line rental.
  • Fax rates are typically lower than the cost of traditional fax calls reducing ongoing costs.


As with VOIP (Voice Over Internet Protocol), service quality and security need to be considered before using Internet-based fax solutions to send and receive sensitive patient information.

The main problem with the popular Internet fax solutions is that the email leg of the fax journey is usually unencrypted. In line with best practice approaches to patient confidentiality (and the current PIP IT/IM requirements), all patient information sent electronically needs to be encrypted. Note that this doesn’t just relate to outgoing faxes sent by the practice, but also those received by the practice via and Internet fax service.

As indicated earlier, other options for both sending and receiving faxes using Internet fax services are available (most of which are more conducive to secure transmission), however the problems with email need to be stressed as it is the most widely used technique due to its convenience and ability to be integrated with third party software solutions.

Another security related issue to consider is the fact that Internet fax solutions introduce an additional third party (potentially overseas) that could technically intercept fax transmissions. Practices considering Internet fax as an option should therefore enquire as to whether the provider offers secure solutions, and what guarantees they make about the integrity of their service and the confidentiality of the faxes they process.

Modem Faxing

First introduced in 1985 by GammaLink, fax modems have long been used by organisations looking to streamline the receipt and sending of faxes.

Unlike the previous scenario, this arrangement uses the dial-up modem in a computer in much the same way as a traditional fax machine i.e. a call is made to the recipient’s fax using the attached phone line. This functionality can also be shared with any other network-attached computer.

As with Internet solutions, faxes can be forwarded to the modem-attached computer using a variety of methods including fax “printer” drivers and purpose built software. While outside the scope of this article, many modern multifunction centres also offer similar functionality, negating the need for a computer to be attached directly to the fax line.

Despite originating from a computer, the Internet is not used for any part of the transmission, which avoids the potential security problems associated with Internet fax solutions.

Where to from here?

While not without issues, I feel that computer-based fax solutions have matured to the point where many medical practices would benefit from deploying either a secure Internet or modem-based faxed solution (or a combination of both). Regardless of which option is chosen, practices should be able to reduce the amount of paper entering the practice, as well as minimising the amount of paper they themselves generate. More importantly, cost reductions and efficiency improvements should result.

Despite the benefits computer faxing can provide, practices should continue to work towards the ultimate goal of secure electronic messaging. Now readily available, these solutions promise to maximise efficiency while providing the highest level of message security.

Posted in Australian eHealth

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