[Spooky23]

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.

[Zak]

> 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.

[Spooky23]

If you’re in a hospital, a doctor has privileges there, but is often not an employee.

You also have the scenario of unaffiliated doctors... your GP doesn’t work with your urologist, and they do not have a secure way to communicate.

It is possible to use things like Zix or other “secure” email solutions, but all are painful and all will vary from organization to organization.

[epochwolf]

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

[Zak]

[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.

[Spooky23]

Encryption is easy. Key management is not. PGP is a lousy solution. Too difficult to use and sacrifices too much functionality.

The world needs something like iMessage but more open.

[Zak]

Key management is moderately difficult, and more of a UX problem than a technical one. A UX very much like that of iMessage could be built on top of PGP and keyservers.

We've had the ability to do this for a long time, but only a few major players are in a position to ensure sufficient user adoption, and they're not interested in creating anything that doesn't drive users to their walled gardens.

[dqv]

The bigger problem is that neither Apple nor Google have implemented device-local PGP encryption in their default email clients. Apple is one-step ahead and actually has had s/mime support for a while, but it really needs wide support on Android phones as well to become ubiquitous. It would set an implied standard for all other email apps on iOS and Android.