| 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 numbers have, but PGP throws that right out the window. Beyond the technical discussion, I remember reading that fax is considered "secure" from a regulatory/legal standpoint because fax lines are subject to wiretapping laws just as a regular phone line is. An email however, sent in plain text, can be legally read by anyone along the line who has the authority to do so. No surprises there, we know what GMail does. What we've ended up with in Australia is a trio of internet-based secure messaging systems which have only just recently been in discussions about interoperability between themselves. I believe two of them are just end-client software which automates the PGP encryption/decryption of a given email address that you register, sending and receiving directly from your practice's clinical management system. Uptake has been kinda miserable. Until the systems are interoperable and have a large centralised directory of all health practitioners in the country, uptake will remain low. It's also only for medical practices and hospitals. It doesn't cover all the crap we get from legal and insurance firms. Other legal issues are also stymieing progress. I have been told specifically by the CEO of a large specialist group that they won't be using any of the above systems, because having the software available means they might get electronic referrals directly from GPs.This would be instead of paper referral letters that simply go with the patient. This changes the legal onus of who is responsible for following up with patients who don't make that specialist appointment when referred. It matters when a patient decides not go do anything with a given referral, and then finds out they're terminal months later. And so, we fax and get faxed. And it sucks. |
Oh my. The unexpected legal implications and associated perverse incentives. Thanks for sharing that!
Reminds me of what I heard about information security space, where some large companies don't want to know their risks too well, as if something would happen, they wouldn't be able to say "we didn't/couldn't have predicted that".