I recently asked a college friend of mine who works in publishing: “When’s the last time you sent a fax?”
She responded: “A fax?...if you’re talking about faxing like we did in the 90’s, I guess I’d say I haven’t faxed in years. Honestly have no idea. I feel like they’re outdated? Email all the way baby!”
Faxing and fax machines have always been concepts that I understood…though, I asked myself that question and I couldn’t tell you the last time I even interacted with a fax machine. I know they’re in every office I’ve ever been in, but how did fax machines infiltrate every office around the globe? Do kids these days fax? Do my friends fax?
All relevant questions for us living in an ever more digital world. Long gone are the days of rotary phones, dial-up internet, cassette tapes, and even Blu-ray. So, why are we even still thinking about a piece of paper flying through telephone wires? Like many technologies, fax machines have a complex history, but they are a clear success story in adaptation.
The year is 1843, the telegraph (precursor to Alexander Bell's telephone) has not even sent its first message, photography is just entering its teenage years, and the light bulb is another 3 decades out; but more importantly, human curiosity and ingenuity is thriving. The era brought a slurry of wacky ideas, but one not-so-far-off idea came from a clockmaker's apprentice: Alexander Bain (not to be confused with the Batman villain). Bain keyed off from recent advances in electricity and the novel concept of a photograph: what if we could transmit a photograph rather than just words and numbers?
Turns out, Bain was just the person to answer this question. He deduced that if a picture could be interpreted in simple terms like a grid with empty squares or filled in squares, it could be reproduced with that same gridded interpretation somewhere else. By 1846, he devised a system using synchronized clock pendulums, a telegraph stylus and transmitter, and chemically soaked paper that was able to "transmit" an image across a telegraph wire and imprint it on paper. This was the world's first facsimile machine and the first “image” transmitted electronically. However, this was far from today’s fax machine. It would take another hundred years for the fax machine to become a household name.
1865: First commercial facsimile service used between Paris and Lyon.
1880: Shelford Bidwell invented a phototelegraphy scanner. First 2D image sent over telephone wires.
1888: Elisha Grey created TelAutograph service to send images of signatures.
1924: AT&T modernized faxing transmission protocols to transmit high quality images.
1930-40s: Railroads, newspapers, and banks adopt basic fax services for transmitting critical business information. (https://faxauthority.com/biographies/giovanni-caselli/)
1964: Xerox Corporation releases its commercial fax machine that sent faxes over standard telephone transmissions.
1974: Fax sending time reached an all-time low of 3 minutes!
1976: Faxing Commercial (just for fun)
1985: GammaLink developed the first computer fax interface.
1996: First internet fax service allowed users to send a fax from a computer vs a fax machine.
1997: Fax machines reached their peak sales volume in the US of 3.6 million.
2010/11: Internet Faxing hits the Apple and Android app stores!
By the 1990's, populations were addicted to faxing. A judge could fax a signed warrant, banks could fax signed checks, hospitals could fax patient records from state to state; the world needed faxes.
A fax machine was affordable, could be used almost anywhere and by anyone, and some would argue "fun." (I could imagine a pre-TikTok fax service that faxed you personalized images of content you enjoyed…maybe it's not too late?).
However, the fax machine's biggest challenge entered the stage around this time: the internet. Though its adoption was slow, the internet is more regarded as the technology that changed the world compared to the fax. The internet brought with it the digital age: email, instant messaging services, chat rooms, and who could forget MySpace? With so many options to communicate, how did fax machines remain so relevant?
I am not sure there is a single answer here, but I will say this: fax machines were sneaky and ruthless. Since 1846, they maintained relevance over telephones, television, radio, the world wide web, Adobe Acrobat Reader and even EHR platforms. Today, fax machines are not as popular as they once were, nonetheless, they serve a purpose. Faxes have some benefits: you only need to know a phone number, they are reliable (if you send a fax, you can guarantee it will be received), and dedicated fax lines are arguably more secure than the wild west of the internet. Faxes even found their way into legislation with verbiage like: "XYZ is considered valid only if signed by hand or fax"…now that's power.
One popular faxing industry is healthcare. As of 2021, surveys indicated that at least 70% of healthcare providers in the US still exchange medication information via fax as a method of communication. Some might find this surprising given that in 2016, the US government pushed healthcare into the digital age with the 21st Century Cures Act. In 2021, 96% of hospitals and 78% of office based physicians had adopted an EHR. Even more surprising, healthcare organizations have reported increases in fax document volumes since implementing EHRs. What the fax?
The simple answer here: the fax machine was in the right place at the right time. Faxes are HIPAA compliant because they are considered "secure" (even though there is no encryption like most data exchanges services) because they are a point-to-point transmission. Due to their huge adoption in the 1980's, smaller healthcare organizations and physician practices still have fax machines from their heyday. Even today, buying a new fax machine is cheap and, as long as you have a dedicated phone line, you are connected to a global network of fax machines! Lastly, the very legislation that cemented healthcare's digital future also secured the fax machine's place in it. The Cures Act did not affect the entire industry equally and allowed services like reference labs, mental health and recovery services, and prescriptions to remain on paper.
Further, EHR interoperability has been a challenge for organizations and sometimes faxing a patient record is easier than dealing with systems that do not communicate and risks losing or corrupting data in its transmission. Some parts of the healthcare industry barreled forward while others were left with solutions that worked for them. Hospitals were forced to take on the challenge of digesting all types of information to provide quality care for their patients and meet modern requirements for information exchange.
Now in the past several years, fax services have yet again been re-inventing themselves. Today, cloud-based fax services are on the rise. They aim to offer a modern approach to the faxing experience as well as enhanced security practices in the healthcare space. These services can send a "fax" to a phone via text, send a fax from an email, and even turn your phone into a scanner. Modern fax technology brings ease-of-use to the forefront and offers security encryption to meet most regulatory requirements. The best part - it is still cheap and accessible.
What’s more, there are also software solutions available, like Extract’s HealthyData, that can take the faxes and scans you receive and identify then deliver all of the important discrete data anywhere you’d like. Receiving health information via fax can be akin to receiving interfaced data when you use powerful software that can match patients, orders, or encounters and retrieve only the data you need from a particular document type.
Do you need to practice faxing? Or teach your kids to fax? Probably not. But faxes are undoubtedly going to persist for some time. If history tells us anything, faxes are reliable at evolving and wooing the masses. Don’t write off the fax quite yet. And just for fun, send a fax to someone!
About the Author: Thomas Plackemeier
Thomas is a Customer Support Specialist at Extract with experience in enterprise software implementation, research/product development, and process engineering. Thomas received his bachelor's degree in Chemical Engineering from Rice University. Thomas has a keen eye for process development and strives to make tasks easier and more efficient for everyone.