The fax machine is undefeated

There are eleven ways a medical record can arrive at a small clinic, and ten of them are a fax. The eleventh is a patient carrying a manila folder like contraband. I have watched a nurse practitioner spend forty minutes of a Tuesday reconciling three versions of the same lab result, each of which had been faxed, printed, scanned, and faxed again — a photocopy of a photocopy of someone’s blood.

The fax persists because it is legally boring, technically stubborn, and universally survivable.¹ Nobody was ever sued for faxing. And so the machine outlived the pager, the CD-ROM, and several of my optimistic predecessors who announced its death in keynotes that are now themselves only available as PDFs.

So we stopped trying to kill it. The software we build at Layrd treats the fax as a fact of nature, like weather — something you read, triage, and file before the humans arrive at eight. The machines can keep winning. The people just stopped playing against them.

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