Re: At a guess, it'l be the eye watering amount
For handwriting substitute:-
"The inane scribblings of a trapdoor spider after two pints of ketamine..."
The NHS has been told to stop clinging onto the past, after it was revealed trusts have more than 8,000 fax machines still in use. According to Freedom of Information requests submitted by the Royal College of Surgeons, Newcastle Upon Tyne Hospitals NHS Foundation Trust is the worst offender – with a whopping 603 machines. …
Faxes still have their places. When I moved to another state there was a screw up with DL. Now My choices were to drive back to California and hand delver the documents they wanted. Mail them and it will get there when it gets there or fax it(no they would not take email) Faxing it allowed me to clear it up in under an hour vs mailing it.
Change anything and it has to be done medical standards .....
I'm running a clinical trial. One of the official steps, argued over in many meetings, minuted, recycled as firelighters etc and finally agreed with the FDA:
Dump an SQL database on system 1, open it in Word, change all the occurrences of "centre" to "center", import the database into system 2.
The PC this is done on has a medical grade PSU and medical screen, the version of Windows and MS Office has been agreed and specified. The data analyst has to sign a form to say they have done this in accordance with the procedure and that they have been properly trained.
We wrote the analysis software and could change one line to accept "centre" but that would apparently take approval from 3 popes and the captain of a winning world cup team.
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"Faxes still have their places. When I moved to another state there was a screw up with DL. Now My choices were to drive back to California and hand delver the documents they wanted. Mail them and it will get there when it gets there or fax it(no they would not take email) Faxing it allowed me to clear it up in under an hour vs mailing it."
And yet, for various security clearance I've had over recent years, emailed scans of documents have been acceptable. In some cases, an "authorised person" in our company has to put eyes on the originals and sign off that the scans are true and correct, but not in all cases.
I have spondylitis and need some quite powerful pain killers which includes tramadol and morphine patches. Both are controlled drugs and the way prescriptions are issued for them is a PITA.
Most of the meds I need, I order them online via the patient access app. Its issued electronically to the pharmacy and 2 days after its ordered a nice man delivers them for me. Except for the patches... I have to tell the delivery man there's a CD prescription to pick up from the doctors, who will pick it up, take it to the pharmacy, then it will be delivered.
There is no way for the pharmacy to be informed that a CD prescription needs to be collected, unless after I order my prescription, wait 2 days, then phone the chemist to tell them to pick up .
I was talking to the delivery driver about the idiocy of it and he told me that if yo do not have a nominated pharmacy your doctors can FAX a prescription, but if its a CD prescription, even a fax is not good enough.....
eat this...well If I dont eat my tablets my back feels like the trinity test site !!
The fax machine is getting long in the tooth, but it's a technology that people understand and it's a still a reasonable way to transmit a facsimile copy of a printed page. In the medical world, that can mean old patient charts or a doctor's scribble on something. Until paper is completely eliminated, fax machines will still be useful.
In my experience, working for a mental health trust, there was a lot of resistance to changing from fax to email. There were the obvious pitfalls with unattended fax machines, so they were in locked offices that were designated 'safe harbours'. If you didn't have a key you needed to find an accessible fax machine to get your documents sent to.
And the reason the like faxes so much?
Entirely down to deprivation of liberty safeguards. I mean, we had a handcuff policy, a lot of people were in our hospitals because they were sent there by a judge. Roll forward to the benefits of emails over faxes .... they don't need to go to a locked room, where they lie until they are discovered. You can put business rules around an email and direct it to more than one recipient,
And the downside with email? It doesn't work if the networks down (also true of T38 fax over IP), when a fax is sent it goes directly to the recipient machine. Sending it isnt possible if receiving it isn't happening at the same time, faxes are transactional, email is store and forward, if somethings broken with email the sender may not know for days, weeks, if at all, that it wasnt delivered.
AC cos.
Sometimes having something physical that can be seen and picked up as it comes out of the machine, can be held as you walk around and can be kept on the (real) desk top so that you can refer back to it is the best way.
Whereas the number of people who have a long list of unread emails in a mail folder points out one weakness of that system- emails seem to be easier to ignore (or get overwhelmed by). Perhaps partly due to the fact that because it is so effortless it becomes undervalued. A physical fax has a degree of substance that one more email just doesn't.
And since I had a fax on my 4in1 printer until a few weeks ago, when I had to replace it, I am very aware that a complaint email to a senior manager gets automatically fobbed off by the automated (or AI) systems, but a fax pretty much always got a proper response, and usually a resolution.
"(or get overwhelmed by)."
Arse coving emails are the prime reason for being overwhelmed by emails. We've all worked with people who will email after every conversation or phone call to "confirm" what has been said and enter it into the "chain of evidence."
"We've all worked with people who will email after every conversation or phone call to "confirm" what has been said"
And very welcome they are too. Though they could probably save time and dispense with the conversation. I'd much rather search my inbox than my memory.
"if somethings broken with email the sender may not know for days, weeks, if at all, that it wasnt delivered."
You can set email servers to report back on delivery status. Most are set to report back in a scale of days but can be set to hours or even minutes. If the receiving mail server is down, there's no reason the sending server can't inform you in a timely manner. That means all servers in the chain need to be properly configured to deal with time sensitive or mission critical email systems so it doesn't get received by a gateway then "lost" in a virus scanner without some sort of message being passed back up the chain to the original sender. (Of course, spammers can abuse this if not properly set up)
"You can set email servers to report back on delivery status"
The sending server. The one under your control. Nothing else it.
And there's no guarantee that the receiving server hasn't diverted it to /dev/null, or that the recipient hasn't auto-filtered it to the same location, or that he's not just 25,000 messages behind.
It's not just the NHS, needed to submit a form to the UK patent office but when asking (by email) which email address I should send the completed form to the response was...
"we don't accept that form by email"
Seems that while they do allow some forms to be filled in online this particular one could only be done via snail mail, courier or... wait for it ..... fax!!
The reason? Apparently this is because they need to have it date stamped and counted by their document reception department only for it then to be scanned in. Sounds like some wonderful job creation right there.
Given I've never sent a fax in my life I thought I may as well try before they go totally obsolete. How hard could it be, right... Easy, look, windows has a fax and scan app that will sort it out... NO. You'll need a fax modem for it to work, an ADSL modem is far too modern for that and you're totally out of "luck" if you're on fibre. Ok the local library they should have one... NO. Free wifi, access to photocopying but fax haa must be joking.
Searching online I found many places offering free fax but most require you to sign up for a contract to allow you to send, perfect if you need to send many, but for one single item seems a bit of overkill. I did eventually come across one that seemed trustworthy and provided a few free sheets called "hellofax" fairly straight forward so if you find yourself in this situation you may like to check them out.
It doesn't half seem ironic though that an office that is handling patents for cutting edge technology relies on fax.
"It doesn't half seem ironic though that an office that is handling patents for cutting edge technology relies on fax."
Wait! Are you saying patents something has to be cutting edge technology to get a patent? Or is it that "with a computer" makes it cutting edge?
"The reason? Apparently this is because they need to have it date stamped and counted by their document reception department only for it then to be scanned in. Sounds like some wonderful job creation right there."
This is a legal requirement. Under a first to file patent system the first physical filing is the one that gets the patent. Hence the requirement for a time stamp step. An email would have to be printed then time stamped or have some way to validate time of arrival. This could be done but getting the courts to accept it would take some doing.
The catch would be standardizing it and then establishing some legally-accepted system of authentication (both party-wise and time-wise). I mean, if push came to shove, you could do IRC Direct Client-to-Client, but try explaining such a system to a judge.
....was written like an advert of course. All fancy graphics and no substance. I know pagers are out of date, but they just wrote about 'pagers per bed' and 'staff members per pager' which infographic-style pictures. They made common errors like quoting figures to rather too many significant figures such as
"In the UK, the direct cost of pagers to the NHS is estimated to be £6,600,879". Really? £9 on the end of that, not £8 or £0'? And the savings from mobile software of £ 2,718,009!
But the thing that got me was the paragraph that read:
"This high figure is often
attributed to reliability of the
devices, which operate on radio
frequencies as opposed to
mobile or internet networks."
What in hell are they talking about?
All this leads me to think that the report is totally biased, while in fact there are genuine use-cases for pagers after all. And who knows? Maybe fax as well (but I doubt it).
"while in fact there are genuine use-cases for pagers after all"
Mainly that POCSAG standard pagers run at 150MHz and that frequency was chosen because it tends to penetrate buildings fairly well (the human body is more or less a 1/4 wavelength at that frequency, so pagers worn on the belt get reasonable coupling into a decent salty antenna, and the bit rate is low enough that they work even at really shitty s/n ratios.)
We demand you replace an old shit version of windows with a new shit version, whatever could go wrong?
In the meantime, what is so differnet about an emailed doc printed out and a fax?
Don't pagers have guaranteed delivery? I suggest they send a txt whenever ther'es an emergency in which a politician needs urgent care, hopefully this may lead to less of them spewing garbage.
The old version of windows is shit because it's ancient and out of step with computing in the 21st century. The new version of windows isn't so shit when you look at how many shitty things they're trying to fix. But I digress.
You wrote "In the meantime, what is so differnet about an emailed doc printed out and a fax?" - well, the difference is that an emailed doc DOES NOT HAVE TO BE PRINTED!! What is this fascination with having to print everything?
And you wrote "Don't pagers have guaranteed delivery?" and the answer is NO. For guaranteed delivery you'd need something like, um, a mobile phone, which can actually send delivery receipts with texts and also can run several apps that do the same such as whatsapp, google hangouts etc.
"What is this fascination with having to print everything?"
So that it can be kept where it's needed, such as on the patient's notes in this instance, and not on the doctor's computer at the other end of the corridor two floors down, or on the doctor's mobile when he's scrolled through a hundred other emails to find it, or on the doctor's mobile except it's a nurse who needs to see it, or....
"You wrote "In the meantime, what is so differnet about an emailed doc printed out and a fax?" - well, the difference is that an emailed doc DOES NOT HAVE TO BE PRINTED!! What is this fascination with having to print everything?"
Two words: paper trails. For many environments, having an unpowered, physical copy of something is a legal requirement. The biggest reason the paperless office went nowhere was because it ran smack into the law.
One of the reasons why NHS is still using fax machines is probably due to the adage: If it ain't broke, (then) don't fix/replace it.
My wife has retired, whenever we send insurance claim form (like up to 2017) she will always insist on faxing it to the insurance company (website allows email submission). When I asked her if they accept scanned email attachment she replied with "they will only accept faxed submissions".
It was only recently when she finally gave in.
Not being in the industry, but interested observer, I think the reason FAXs are so prevalent in the health industry is because printed documents transferred in "modern" protocols fall within HIPPA, and FAX's are preexisting tech and don't have all those silly data protection rules attached.
I've heard of medical billing outfits in the US that emulate 1,000's of concurrent online FAXs machines at a time so all those medical billings can go back and forth on paper, bypassing HIPPA rules.
I've had so many of my customers that have to process PHI billing just how they can do email with PHI and still be HIPPA. My answer of you can't just pissed them off all to no end. I think this is the industry's end-run to still have paper record shuffle.
If they substitute email, will the email be encrypted and signed? Will they set up TLS tunnels with everyone receiving such emails? Though not exactly secure, fax is still better than email.
(I once worked for a company that made inline encryptors for fax machines, complete with PKI. Very, very few people bought them despite their reasonable cost. We even had a sales demo of intercepting a fax, altering the sums, and sending it on. Usual response: that's not right!)
Maybe the negative comments about the use of fax machines ( in the NHS and elsewhere) tie in with various other posting around El Reg over the last few years, when for whatever reason Fax has been mentioned. There does seem to be a core of Commentards who just don't like Fax and won't hear a good word about it. To me it's just one more tool. And if it does the job and gets the result I need I'll use it if I can.. And why not?
and they are low risk machines. It's far more problematic that they _still_ use unhardened Windows boxes without the budget/competency to run them in any moderately secure way.
Complaining about Fax machines is like switching from fast terminal based unixoid systems to buggy and slow web services.
Having spent some time in hospital recently, as a victim of a weird spider/insect bite. The only successful process was the triage, driven by an ex-military doctor in trainers.
I was paying attention as well. The whole set up needs root and branch process analysis review. The administration is antiquated, slow and run by luddites, who haven’t a clue and fallen for the most basic of comercial tricks, such as decade long contracts, which you have to pay to end and such-like.
I even spent time in psych-ward, the most pythonesque experience, you can imagine, being chased around by women with no pants on. What do you do for a living? Wow, and you talk to your phone! You’re clearly bonkers and are making it up! What I’ve never met you before!? It’s ok the junior idiot is back in on Monday they understand technology...
There are so many areas for efficiency gains and costs savings.
To give you one example alone, it was quicker to find the ECG department on my own, get a scan and take the results back to the funny ward, rather the wait another day for the orderly had wheel-chaired my there and back and hand-delivered the results the next day.
I walked out at the first opportunity when the door was unlocked, before the results were processed and whatever my release from the unit is actually called. #oneflewoverthecuckoosnest
I left local government six years ago, so things may have changed, but the NHS would not let local authorities email NHS Trusts anything with patient data in it as this was only permitted within the NHS using their own secure email system, which the NHS was not prepared for us to be a part of. We had to send everything by fax (mainly water and food-borne disease case notifications and outbreak questionnaires).
Given that all kinds of non-NHS organisations exchange medical data with the NHS, including employers that have to organise and assess regular routine screening of employees, one wonders how they get on.
things may have changed, but the NHS would not let local authorities email NHS Trusts anything with patient data in it as this was only permitted within the NHS using their own secure email system
Amusingly enough, the NHS also wouldn't let the NHS email patient data. Because the central nhs.net service was encrypted but local Trusts' nhs.uk setups weren't necessarily.
Things have changed, a bit. See: https://s3-eu-west-1.amazonaws.com/comms-mat/Training-Materials/Guidance/encryptionguide.pdf (PDF, soz)
Seems like a bit of a faff to set up to be honest, so I wonder how much it gets used. But it also looks like they were aware of the problem and tried to address it.
As a trainee doctor, ward fax machines were perfect "push notifications". During a busy day we sent off blood tests, arranged investigations. While working on a busy ward it was brilliant that as soon as a result was available or a test reported, the fax machine buzzed. At next opportunity we would check the result, initial it, and stick it in the notes.
The current expensive network systems are miles away from providing the speed and convenience of this setup. We have no push system, and are reduced to repeatedly logging in and going through interface-hell to see if an important result is available yet.
Providing timely clinical information to busy medical staff in the NHS has without a doubt gone a long long way backwards since the 1990s :(
If a fax goes from your machine to the destination machine down a phone line, how easy is it to intercept?
How many Viruses are spread via fax machines?
If a scanned document goes out over the Internet via email, how easy is it to intercept?
How many viruses are spread via emails?
do you know how many fax communictaions are involved in a football transfer?
if the FIFA fax line goes down on deadline day, the deadline gets extended.
On the subject of the NHS, the system is broken, there is not enough cash in the right places and the wrong things are centralised and pushed to the edge. THere have been numerous attempts to remove the middle managment an beurocratics, but somehow regional and national and sub-national structures make there way back.
The current money wories in the NHS can be traced to the (finaly) former health secretary's Health and Social Care Act 2012, that formed the current funding system of the NHS, that sees these non-medical non-accountabale bodies known as CCGs get to choose where everyone in their area gets certain things done and by who, this frequently entails private companies who pay there less qualified staff considerably less than the NHS and get to deliver services from the NHS buildings.
A few points in reply to some of the comments made on this story.
1) No - we don't use thermal paper. For the love of God, it's 2018 !
2) Many of the "fax" machines are indeed part of a multi-function copier which in it's default configuration under the OGC (Office of Government Commerce) contract, has the fax option installed as standard.
3) Many departments have an analogue line for fallback, in case the VOIP system fails (and it can), so even if you rid the NHS of fax machines, there will still be a large number of analogue phone lines in use.
4) Fax isn't used anywhere near as much as it used to be - it is on the decline, but it's taking some considerable time for each use case to be resolved with other technologies.
5) Fax as a protocol is far more capable than you'd think. Unfortunately, the full possibilities never really took off much outside of Japan. Colour fax was actually a thing there !
1. Some places are stuck with them for lack of alternatives.
2. I have to use a fax modem because the scan unit on my MFP is iffy (tends to stripe).
3. What happens when it's the analog line that fails? Many places, if one goes, it's usually something that takes out the other.
4. As I've said, the big stumbling block is standardizing some kind of authentication system to lock digital documents. Perhaps instead of relying on format allowances, perhaps something prepended to the file.
5. Much like the typical photocopier, the usual response is "Who cares?" Color fax is even more 's niche case than color copying, to the point it's easier to e-mail for those rare occasions. No legal standard AFAIK requires a color copy of a document.
I was going to make a snarky comment about the use of "farcical", as since I were a nipper, the word was always "farcial" (pronounced far-shul). It occurred to me to wonder whether there'd been a change in the spelling of the term denoting "having the quality of a farce" over the years, as language and spellings do drift over the years (I'm old enough to have seen "shew" used on a [ublic noticeboard - archaic spelling of "show"). To my surprise, so far as t'internet is concerned, "farcial" seems never to have existed - and yet I know it was in common use. Similarly, "having the quality of fantasy" was "fantastic" not "fantastical"
Did the good citizens of Bristol manage to hack the worlds online dictionaries and thesauri or have I drifted in from the universe next door and only just noticed - or has the cider finally rotted my brain?