Australian healthcare has taken a significant step to end the use of archaic fax machines in healthcare, according to the government agency tasked with digitising the healthcare system.

But doctors warn that many issues have yet to be resolved before practices can transmit sensitive patient information through secure digital channels.

The Digital Health Agency says a milestone was passed at its secure messaging forum this month, when more than 50 healthcare sector stakeholders reached consensus on adopting the tools, processes and standards shown to solve the interoperability problems across secure messaging and clinical information systems.

“Secure messaging systems and standards have been in place for many years, but as a country, we’ve struggled to implement at a national scale,” says the agency’s chief operating officer Bettina McMahon.

“It has taken time to co-produce a workable solution with industry that meets the expectations of the clinical community – we started this project 18 months ago. But to adopt a true co-production process takes this long, and ultimately, has allowed us to reach consensus about how we will scale digital communication,” she said in a statement this week.

Fax and post are still the primary modes of transmission of clinical information for 80% of health professionals, according to a 2018 study of 204 specialists, GPs and allied health professionals. Almost one in four  (23%) cited software’s lack of ease of use and interoperability as barriers to using e-referrals.

But while fax is often seen as an archaic technology, it’s still got an edge when it comes to meeting compliance standards for security, says Robin Tang, senior marketing manager with fax machine supplier Brother International (Australia).

Mr Tang says that while demand for fax machines is in decline, “we do see certain markets that continue to depend on it”.

These include the healthcare sector  but faxes are also still widely used in Australia’s Defence sector, which Mr Tang says favours the technology for its security profile and “is not showing any signs they want to terminate”.

Fax machines are also inexpensive and can operate in remote areas where mobile reception and broadband coverage may be poor or non-existent.

For these reasons, Mr Tang says he believes the fax machine will still still be around for another decade.

Respiratory physician and AMA vice president Dr Chris Zappala tells the limbic there are still many practical hurdles to be overcome before practices start disposing of their fax machines, and he adds it is frustrating that the long-standing issue of solving interoperability is taking so long to resolve.

“I’m glad they are talking, and we have got a resolution, but we need to see the fruits of that labour,” he said.

An effective IT solution will need a  universal searchable database of health practitioners’ details and reliable encryption, Dr Zappala says.

“I am relaxed about the phasing out of the fax, and I think most people would be quite happy not to have to deal with faxes and have a full, immediate digital solution that we could rely on, but the IT is just not up to it at the moment.

“For example, when you get a report that’s come through the encrypted systems it needs to appear in your computer system at the other end in a format that’s intelligible, sometimes they get all mixed up as part of the encryption and are really difficult to read. So, there’s really basic stuff that is still yet to be solved.”

Dr Zappala says he was also disappointed that the high costs of e-health solutions is not on the agenda in the current industry discussions.

“These products are really expensive and that’s just death to practices. We can’t be spending all the practice profits on IT solutions that don’t even work properly,” he says.