Fax machines are widely regarded as insecure, clunky, and just generally obsolete pieces of tech that deserve to be burned in effigy, not unlike a lot of the other shit we remember from the earlier decades of technological innovation. But because bureaucracy’s gonna bureaucracy, federal officials can’t seem to stop relying on these pieces of outdated junk—and we’re the ones left paying the price.
Case in point: Earlier today, the New York Times dropped this piece describing exactly what happens when a fax machine based in a suburban Texas Health Department is faced with the state’s current record-breaking influx of new covid-19 cases—and of tests to process. As the Times describes:
The machine at the Harris County Public Health department in Houston recently became overwhelmed when one laboratory sent a large batch of test results, spraying hundreds of pages all over the floor.
“Picture the image of hundreds of faxes coming through, and the machine just shooting out paper,” said Dr. Umair Shah, executive director of the department. The county has so far recorded more than 40,000 coronavirus cases.
The idea of a machine spewing docs describing case after case after case is kind of an apt image for what’s going on across Texas right now. Even outside of Harris County, the state’s rates of hospitalizations and deaths have continued to climb, with the most recent numbers pointing to more than 3,000 deaths attributed to the virus. It’s gotten bad enough that Texas Gov. Greg Abott walked back his previously wobbly stance on masks, making them mandatory for most counties at the start of this month.
(Emphasis on “most.” As of this week, there are still nearly 80 counties statewide that refuse to uphold the mandate, hospitalizations and death rates be damned.)
Naturally, though, more hospitalizations means more paperwork, and more paperwork means more faxes. While clinics have gotten better about digitizing their workflows over the past decade, more often than not, their shiny new electronic systems can’t quite mesh with their counterpart systems in the clinics in the next town over. That means they’re stuck relying on ol’ faithful—the fax machine—to get these messages across. As one Travis-county-based doctor told the Times, their own office machine is currently cranking out around 1,000 test-related faxes per day.
But as anyone who’s ever tried sending a fax can tell you, pages fluttering onto the floor are the least of these clinic’s problems. Faxes can be blurred or leave chunks of someone’s medical record out of the transmission entirely. Other times, printouts can be too dark or too faint to even read. And as the doctor explained, tracking down all of that information takes too long to make any sort of contact-tracing effort worth a damn:
He has been advising those in the area with virus symptoms to assume they are positive, since the tests take so long to come back.
“When we are receiving results back 14 days after the individual became symptomatic, it’s not useful at all,” Dr. Escott said.
Back in 2009, the Obama administration did try to pull our healthcare systems out of IT hell with the HITECH act, which promised a $35 billion dollar investment to encourage, among other things, the adoption of electronic records in doctor’s offices across the country. The act has widely proven to be something of a flop, in part because it left public health departments off the table, meaning they had to upgrade their tech themselves—something that none of them could really afford to do then, and still can’t now.
Coming back to the present day, that means doctors in Texas and elsewhere who might want to, say, send their laboratory tests to just about anyone who isn’t another doctor in the state is stuck still using faxes to do so.
Before covid-19 hit, this might not have been a major issue, but just about everyone agrees that a nationwide pandemic requires requires all departments—upgraded or otherwise—will need to work together to get things under control. That doesn’t only mean agreeing to wear a damn mask and stay away from other people, but giving our healthcare officials enough money to actually step into the same century as the rest of us.