Culture

Fax machines are hamstringing how the U.S. contends with COVID-19

The U.S. healthcare system is a mess of mixed technologies that are proving a choke point for public health officials, doctors, and testing labs alike.

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You'd be forgiven for thinking the self-proclaimed Greatest Country on Earth had firmly related the fax machine to the annals of history. But it turns out that this old technology is still very much a part of the American healthcare system. And it's proving to be a massive stumbling block for the system's ability to respond to the worst health crisis of the 21st century to date: COVID-19.

The New York Times reported this week that some areas hard hit by the coronavirus, like Houston, Texas, are struggling to trace COVID-19 cases and recommend effective self-isolation measures because they're inundated with faxes. For the Harris County Public Health Department — a county that has reported over 40,000 COVID-19 cases — this antiquated tech has resulted in countless headaches for health officials. The litany of woes includes blurry prints, the need to manually input information, duplicates of the same results, and a flood of paper. It may be the perfect metaphor for the administration's response to the virus, but it's also a nightmare that could cost lives.

All over the place — In many instances, the lab tests that get faxed are incomplete. This means that analytical reports may lack basic information related to patients, including their home addresses, phone numbers, names, and other information that could be used for potentially life-saving contact tracing.

It makes the work of the U.S. healthcare system — which has already suffered repeated and steep cuts to funding over the past decade — much more complicated and burdensome. Details like race, sex, gender, income, and more allow these public health officials to look closer at the demographic nature of COVID-19's spread. But these paper results often lack critical insight into those biometrics. Also, they're paper. In 2020. Which seems not just inefficient, but insane.

Fragmented and fractured — The healthcare system has to rely on a patchwork of solutions. While it has some new technology, many of its solutions are legacy, and some of it is downright ancient. Consequently, data arrive in varying forms, making it both difficult and labor-intensive to analyze, collect and retain in a single, cohesive system. For example, some of it arrives by phone, email while other forms come through snail mail, and yes, facsimiles.

The lack of interoperability between different departments — in this case, doctors, labs, and public health officials — is already a pain, but during a pandemic, it's a catastrophe. The cracks of the U.S. healthcare system were already showing before COVID-19 arrived, now they're positively glowing.

Piles of pointless information — In some cases, there has been such a lag due to the time required to parse torrents of faxes that doctors say information around results is often worthless.

"The best way I can describe it is to imagine you’re on the information superhighway, but you’re traveling with a bus pass," Oscar Alleyne, who is the chief program officer at the National Association of County and City Health Officials, told The New York Times. "Money was invested to get physician practices onto electronic health records. There was no investment to build up a similar technology to tie public health into that system." The worst part is that some U.S. citizens will likely pay for that negligence with their lives.