IT Administration and Diabetes Management Part 1 Faxes

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As an IT Manager for a small business I run into many problems on a regular basis. Most of these problems boil down to one thing: Communication. Over my decade doing IT for The Diabetic Shoppe, IT has changed a lot. Mostly for the better, some for the worse. I want to talk about a few of my favorite issues going on within the Medical industry and within The Diabetic Shoppe. This will be a series that covers a lot of different areas, but it will start basically with B2B and specifically faxes.

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First, and foremost let’s talk about issues related to B2B, or clinic to provider. Lots of clinics are moving to electronic prescriptions only. However, for certain DME businesses this isn’t a viable option for a number or reasons, such as the inability to request orders for new patients who have called in, the inability to request refills until arbitrary requirements are met, and the inability to have electronic prescriptions delivered to a DME without a NCPDP number. National Council for Prescription Drug Programs, (NCPDP) is an ANSI-accredited, standards development organization providing healthcare solutions.  The e-script process, usually provided by a company like Surescripts LLC, is a template that can’t fit every mold. Thus, faxes are still a major part of the medical industry.

Faxes are great. They prevent data loss and secure data because they are an older, analog technology. Modern internet fax companies have taken the place of the fax machine in most offices, but the concept is still the same. In the southern United States, and with the rise of Voice over Internet Protocol (VOIP), we are particularly at the mercy of longstanding fax issues like line noise. By my estimation and what I think is industry standard, roughly 9% of transmission attempts will “fail” for one reason or another. A few are simple, like the paperwork being oriented incorrectly (backwards), faxes being sent to a wrong number, etc. However, when clinics use tech like VOIP (which is not viable for faxing if your business depends on it) or when they are operating on and older infrastructure that was lain decades ago, or when they are in a swampy and wet region, line noise can play a major factor.

I will, from time to time receive a call saying “your fax lines are down.”Of course, due to the hundreds of successful faxes we receive daily, we don’t have fax lines, we use an array of Health Insurance Portability and Accountability Act (HIPAA) compliant fax service providers to diversify the risk of fax issues being on our end. I’ve also heard many times that “we’ve faxed you something, didn’t you get it?” Best practice must be followed in order to guarantee that important medical paperwork is transferred with each fax.

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  1. Always get a confirmation sheet. If your fax fails or partials out, you will get a reason. Look up the code. If that reason is line noise, ask the provider or clinic to give you another fax number to try. If you notice you get a lot of line noise issues, you may check with your Internet Service Provider (ISP) to verify that you are not using VOIP technology to try and fax important content. Switch to a HIPAA compliant Internet faxing service to guarantee transmission.

  2. Adjust your fax machine. The default mode of fax machines are perfect, if you live in New York City and have an optimal connection to a telephone company’s central office. If you are rural or even if you live in a city, you should turn your baud rate down and turn off error correction mode (ECM). The maximum compatibility settings should be used in a medical environment. Most often this is a template on your machine called “overseas mode.” Use this and your fax issues will dry up.

  3. Reduce the number of pages you are trying to fax. Instead of faxing a 60 page document, fax 3 20 page documents. The more you try to fax the lower the chance it will go through. The relative content on each page also matters. Photos and pics take much longer to fax than text.

  4. If you have line noise, call your telephone company. They need to fix that, since you are paying for a standard of service you are not receiving.

There are a lot of issues and some benefits related to faxing. Make sure you always use a cover sheet in a medical environment and TRIPLE CHECK the destination phone number. Mis-faxes can violate HIPAA. Your business and your patient’s privacy depend on it. Never leave or place a fax machine in an area where non-employees can view the content, and always keep your machine in view of at least one other employee. If you use a HIPAA compliant provider always make sure that both ends of the transmission are encrypted properly and that the web portal or email solution you use is secure and HIPAA complaint specifically for transmission of patient medical records.

In part 2 of this series, I will cover the ins and outs of e-prescriptions. I hear this a lot, “Our office only handles e-scripts.” Did you know that, for example, that limits the number of providers you can work with significantly? Have you, for example, often sent out for a wheelchair with an e-script? We’ll discuss that soon. Have a great day!

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