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FaxBetter and HIPAA compliance

This document outlines the requirements of HIPAA in terms of faxing protected health information and how FaxBetter, an easy-to-use cloud-based fax service, can help health organizations to comply with HIPAA’s regulations for information flow and exchange. Fax server technology is a secure method of communicating and is simple and affordable way to assist healthcare organizations in becoming HIPAA compliant.

Introduction
The U.S. Congress recognized the need for national patient record privacy standards in 1996 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted. The law included provisions designed to improve efficiency and reduce costs for health care businesses by encouraging electronic transactions, but it also required new safeguards to protect the security and confidentiality of that information. In November 1999, the U.S. Department of Health and Human Services (HHS) published proposed regulations to guarantee patients new rights and protections against the misuse or disclosure of their health records. The Act has changed the way healthcare organizations send, receive, and manage confidential information. Previous hard copy paper systems are considered insecure and a liability and therefore new alternatives for exchanging and tracking protected health information (PHI) are required.

HIPAA and faxing
The primary objective of HIPAA is that health organizations have the infrastructure and procedures – administrative, technical and physical – that allow them to safeguard patient health information from any kind of exposure or disclosure to unauthorized parties when this information is required to be transmitted or delivered to authorized individuals. HIPAA does not prohibit the use of fax machines to communicate however the information is subject to strict regulations that protect the privacy and security of the information both at the point of dispatch, during transit and at the point of delivery. The security provisions of HIPAA require “reasonable” efforts to make sure that the information delivery via fax has been sent securely and was received securely and by the person intended.
HIPAA makes a number of demands to ensure that patient health information is properly protected. These, in relation to security and privacy, include:

• All fax machines are to be placed in a secure area and are not generally accessible.
• Only authorized personnel are to have access and security measures should be provided to ensure that this occurs.
• Destination numbers are verified before transmission
• Recipients are notified that they have been sent a fax.
• Include a cover-sheet clearly stating that the fax contains confidential health information, is being sent with the patient’s authorization, should not be passed on to other parties without express consent; and should be destroyed if not received by the intended recipient.
• Any patient data should be in the fax body and not in any of the data fields.
• Faxes are to be sent to secure destinations; i.e., the fax machine of the recipient must be in a secure location, accessible only by those authorized to receive the information.
• Maintain a copy of the confirmation sheet of the fax transmission, including the necessary data such as time and recipient’s number.
• Confirm fax delivery by phoning the recipient.
• Received faxes are to be stored in a secure location.
• Maintain transmission and transaction log summaries.

Why traditional faxing methods are problematic
Although HIPAA does not prohibit patient health information from being faxed to authorized recipients, manual faxing is fraught with security issues that would certainly prevent health organizations from being compliant with HIPAA strict requirements. With manual faxing, there are a number of risks:

• Fax machines may not be located in a secure area and access to faxes may not be restricted to authorized personnel only.
• Senders are required to wait by the machine until the transmission is completed, waiting for the transmission report, collect it and file. They also have to call the recipient to ensure that it has been received completely and as intended. This takes up precious time for the health professional. If the recipient is not available, important information may be delayed.
• Incoming faxes need to be removed immediately from the output tray and distributed to the recipient to reduce the chance of an inappropriate use or disclosure.
• Any pre-programmed fax numbers need to be validated periodically and regular fax recipients contacted regularly to ensure that the number has not changed. The destination fax machine may be in a secure location but may still be accessible to a number of people.
• The information in hard copy must be filed securely.
• Transmission may not always be secure and reliable (especially in areas with basic telecommunication infrastructure).
• In the spirit of HIPAA, which aims to create more effective health organization practices, manual faxing is expensive – requiring multiple communications lines, hardware, maintenance costs and material (paper and toner).

Why FaxBetter is the solution?
FaxBetter resolves all the fax-related privacy and security issues that are highlighted in a health organization’s HIPAA plan. FaxBetter makes sending and receiving faxes an efficient, simple and cost-effective process. The problems with manual faxing – printing out the document, walking to the fax machine, waiting for the fax to go through, not to mention the cost of fax machine supplies and repair – are immediately resolved; but more importantly, FaxBetter allows users to send and receive faxes directly from their email client – in most cases totally eliminating the need for a manual fax machine. FaxBetter requires no installation or maintenance and integrates with your mail server, allowing users to send and receive faxes using their email client. You can even back up all faxes and search them in the same way that emails are stored and retrieved on the network. Furthermore, if email correspondence is being archived (which is a federal requirement for most sectors), all your faxes are also stored in a central, secure database. With FaxBetter you do away with the need to handle and transfer original or duplicate copies of patients’ medical records, thereby reducing the risk of losing or misplacing files as well as reducing the time to send the documentation. Since faxes are sent and received via email and authentication on the email client is required to access the faxes, there is no concern that the patient health information will be sent to the wrong recipient or that someone else can retrieve the information without authorization. For additional security, health organizations can bypasses the email client and send and receive faxes via our web interface if there are concerns with the security of email. With server systems and database stored in secure locations and managed solely by authorized personnel only, there is not risk that emails/ faxes can be tampered with, deleted or accessed by third parties. This ensures that all patient information is secure at all times – prior to, during and after transmission.

Privacy and security requirements

• All fax machines are to be placed in a secure area and not generally accessible. Faxbetter’s solution is that both outbound and incoming faxes can be sent /received using an email client. This removes the need for a manual fax machine and therefore no special security measures need to be taken to safeguard the data or the equipment.
• Only authorized personnel are to have access and security measures should be provided to ensure that this occurs. Faxbetter’s solution is that is that outbound faxes can be sent via the individual’s personal email client. The documentation does not need to leave the sender’s office nor is it handled by anybody else. With incoming faxes, these can automatically be routed to the user’s mailbox. This ensures that no one else can see the documentation just received except for the intended recipient or other authorized personnel.
• Include a cover-sheet clearly stating that the fax contains confidential health information, is being sent with the patient’s authorization, should not be passed on to other parties without express consent; and should be destroyed if not received by the intended recipient. FaxBetter allows for the creation of cover pages.
• Maintain a copy of the confirmation sheet of the fax transmission, including the necessary data such as time and recipient’s number. Faxbetter’s solution is that transmission reports including miniatures of the fax can be accessed on the FaxBetter website at any time.
• Received faxes are to be stored in a secure location. Faxbetter’s solution is that with email archiving implemented all faxes sent or received using FaxBetter are stored in a secure database, allowing easy access, searching and auditing.
• Maintain transmission and transaction log summaries. Faxbetter’s solution is that with email archiving implemented all faxes sent are received using FaxBetter are stored in a secure database, allowing easy access, searching and auditing.

Other benefits of FaxBetter to help you be HIPAA compliant

• Reduced administration

• FaxBetter is a cloud based application. This means that all updates to FaxBetter are completed automatically, virtually eliminating the need for administration.
• Automated Fax Delivery/Inbound Fax Routing
• FaxBetter can automatically route incoming faxes to the user’s mailbox.

• OCR reading and searching

• All incoming faxes are converted to a readable text using Optical Character Recognition (OCR) technology making searching for a particular fax much easier.

• Receive a fax by email in PDF format

• FaxBetter delivers faxes to the user’s inbox in an Adobe PDF file. This enables users to check faxes from anywhere in the world, using either a normal desktop email client (for example, Outlook) or a web-based email client (for example, Outlook Web Access). Receiving faxes in PDF format means the fax can be easily forwarded and it also allows for easy integration with document archiving systems or workflow procedures.

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