Happy Friday! More importantly, happy No Fax Friday! While it was a nice gesture for the ONC to name October 12th as “No Fax Friday” in honor of National Health IT week, it is highly unlikely that fax machines will stop chirping in healthcare today. Don’t get me wrong…I love all the hype about taking fax out of healthcare. After all, Kno2 has been talking about removing the barriers of interoperability by disrupting fax workflows for quite some time…way before headlines of fax machine hacks, the call to end physician fax machines by the year 2020, or corporate America giants pledging to step in and help remove barriers to interoperability. Since the company’s inception, Kno2 has been aligned to this philosophy.

As far as I am concerned, today is a historical day. Today is about the commitment to remove fax from healthcare. It’s about beginning to treat the problem rather than the symptom. We need to offer an alternative to fax with a cost-effective, fast to implement and easy to use service that utilizes healthcare standards and provides a path to interoperability so providers can simply start somewhere, anywhere, determined by them, at their discretion and on their timeline.

But what if we could all just “say no to fax”…or as we like to call it…”SayKno2Fax”?

Perhaps we’d wake up to headlines that the technology has finally passed away, with an obituary and articles honoring its long life and contribution to society. In fact, one may read a bit like this:

Fax, relic of bygone technology age, dies at age 54 (1964-2018)

The fax machine, a surprisingly persistent and five decades old technology used for sharing documents through telephone networks, churned out its final indecipherable document last night in a New Jersey medical office. Its distinctive, shrill warble was heard for the last time shortly before what appears to be a copy of a patient chart was reproduced via paper form and laid to rest in its secondary tray.

The descendant of the telefax machine, which appeared in 1865 and predated the invention of the telephone, the fax first appeared in its commercialized form as Xerox’s Long Distance Xerography (LDX) machine. Two years later the technology evolved into the 46-pound Magnafax Telecopier, commonly seen as setting the standard for the facsimile machines encountered in professional settings for over 50 years.

Despite the rapid evolution of technology in recent years, the fax machine remained a constant in medical settings. In fact, one study suggests that the fax machine continued to hang on despite news of  terminal prognosis, accounting for 75 percent of medical communication as recent as January, 2018. Its minimal cost and ubiquity throughout medical settings enabled the fax to endure for decades beyond other outdated technologies.

“I think we’re all shocked that the fax lasted as long as it did, but clearly it was an old and familiar friend to many generations,” said Alan Swenson, Kno2’s Director of Interoperability. “That said, I had to explain that distinct fax noise to younger coworkers, who thought the machine was about to self-implode.”

Fighting off many alternatives since its inception, the fax finally succumbed to Kno2, the company that provides Interoperability as a Service to everyone in healthcare. The innovative healthcare technology leader developed a vaccine. Who would have thought you could use fax to eliminate fax, but that is exactly what they did by centralizing all forms of standards-based exchange methods into a single platform, including cloud faxing. “Instead of avoiding the reality of fax or assuming our technology would immediately eliminate fax”, said Therasa Bell, president and CTO of Kno2, “we chose to embrace it by integrating cloud-fax into the platform and leverage the fax-based exchange to assist providers in their transition to interoperable exchange.”

Given its decades-long technology history, the fax is not survived by any immediate family, aside from antique typewriters in museums and the occasional adding machine in an accountant’s office.

Now back to reality….

Studies have shown that about 40 percent of people’s daily activities are performed each day in almost the same situations…this is how habits are formed.1 It has been said that it takes 21 days to either break a habit or to create a new one.  No one is entirely sure where the 21-day rule originates, but it seems to have first been seen in a self-help book published in the 1970’s called “Psycho-Cybernetics.”2

I know this may feel like a strange twist to my message, but faxing runs deep in the healthcare bloodstream and is indeed a habit that may feel as overwhelming to kick as smoking or weight loss. I get it…pulling the plug on your fax machine may be hard, but if we are going to improve patient outcomes, reduce healthcare costs and truly impact the quality of care, then a plan to eliminate fax is necessary and must be intentional.

In an article1 on forming habits, there are steps recommended to improve the chances at successfully breaking a habit:

  1. Take small steps. Don’t try to do everything at once. (So instead of “We want to be fax free by 2020”, start with “We will ensure an alternative method to fax is in place, like Direct messaging”.)
  2. Only try to change one habit at a time. (So instead of “We will stop faxing altogether”, start with “We will identify providers we’d normally fax to and see if they have a Direct address”.)
  3. Write down the habit you want to change and write down specific plans for achieving that goal. (Again, rather than writing down “We will stop faxing”, start with “We will send to a Direct address instead of a fax number where possible.”)
  4. Repeat the behavior you’re aiming for as often as you can. The more a behavior is repeated, the more likely it is that it will become “instinctive.”

If you are not sure where to start, that’s okay…we’ve got you covered.

Kno2 is poised and ready to tackle the challenge of helping your office ultimately become a fax free organization. Kno2 enables cloud fax, Direct messaging, patient query, referral networks and HIE connectivity all in a single experience. By following similar workflows and maintaining the focus on the patient information and not the technology driving it, Kno2 has successfully migrated care providers away from fax and to interoperability.

When healthcare is ready to #SayKno2Fax; I’m looking forward to a party rather than a funeral.


  1. ScienceDaily – How we form habits, change existing ones
  2. How Stuff Works: Is it true that if you do anything for three weeks it will become a habit?

Contributing Author: Tina Feldmann, VP of Corporate & Product Marketing, Kno2