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Thursday, September 16, 2021

Outdated and Antiquated

Outdated and antiquated. First conceived in 1842 and patented by a Scottish inventor, it took decades for the facsimile machine to catch on. The history includes innovation by an Italian priest in the 1860s. Remember, it was not until 1869 that the golden spike driven at Promontory Point Utah completed America's first transcontinental railroad, according to the History Channel. The facsimile machine is truly 19th Century technology.

Certainly, it was not all that useful back then. It took decades for the machines to become accessible to the masses, the 1970s marked the real ascent of this technology, over 120 years after its invention. Along the way, there was innovation and improvement. Most readers will not remember that even in the late twentieth Century most of those machines printed on thermal paper that was specialized, expensive, and came on a roll. The pages produced would tend to curl up long after the print was created, and over time the text became difficult or impossible to read as it faded.

By the late 1980s, every professional office had a facsimile machine. They were fast, confirmable, and convenient. People liked that a "confirmation page" could be generated showing the time, date, and destination of a particular fax. We stapled those to the back of our file copy and stored them with other papers in our bulky files, file cabinets, and file rooms. It was a different era. 

But, since the early 1970s computers had been linked together in communication networks, mostly in academia. And by 1983, it can be said that the Internet was officially born. The sharing of information became more rapid, and less constrained by special equipment, and innovation progressed rapidly. The 1990s brought electronic mail to the masses, but the Guardian assures us it also had its birth in the 1960s. Over the last 30 years, the email paradigm has gained prominence. Despite the other available options, it remains the standard communication tool of most professionals. 

Each OJCC District Office had a fax machine in the 1980s, but electronic mail had not yet come to call there. In fact, in the early 1990s, the OJCC did not even have personal computers (PCs). Documents were created on proprietary word processing machines, and the PCs were just beginning to enter the scene. It is fair to say the OJCC was behind the curve as to computers. 

Facsimile was "the" way to send a document rapidly in the workers' compensation world of the 1990s. They were so convenient that judge's offices began limiting their use; too many incoming faxes with their potential, yet too often illusory, urgency were disruptive of the office workflow. If people had been discrete and used the urgent tool only when urgency was real, perhaps that would have been different. Even today, many people periodically add the word "emergency" to the most mundane of motions. When the Rules were adopted, facsimiles were addressed; Rule 60Q6.108(1)(d) requires permission for filing via a facsimile.

The Twenty-first Century brought electronic filing. The OJCC rolled out e-JCC in the fall of 2005 without fanfare. The early adopters found the tool on their own, used it, provided feedback, and led the (r)evolution. The rules mandated e-filing in 2010, and the statute largely required it in 2011. The age of the Internet was well upon us a decade ago, and yet those fax machines remained. They were largely silent, except for the periodic advertisement or solicitation. 

With e-filing, noticeably, the use of fax machines diminished. The OJCC has discussed discontinuing its expenses repeatedly over the last decade, and the time has come. The OJCC has eliminated all facsimile machines except the one in the OJCC Clerk's office in Tallahassee. That is logical. First, all documents filed with this Office are to be e-filed, Rule 60Q6.108(1)(a). There is an exception for those who self-represent. However, any paper filings are to be only filed in Tallahassee anyway: "Any document filed in paper form by U.S. mail, facsimile, or delivery shall be filed only with the OJCC clerk in Tallahassee." Rule 60Q6.108(1)(a).

There were those who occasionally faxed in some late-breaking document for a mediation, but even that has diminished. Thus, the consolidation is logical, cost-efficient, and frankly overdue. Any facsimile to the Florida OJCC should now be to the Tallahassee Clerk's facsimile number: (850) 487-0724, and the use of facsimile should remain exceptions to the rule. Rule 60Q6.108(1)(a).

The OJCC is not alone. The recent pandemic has driven reform in the medical community. As the OJCC has debated discontinuing facsimiles, the main objection has long been that medical professionals prefer facsimiles. We communicate with physicians largely due to the Expert Medical Advisor (EMA) statute. There are some doctors who describe that they "don't do" email. Our remaining fax number will accommodate their use of facsimile if they persist. 

The British Broadcasting Corporation (BBC) recently reported that the medical profession's reliance on facsimile was a challenge during COVID-19. In September 2021, it reported, "The outdated machine hampering the fight against Covid-19." It says that the volume of facsimile transmissions increased with the pandemic, and medical staff was challenged to keep up. 

More troubling, they were forced to devote significant time to converting those paper submissions into database information, sifting for duplicates, and maintaining records. In a time that put significant demands on medical practices, the absence of effective, modern, data management was a distraction and detriment to the practice of medicine. The medical community and regulators apparently have taken notice. 

The BBC reports that "the inefficient sharing of data has left a growing number of governments promising to finally abandon their use of fax machines." The Netherlands, Japan, and others are noted specifically. The article notes that the reliance on "outdated technology" in the medical profession persists beyond facsimiles, with pagers and other dated paradigms still relied upon. The seemingly singular strength attributed to the fax is security, a facsimile is far harder to hack than an email, but the primary driver of continued reliance seems to simply be resistance to change in a general sense.

Before these machines can be permanently relegated to the scrap heap of history, there is work to do in the compatibility and sharing of medical data and records. database evolution is needed in that profession. I spoke recently with a doctor who expressed frustration. Despite this physician having a robust data system and electronic records, data from a patient's care elsewhere cannot be seamlessly added. The information from other providers is received in PDF format, printed, and then re-entered. The physician is confident that her records sent to other care providers are likewise being handled, interpreted, and re-entered by humans. Time-consuming and inefficient don't begin to describe that. But, that is not an argument for the facsimile, merely a criticism of how fast a profession is evolving. 

There will be an algorithm and artificial intelligence. There are already computer programs that scrape data from electronic records and reorganize and recategorize it. That innovation is coming. There will be truly integrated and seamless sharing of medical records in our lifetime. First, because it is practical for such a program to be developed, and second because the cost of manually re-creating all that data on a doctor-by-doctor basis is expensive. The profession will evolve, mark my words. As we see regulators mandating modernization with facsimiles, similarly we will see the mandate for such record integration and standardization. 

For now, the message is facsimiles have, after a century of obscurity, and decades in the limelight, faded like those old, curly, thermal pages. The OJCC will retain some capacity for now at the clerks' office, but gone are the various machines sitting, humming, and waiting throughout the state. This is progress, and a day will likely come when people you hire will know "facsimile" only because they looked it up on the Internet, or their grandparents had one. Welcome to the next step it the facsimile revolution, its end. 

Any facsimile to the Florida OJCC should now be to the Tallahassee Clerk's facsimile number: (850) 487-0724, and the use of facsimile should remain exception to the rule. Rule 60Q6.108(1)(a).