The dream is that the PSTN will be done away with entirely, with all traffic going through the internet.
A big problem is with fax machine manufacturers simply claiming that their machines “are not voip compatible” which is ridiculous, but the extra effort involved with getting faxes to work smoothly over voip can be a nightmare, and not something any vendor wants to be involved in supporting.
The result of this is clients with $15k fax machines reporting a myriad of problems, which the fax machine vendor claims that the only solution is a PSTN phone line for the machine, which in many areas is no longer possible due to the incumbent carrier phasing out the infrastructure or making it incredibly difficult to obtain.
There are a lot of “Efax” services whose purpose is to get around this problem by making the “fax” step just a transparent formality to appease regulatory constraints. Users can send an email with a specially formatted subject, then the “efax” company will actually “fax” the document specified in the email to a phone number owned by the efax company, which is then emailed to the intended receiver.
Either because of poor implementation or a lack of universal uptake T.38 doesn't seem to solve the problem well enough to resolve the issues.
E-Fax is the current best end solution - but adoption is slow, or lacking.
What I'd like to see is a universal, easy to use encryption system come into use, so we could just send this stuff over email.
Even with the T38 protocol: this protocol is simply not very robust and does not have much error-correction built into it.
How far off the mark am I in thinking that part of this dream you have, that was left unstated is that 'all traffic going through the internet' assumes we've fixed the last mile problem of broadband connectivity to rural areas? Because otherwise that dream effectively cuts a lot of people off from the rest of the world.
The companies want to replace the copper with wireless service because the regulatory environment is more profitable, even though they sell fully depreciated copper at $40/mo.
Worse yet, those running what service there is can go out oof business or hang up on users they don't want, and your totally SOL: https://www.cnet.com/news/in-rural-farm-country-forget-broad...
Email and fax-to-email services are generally frowned upon by the relevant medical accreditation boards, as they consider these to be insecure unless PGP is used. Email addresses have the ease of use and interoperability that fax numbers have, but PGP throws that right out the window.
Beyond the technical discussion, I remember reading that fax is considered "secure" from a regulatory/legal standpoint because fax lines are subject to wiretapping laws just as a regular phone line is. An email however, sent in plain text, can be legally read by anyone along the line who has the authority to do so. No surprises there, we know what GMail does.
What we've ended up with in Australia is a trio of internet-based secure messaging systems which have only just recently been in discussions about interoperability between themselves. I believe two of them are just end-client software which automates the PGP encryption/decryption of a given email address that you register, sending and receiving directly from your practice's clinical management system. Uptake has been kinda miserable. Until the systems are interoperable and have a large centralised directory of all health practitioners in the country, uptake will remain low. It's also only for medical practices and hospitals. It doesn't cover all the crap we get from legal and insurance firms.
Other legal issues are also stymieing progress. I have been told specifically by the CEO of a large specialist group that they won't be using any of the above systems, because having the software available means they might get electronic referrals directly from GPs.This would be instead of paper referral letters that simply go with the patient. This changes the legal onus of who is responsible for following up with patients who don't make that specialist appointment when referred. It matters when a patient decides not go do anything with a given referral, and then finds out they're terminal months later.
And so, we fax and get faxed. And it sucks.
Oh my. The unexpected legal implications and associated perverse incentives. Thanks for sharing that!
Reminds me of what I heard about information security space, where some large companies don't want to know their risks too well, as if something would happen, they wouldn't be able to say "we didn't/couldn't have predicted that".
Like.. the one Estonia has and uses for all the government services, registries and hospitals.
https://en.wikipedia.org/wiki/X-Road
Source: am Estonian.
So weird seeing other countries doing backwards things.
Talking more about citizens phone lines than medical stuff now, but...
Surprise, surprise, all of a sudden there's no warrant necessary for wiretapping.
Wonder how many of our elected representatives are working long hours to fix that curious oversight?
I know many practices use eFax though, even though it uses email and hence is against accreditation standards. Small one- or two-practitioner clinics don't have the means to trudge through the RACGP's information security standards like we do.
I did trial a local Australian eFax competitor who offered a fax-to-my-server-via-SFTP method, and was accredited with several government health agencies. The PDF image quality sucked so badly though, I couldn't run with it. Illegible. Even if it worked well though, it's still just faxes as image files, which is painful. OCR doesn't look like it'd help much, even before you think about doctors handwriting.
I've got 30 practitioners and I need incoming messages to be directed to their respective inboxes in the practice management system so we don't all go crazy.
I don't know a lot about the inner workings of Medical Objects or the third one, HealthLink. I just hope their interoperability discussions end up being fruitful.
[0] https://www.amazon.com/gp/help/customer/display.html/?nodeId...
Alternatives for actually secure document transmission boil down to difficult to use private messaging/"secure" email systems (that only work in their walled garden).
Many in the general public get frustrated with these walled gardens, as it is another login & interface to remember, and their credit union/bank, healthcare provider, company, etc will each have its own totally unique system
Oh bloody hell. Begin rant.
We've had PGP for 27 years. Twenty seven years. Since 1991. Why the hell haven't we, the tech community, gotten the rest of the world to use it? I think the only person I've had a PGP-encrypted email exchange with is my mother. It's not a walled garden, and it solves the problem described here perfectly.
We could have vote-by-email (using the key registered when registering to vote). We could have universal passwordless login. We could have virtually all communications secure from eavesdropping all the time. But no, nobody uses it outside of a few computer geeks, spies, and journalists.
* Obsolete
* Insecure (no encryption in transit)
* Insecure (no recipient validation)
* Insecure (no validation of sender or data integrity)
* Horrid quality (200, maybe 300, DPI, monochrome)
* Like PTSN interlinked phones, fairly ubiquitous.
Sadly, that last line item there is why they still exist.The exempt status also precludes any real attempt at security which makes 'fax the thing' quick and easy for untrained end users. Fire, and forget until someone pokes you about a failed fax, or even claim you tried and just assume gremlins ate all record of the first (never happened) actions.
There's also not a /ubiquitous/ replacement. The mere cost of telephone calls and duration makes blindly trying to fax out spam that way not-cost-effective (plus the negotiation of fax technology inhibits just recording a dumb audio file to play against VoIP lines). Email is practically free, but HORRENDOUS for file transfers, and at any corporation where data retention is required for legal discovery holding on to EVERY file transferred forever is hell.
While some better standards do exist, they aren't ubiquitous and often require 'non standard' software (mostly because Microsoft is highly allergic to any protocols/formats not invented by them).
Also, it needs to be part of the /default/ OS install. It would be really great if Windows Explorer (the desktop shell) understood SFTP (SSH file transfer).
One argument that could be made for the fax is the lack of availability. Some government office in Denmark have been known to email sensitive information to wrong email addresses, because of poor spelling. Some guy owns anders.dk and have a catch-all email address, and employees of the city of Randers sometimes do check that they actually typed randers.dk and not anders.dk. That guy receives have received a boat load of sensitive data. The solution is to block his domain in the citys Exchange server.... Yeeeah.
Neither fax, phone or email is particularly well suited for transmitting sensitive information, but the fax is seen as more secure, because when was the last time someone received a fax by mistake.
Don't send anything you don't want to post publicly via fax people.
Pretty sure that fax-to-email gateways have existed at least since the early 90s, most consumer-grade modems could send and receive faxes (with software to save them as images). Hooking that up to an email sender seems trivial.
Hell, back in '96 an old friend needed to get a signed letter to the bank by close of business one day, so he used a tablet to sign a document and then the modem to 'fax' it over.
--edit--
I misunderstood, you were talking about a MITM attack to prove the insecurity of faxes. Ignore me, carry on :)
Do those things no longer exist? You would think, if anything, that would be easier today than it was 25 years ago.
Doctors can’t be bothered doing anything differently, and they often don’t work for the place they are providing service at, and don’t have reliable access to email.
As doctors get swallowed up by medical networks/cartels, fax will shift to EMRs and patient portals that will leave you wishing for a fax machine.
Why? It would be very unusual for a doctor in a wealthy country not to have a smartphone with service, or the ability to get one.
I think the persistence of the fax is almost entirely a social problem, not a technical one. This article links to another, which contained this statement I found fascinating:
> Lately, doctors have taken to hand-delivering the most important records. > > “We used to fax the labor and delivery records, but they didn’t get > them or they were misplacing them,” says Hilda Moreno, who manages > the office’s medical records. “We kept getting calls like, did you > send this? And we’d say we did. So we started printing them out.”
We also had fax -> email. Believe it or not there were plenty of accounts sending email -> fax which they had configured to forward using fax -> email. ️
They incured costs on both ends rather than just sending an email. Stupidity knows no bounds...
In Australia, perhaps not.
Our home phone service was moved from copper to VOIP as part of the NBN rollout. The technician who did the installation confirmed our multifunction laser printer would no longer fax, as the network didn't enable it.
And a vast number of businesses in Japan, unfortunately
It's kind of amazing what kinds of things they will put in a fax. Stuff I would find very personal, for sure, and wouldn't want to have faxed around carelessly.
Are there any public X25 networks still in use? What about telex? Telex over HF? Inmarsat C? Any X400 gateways still running? Can you still send a UUCP mail?
This kind of digital archaeology has a strange fascination to it.
There are a bunch of nostalgia computer geeks on youtube, but I haven't seen any of them focus on unix yet. Could be fun though.
Uucp can still be used when you have intermitent connectivity.
The only way to fix it in any "reasonable" (weeks) amount of time was to fax them a bunch of documents.
How about a JPEG-borne virus instead? https://research.checkpoint.com/sending-fax-back-to-the-dark...
https://www.youtube.com/watch?v=qLCE8spVX9Q
> "See for yourself first-hand as we give a live demonstration of the first ever full fax exploitation, leading to complete control over the entire device as well as the network, using nothing but a standard telephone line. "
Maybe it's time for you to find another tax preparer. Mine accepts encrypted documents with her public key.
Not as long as you can send faxes from the Internet.
FaxZero even allows you to put in the phone number the fax comes from. It's $1.99/fax to remove the FaxZero cover letter, and they accept PayPal.
(Also, someone with the username iptel might know a bit about this.)
It's hardly surprising that fax machines are still used.