When was the last time you saw a fax machine, or heard its dulcet tones? If you work in a hospital, it's likely you've seen one recently.

Do you remember when the floppy-disk was more than the 'save' button in Microsoft Word? Or the goose-bump inducing sound of dial-up internet ringing through your ears?

Technology has come a long way since then.

In a New Zealand hospital today a surgeon can assist a robotic operation; an anxious child can go through a procedure before it happens through a virtual-reality headset – and down the corridor, a doctor will pick up a patient's sensitive medical information from an antiquated, stuttering fax machine.

Today, the fax machine - or the 'electric printing telegraph' as it was patented in 1843 - has all but disappeared, but lives on in our hospitals.

READ MORE:

* Want to see your medical records? Simply go online

* Medical records still coming to wrong fax

* Work on troubled health IT project suspended; four DHBs already live

* Damning report into beleaguered $90m health project released

New Zealand's health sector is dragging its feet on going digital, instead relying on a relic of the past which leaves patients and hospitals open to privacy breaches, according to an international expert.

SUPPLIED Richard Corbridge, chief digital officer at Leeds Teaching Hospitals NHS Trust is behind the Axe the Fax campaign, trying to get fax machines out of his hospital.

This week research by the Royal College of Surgeons found NHS hospitals trusts remained heavily reliant on fax machines - with more than 8000 machines still in use in England - prompting calls to modernise the IT infrastructure of the health service.

Chief digital and information officer at The Leeds Teaching Hospitals NHS Trust Richard Corbridge said the NHS could not "afford to continue living in the dark ages", and New Zealand risked falling into the same trap.

He spoke to Stuff ahead of a visit to Wellington in November, where he will speak at the Health Informatics New Zealand (HiNZ) conference.

Corbridge is spearheading the 'Axe the Fax' campaign at The Leeds Hospital Trust — pledging to remove almost all its "antiquated" fax machines by 2019.

It's not just that they're old-fashioned, they can be a weak point for hackers to gain entry to an organisation's entire network, the Washington Post reported in August.

Stuff approached the 20 district health boards to ask whether they still used fax machines.

Of the 12 who responded by deadline, all still used fax machines to exchange patient files, or test results and prescriptions internally - among clinicians - or externally to/from GPs, rest homes, palliative care facilities, or NGOs that still rely on paper-based forms.

Twelve - Auckland, Waitemata, Counties Manukau, Waikato, Lakes, Taranaki, Capital and Coast, Hutt Valley, Wairarapa, Nelson/Marlborough, Canterbury and West Coast - responded by deadline.

Most were aware of the insecurities fax machines posed and the potential for misdirection, and many were moving to phase standalone machines out.

Some were actively going digital: adopting e-triage and e-referral systems, as well as using shared care electronic medical records.

For example, all South Island DHBs used a shared electronic health record, which reduced the need to transfer patient information, they said.

The sectors' reliance on fax machines presents multiple shortfalls, chief executive of health IT company Celo, Steve Vlok said.

New Zealand's health sector - and the public sector in general - have been slow to adopt digital technologies, a health IT expert says.

First, "it's just a number, it's very easy to put the wrong number in". If you get the number wrong, sensitive files can go to anyone.

Even if it reaches the right person there's no traceability, as a fax number goes to a device not an individual.

Documents just sit in the tray waiting to be picked up, which is not ideal if its an urgent lab result or referral, Vlok said.

"You don't know who has read it, if they've read it, what they've done with it..."

It also took away from time spent with patients - uploading, scanning, faxing and filing a document was "time wasted" - and having those documents sitting around was "not the best way to store confidential information".

The public sector is slow by nature when it came to adopting new solutions and new technology, Vlok, who co-founded a secure messaging platform for health professionals, said.

Government cyber-security agency Cert NZ's operations manager Declan Ingram said issues around fax machine security have been known for more than a decade.

"They often keep a record of everything that has been sent and received - information that can be viewed by an attacker if they get hacked."

Chief technology and digital services officer at the Ministry of Health Ann-Marie Cavanagh said fax machines, like all telecommunications mediums, could be subject to "malicious" activity.



Technical security guidance from within the New Zealand Information Security Manual (NZISM) and the Health Information Security Framework is used securely manage communications technology, and there are specific connection and configuration controls in order to prevent unauthorised access to them, Cavanagh said.



"Patient privacy and safety is taken extremely seriously throughout the sector, and all reasonable steps are taken to apply appropriate assurance measures to ensure the ongoing integrity of information and communications systems," she said.