HIMSS; Fax 2.0 in Health Care: How Cloud Fax and AI Are Turning “Outdated” Technology Into a Scalable Interoperability Tool

Fax technology is often criticized as a symbol of health care’s slow digital transformation. Yet many providers still rely on fax to exchange clinical information across disparate systems. As interoperability requirements expand through federal policy and industry initiatives, some experts argue that modernizing fax rather than eliminating it may offer a practical bridge toward fully connected health systems.

In this interview, Bevey Miner, health care strategist at eFax by Consensus Cloud Solutions, discusses how cloud-based fax combined with artificial intelligence can convert unstructured documents into structured, FHIR-ready data. She also explains how this approach may help smaller or resource-limited providers participate in emerging interoperability frameworks.

ICT: Fax is routinely mocked in health care innovation circles. Are we wrong? Is ripping it out actually less efficient than upgrading it?

Bevey Miner: Let’s first distinguish between paper fax and digital cloud faxing. We support eliminating paper faxing. The mockery of fax in innovation circles often stems from a misunderstanding that overlooks the operational realities of the broader health care landscape. The call to 'rip and replace' fax is not just an efficiency risk; it is an equity risk.

Many providers lack the financial resources to deploy the advanced data-sharing standards that are driving the interoperability architecture vision, many of which are mandated by regulations. It would inadvertently create a 2-tiered system that leaves small, rural, and underresourced communities behind. Furthermore, many health systems have disparate technologies, and secure digital cloud faxing is the most efficient way to ensure continuity of care.

The ubiquitous use of digital cloud fax can’t be ignored. Look at the statistics. 80% of health care data is unstructured. The next level of digital maturity from a fax machine is cloud fax. Billions of pages of cloud fax are sent and received annually, and that number is growing.

Digital cloud fax is not the problem. Modernizing it and creating intelligent faxing processes are the solutions. By layering AI, specifically intelligent data extraction solutions, directly into the cloud fax workflow, we can turn unstructured, static documents into searchable, actionable, and FHIR-ready data. This also includes extraction from other unstructured documents, such as Portable Document Format (PDF) files and scans. This approach ensures greater continuity of care without delays caused by data entry. With greater visibility to patient longitudinal data, more informed patient care is possible.

In short: Innovation that excludes is not progress; innovation that integrates is. Cloud fax isn’t a roadblock; it’s an accelerator that today allows lower-tech providers to keep up with high-tech counterparts. With cloud fax as the foundation, organizations can meet modern interoperability standards now without the enormous cost and complexity of a total system overhaul.

ICT: If AI is extracting structured data from a fax in real time, what stops this from becoming a shadow interoperability network outside the electronic health record (EHR)?

Bevey Miner: The right digital cloud fax workflow prevents current and potential "shadow networks" by acting as an integrator layer and a passthrough platform rather than its own data repository. Using National Language Processing (NLP), machine learning, and artificial intelligence (AI), these solutions extract content from unstructured sources, such as handwritten documents or scanned images, and map it directly into the EHR. The data isn’t stored within the extraction engine; rather, it is injected directly into the organization’s workflow, functioning as a high-speed data transformation pipeline that eliminates data silos and makes the vast amounts of "dark data" in health care searchable and actionable.

This architecture operates within a strict governance framework of Health Information Trust Alliance Risk Management Framework (r2) and Health Insurance Portability and Accountability Act compliance. Ethical, transparent, and compliant operations are fundamental to the design, with data being access-controlled. By prioritizing EHR or other organizations’ workflow ingestion, these tools provide the essential infrastructure to securely integrate data, ensuring a single, comprehensive patient record.

ICT: Healthcare Information and Management Systems Society (HIMSS) is synonymous with progress in interoperability. At HIMSS 2026, how do you position modernized fax as an evolution rather than evidence that health care transformation has stalled?

Bevey Miner: Health care’s interoperability progress has been a theme at HIMSS for over a decade. With the possibility of data extraction and AI, we now have the capability to advance interoperability for all. This is the greatest level of progress.

While the industry’s ultimate goal is seamless and secure integration between systems, this can only happen when all providers participate. Our solution presents the greatest opportunity for the success of Trusted Exchange Framework and Common Agreement and the Centers for Medicare & Medicaid Services Interoperability Ecosystem to include more patient data. You cannot query what you can’t find.

Modernized fax represents an evolution because it addresses the resource gap that often leaves under-resourced or rural communities from participating in these initiatives. Cloud fax technology provides the crucial foundation, guiding organizations through the 3 essential phases of digital transformation necessary to achieve advanced interoperability.

Migration: Moving paper-based fax processes to a secure, HITRUST r2 certified, fully cloud-based environment.

Digitization: Utilizing proprietary AI to unlock unstructured data from scans, handwriting, PDFs, and faxes, turning static images into Fast Healthcare Interoperability Resources (FHIR)-ready structured assets.

Intelligent Workflow Automation: Transforming extracted data and accelerating critical workflows prone to bottlenecks; patient intake, referrals, orders, and prior authorizations.

ICT: Do you have anything else you would like to add?

Bevey Miner: Recent or proposed regulations require that providers implement FHIR for interoperability. As an example, effective January 1, 2027, any provider submitting a prior authorization for Medicare Advantage patients must send it using FHIR. Without a FHIR-enabled EHR, this becomes a challenge. Not every provider is on a certified EHR with this capability.

Another example is within the new proposed rule from the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology, which requires FHIR for electronic case reporting (eCR). What is the rural community clinic supposed to do in order to populate the CDC’s registries? Without all providers participating, the data becomes biased. There are other examples in the proposed rules, as well as participation in TEFCA, that require FHIR.

Intelligent digital cloud fax can help providers satisfy these rules and participate in these interoperability initiatives by intercepting a digital cloud fax, moving from unstructured to structured data, and converting the data into a FHIR message.