Question: Wheres the Fax Number?

Apr 6, 2018

Question:

Where Can I found Fax number in PID Segment?

Answer:

If you look at a standard display of the fields in the PID segment (this one, or this one), there’s no fax number, just home and work phone numbers … in spite of the healthcare system being obsessed with faxing. So where is it? (and, while we’re at it, there’s no field for email either…)

Well, HL7 finally did something about this in v2.7, in 2011:

PID-40 Patient Telecommunication Information (XTN)

This field contains the patient’s personal telecommunication contact information. This field replaces PID-13 – Phone Number - Home and PID-14 – Phone Number – Business with the intention that the components of the XTN data type be used to identify phone usage (Telecommunication use code) and type of equipment (telecommunication equipment type). Jointly, these components will describe the nature of the telecommunication data contained in this field

The important thing about this is XTN component 3 which carries one of these codes:

  • PH Telephone
  • FX Fax
  • MD Modem
  • CP Cellular or Mobile Phone
  • SAT Satellite Phone
  • BP Beeper
  • Internet Internet Address
  • X.400 X.400 email address
  • TDD Telecommunications Device for the Deaf
  • TTY Teletypewriter

Actually some of those show their age… but records are forever, and healthcare institutions have records going back a long way.

Yay for faxing

Aside: healthcare is well known for reliance on faxing, and not only the fax protocol, but on physical paper based faxing. A lot of the commentary about healthcare’s reliance on faxing misses the second point, and I think it matters.

See, most of the discussion about fixing the dependency on faxing relates to replacing the fax protocol with some kind of digital transfer protocol. but you can do that with faxing right now - it’s just a protocol, and any healthcare institution can replace the physical fax with a network fax receiver and start handling PDFs. Yes, digital protocols can make that even better by transferring some processible information like patient identifiers. Which matters, maybe, if there is shared patient identifiers. but even when there is, you still routinely see photos of stacks of papers produced by faxing… when there’s no protocol related reason for that to happen. I presume that there’s some deeper resistance to handling information electronically.

So I think that the problems are deeper than a protocol replacement - mainly a mix of technology policy & acceptance problems, and that paper faxing got grandfathered in before security started getting tight - and the fact that faxing paper doesn’t scale well is a feature in that respect. Change don’t come easy…