Hey there,

Here's a fact that never quite lands: the fax machine was patented in 1843. Not 1943 — 1843. The telephone was still 33 years away, and Confederation hadn't happened yet. The first commercial fax service ran between Paris and Lyon in 1865.

So when people learn their doctor still faxes in 2026, the joke writes itself. And it happens a lot — Ontario's physicians send roughly 152 million faxes a year, on a technology older than the lightbulb.

But the dunking misses the point. They're not faxing because they're behind. They're faxing because it's the one thing that reliably works.

Ontario runs on a patchwork of electronic records that can't talk to each other — the province itself has called it "thousands of separate, disconnected versions" of the medical record. In that world, the fax is the universal translator: every clinic, lab, and hospital has one, it's PHIPA-legal, and it reaches anyone no matter what software they run. Close to 90% of doctors still rely on it, and 56% of referrals still travel this way. Necessity, not nostalgia.

Here's the encouraging part: where systems actually connect, the fax quietly disappears. OntarioMD's Health Report Manager now routes hospital discharge summaries and imaging reports straight into EMRs — 211+ facilities and more than 30 million reports in 2025, no fax required. The pipes are being built; it's just uneven, and slow.

Which points to where the real progress is. The smart money isn't on killing the fax — it's on making it intelligent. A faxed requisition is just a document, and modern OCR and language models can now read one and turn it into structured data about as reliably as a person keying it in, without waiting for two EMRs to ever agree on a standard. The fax stops being a dead end and becomes an on-ramp.

A 183-year-old machine isn't going away this year. But the manual retyping behind it might.

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