The New Fax: A Technology Reinvented from Fax Machine to Enterprise Fax Software 1 THE NEW FAX

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1 1 THE NEW FAX A Technology Reinvented from Fax Machine to Enterprise Fax Software By Peter Davidson, Davidson Consulting ABSTRACT Fax has evolved into an advanced document management technology, offering significant cost, productivity, and security benefits to today's enterprises. Savvy organizations are deploying enterprise fax software to transform paper to digital media, automate diverse and mission-critical business processes, save on usage and telecom costs, drive green initiatives, virtualize hardware to software, achieve business continuity, and increase security of their sensitive data. This whitepaper covers 10 key areas in which to get the most out of today s enterprise fax technology that can be completely software-based versus fax machines or hardware-based computer fax servers. Any firm still having a fleet of fax machines or older hardware fax servers has a huge opportunity to drive meaningful cost reductions, efficiency improvements, and information security. A hospital case study is included that describes actual business issues and the results achieved by upgrading their fax technology.

2 2 Overview As a fax industry analyst, I know firsthand that anyone who Fax has evolved into a identifies fax technology with fax machines slowly turning computer driven capability that out images on thermal paper over standard telephone lines integrates with every type of might be surprised to learn that hospital systems, major information system, and is capable banks, shipping companies, government agencies, and of receiving documents, turning scores of enterprises continue to make major investments them from images into data in a in computer based fax solutions to support their missioncritical business requirements. Why? What do they know matter of seconds, and then inputting that metadata into about today s fax capabilities that lead them to make such databases or automated significant investments in something others dismiss as an workflows. outdated technology? And what can other organizations both large and small learn by understanding the sophisticated uses to which these major players apply today s fax technology? Despite the fact that it was invented in 1843, fax is not so much an aging technology as a technology that has reinvented itself. Fax has evolved into a computer driven capability that integrates with every type of information system, and is capable of receiving documents, turning them from images into data in a matter of seconds, and then inputting that metadata into databases or automated workflows. Today there are fax servers, hosted over the Internet fax services, and hybrid systems that combine both on premises fax servers and cloud based fax services to function as the best of both worlds. Fax is silent, fax is inexpensive, fax is not as prone to legal e discovery as , fax is immune to viruses, fax is auditable, and fax can help enterprises comply with a slew of governmental regulations. Fax is now a green technology. Fax is a positive communications medium with real value to any enterprise The fact is that fax integrates with virtually any computing environment, can automate virtually any document routing and workflow process, and is of enormous benefit to both productivity and the bottom line. Specifically, today s computer fax solutions offer the following Top Ten benefits: 1. Drastically reduce usage and telecom costs 2. Capability to virtualize systems and drive green initiatives 3. Integration with legacy production systems 4. Automated rules based document reception 5. Integration with desktop client applications, health IT systems and multi function peripherals (MFPs) 6. Choice to use either premises based server, cloud based fax services, or a hybrid solution that combines both 7. Increased data security 8. Support for mobile devices 9. Automated roles based document processing workflows 10. Directory services integration

3 3 1. Drastically Reduce Usage and Telecom Costs Previously, when I compared fax machine transmission costs to computerized faxing, I reported that while it would cost $0.56 to send a fax from a fast scanning fax machine (considering employee labor), it would cost only between $0.05 and $0.20 to send a fax in the same way as from desktops. In other words, computer based faxing versus fax machine faxing saves $0.36 to $0.49 for every fax sent, which assuming 100 faxes per day works out roughly to a yearly savings of $10,000 to $15,000 per fax machine. Just as using fax servers reduces costs over fax machines, using FoIP servers that don t require expensive fax boards reduces costs over using conventional fax servers, and using FoIP servers with SIP trunking further reduces fax phone costs significantly. As for receiving faxes, I estimated that while receiving faxes to fax machines costs about $0.44 a fax (including paper and toner/ink), the costs to receive to a user desktop via a fax server or hosted cloud fax service is essentially zero to $0.04. In other words, an organization receiving page faxes per day over 250 business days a year could save $.40 for each fax received, which works out to another $10,000 savings a year per fax machine. Enterprises using fax over IP (FoIP) save even more money by using their voice over IP (VoIP) backbones. Every fax sent over FoIP costs less because PBX station ports costs twice as much to use as IP router ports. The savings vs. dedicated PSTN telephone lines for fax are even greater. Using a FoIP server also can allow businesses to centralize fax solutions for their entire organizations into a single site, which means fewer lines. Assuming $30/month for a dedicated fax line and $15/month for service maintenance per fax machine, the annual additional cost is $540/year/machine. When totaling sending, receiving, telecom, and service maintenance costs, companies can be spending an additional $25,500/fax machine/year vs. enterprise computer fax servers or hosted cloud solutions. Enterprises still using a network of fax machines should seriously consider the significant cost and carbon footprint savings alone as justification for getting rid of fax machines. Just as using fax servers reduces costs over fax machines, using FoIP servers that don t require expensive fax boards reduces costs over using conventional fax servers, and using FoIP servers with SIP trunking further reduces fax phone costs significantly because FoIP calls can go from end to end without incurring any telephone company charges. Fax Machine Costs (% of Costs) Labor, supplies and telecom costs represented 10x equipment depreciation and maintenance costs.

4 4 FoIP, of course, works with many VoIP system, from Cisco, Avaya, and countless other IP Public Branch Exchanges (IP/PBXs). And it works best in environments that support the ITU T Group 3 T.38 protocol for real time fax over the Internet that can spoof a fax call so it can handle the packet loss, jitter, and delay that are magnified on the Internet. Because T.38 takes care of any Internet caused delays, FoIP calls are now successfully completed at rates as high as 98%. 2. Virtualize Systems and Drive Green Initiatives Because FoIP servers can work with such virtual servers as VMware or Microsoft Hyper V, they can be installed in a virtual server farm to provide high availability and redundancy. Applications can be rapidly deployed to end users by implementing virtualized software clients. Desktop support related hardware costs can be reduced by implementing virtual desktop solutions that provide standard configurations and fax client version control. Virtualizing FoIP servers typically reduces costs associated with fax operations by as much as 40%. In the new green era, people have started to worry about power usage, mounting electricity bills, and the growing concern about carbon footprints and the corporate social responsibility initiatives. As a result, companies are looking to virtualization and cloud computing to save power consumption and costs by optimizing server utilization. Power consumption can be reduced and users can experience lower cooling requirements. Virtualization enables eliminating old and inefficient hardware servers, increasing the server utilization to 95% and above. When you combine server optimization with the higher energy efficiency of newer blade servers and reduced cooling requirements, the result can be a power saving of 70 to 80% for the same workload. This is over and above the lower consumption and carbon footprint of toner, ink, and paper as networks of fax machines are replaced by today s computer fax systems. 3. Integration with Legacy Production Systems Production fax automates the delivery of turnaround documents, i.e., mission critical documents such as invoices and purchase orders that directly affect an enterprise s bottom line. Enterprises prefer faxing these documents, rather than ing, to ensure their transmissions are secure from viruses and unwanted input, accelerate cash flow, speed up mission critical business processes, and save paper, printing, and mailing costs. So, for example, production fax can transmit thousands of purchase orders in a single batch, without a person involved with the actual transmission, with every purchase order delivered to a different fax number and with different items ordered and no chance for any inadvertent editing/commentary that could raise legal issues for the enterprise.

5 5 Fax is used with every type of mission critical system under the sun. Fax can be integrated with Oracle databases, SAP enterprise resource planning systems, IBM mainframes and mid range business systems. Even a company s own custom applications can be quickly fax enabled through application programming interfaces (APIs) that use any of the programming languages the company wants to use:.net languages, Java Visual Basic, C/C++, or any other programming or scripting language and fax specific APIs. Fax can interoperate with any and all mission critical document applications whether they come off of IBM, Oracle, SAP, Microsoft (e.g. Sharepoint), PeopleSoft, Hyland OnBase Enterprise Content Management, or a health IT EMR/EHR application. 4. Automated Rules based Document Reception A true advance in fax technology is the capability to receive not just the fax image, but the extracted raw fax data. Through the use of optical character recognition (OCR) and barcode extraction, data transmitted through fax images can be turned into metadata in a matter of seconds. In recent years, advances in OCR have resulted in only occasional errors, which can easily be compared to the original fax image and corrected. / Barcode OCR ing the fields in a received fax document not only enables accurately routing and processing the document, but also serves to identify the document in a searchable database for later retrieval. Both the actual fax content and its properties (caller ID, connection time, date received, pages received, time received, sending TSI) can be used to create a document audit trail and serve as points of access for locating the document. An even better way to receive faxes automatically is through the extraction of bar codes, a process that is virtually 100% accurate. A rule can be set up that uses the extracted bar code to launch a program or route the received fax to the appropriate agent in a fax processing workflow, often including the automatic population of key databases. 5. Integration with Desktop Client Applications, Health IT, and MFPs Fax integrates with Microsoft Exchange, IBM Lotus Notes, and every SMTP compatible client (Outlook, Outlook Express, GroupWise, etc.). Sending a fax is as simple as sending an . In addition, there are Web browser based fax clients, roles based fax processing workflow clients, and integration with such health IT Electronic Medical Records (EMR) systems as GE Centricity, Siemens Healthcare, McKesson Technology Solutions, and Epic. In fact, fax is the primary compatibility factor in

6 6 the health care arena connecting disparate systems from multiple providers. Fax, simply put, is the health care interoperability standard, connecting paper to electronic EMR and eprescribing, and practice management systems. Finally, fax servers integrate with multi function peripherals (MFPs) such as network printers, scanners, and digital copiers so that documents scanned into MFPs can be faxed, and faxes can be received by MFPs and either printed out or sent to end user boxes. Fax servers offer the tightest integration with MFPs as suppliers generally write to the MFP manufacturer s APIs, giving the MFPs integration depth. In addition, fax services bring MFPs into compliance as they add audit trails. 6. Choice of Premises based, Cloudbased, or Hybrid In addition to on premise fax servers either equipped with fax boards or virtualized and using FoIP fax is available today as an on demand service hosted over the Internet cloud. The availability of both platforms means that enterprises can supplement their on premise fax servers for automatic failover when the phone network is down, and/or leverage scalability with automatic load balancing and extra capacity for peak usage/fax blasts. A hybrid implementation enables an organization to assure high availability and eliminate busy conditions without purchasing additional hardware, and to have the same enterprise level functionality when faxing over the cloud. The best hybrid system for business continuity has identical interfaces for end users and administrators, enabling once only training and applications development to access both on premise fax servers and cloud based hosted fax servers seamlessly. 7. Increased Data Security Fax remains a leading contender to handle the transmission burdens of all kinds of private data because it works end to end with image data that cannot be hacked. Sending a fax is as easy as sending an , plus the sender gets a confirmation that the fax was in fact sent, and has an audit trail for future searches. And on the receiving end, modern day faxing can receive documents and turn the image data into metadata that can be directly entered into electronic databases. Moreover, received documents can be directed to any password protected inbox through intelligent inbound fax routing so that the informa

7 tion is viewed only by the intended recipient. Ensure your fax data to and from the cloud is safely encrypted. only systems are not inherently secure Support for Mobile Devices In addition to Windows desktop clients, SMTP mail clients, and Web browsers, fax is now available on Apple ios mobile and Google Android tablets and phones. This latest development for fax means that users can both send and receive faxes anywhere and anytime. Mobile fax supports both cameras embedded in the devices and wireless scanners as document input, with the ability to convert pictures into faxes on the device to reduce mobile bandwidth and fax transmission times. Mobile fax also enables received faxes to be shared with other mobile apps, and AirPrint on ipads and iphones. For enterprises, mobile fax can be managed by IT through group policies. In the event a device is misplaced or stolen, accounts can be suspended by IT, thus shutting off access to delivered faxes, received faxes and status. 9. Automated Roles based Document Processing Workflow Fax processing workflows, which can range from very simple to very complex, enables the processing of document images by users assigned specific functions according to their workflow role. In a typical workflow, received faxes progress from role to role based on information specified in data entry fields. In response to the data entry, the status of the image is updated, and, if specific criteria have been met, the image transitions from role to role. Examples include scheduling test procedures in hospitals or storing, and reporting, and EMR intake for medical records departments. Once the fax image and associated metadata have been entered into the database, workflow participants can search for a specific document using both data in the image itself and information entered about the image. Information is immediately accessible as opposed to manually searching through stacks of paper,

8 driving significant efficiencies in process workflows Directory Services Integration The direct integration of a fax application with Microsoft Active Directory (AD) or other LDAP compliant directory service enables the use of the directory service as the fax user list. Regardless of the fax client Windows desktop, Web based, based directory services lookups can be used to route incoming faxes to the appropriate destination. Any changes that are made to the directory service, such as adding/ removing users, are instantly available to and recognized by the fax application without any schema extensions, and with no need to synchronize the fax user list with the directory service. Fax service administrators can specify fax user behaviors in Group Policy, enabling users to be moved from one fax queue to another while maintaining their user profile. Biscom A Key Enterprise Fax Supplier Only one enterprise fax provider has all the leading edge fax capabilities that enterprises require. Only one vendor has a FoIP server and an Internet fax service with identical interfaces and the exact same features. It isn t OpenText, because while OpenText has its own RightFax servers, it offers the Biscom is the only provider in the world offering true Enterprise Fax Server and Hosted Fax Service. Peter Davidson, Davidson Consulting separate EasyLink and MESSAGEManager applications (both recently acquired) as its hosted fax services. It isn t j2 Global because they offer only their efax Internet fax service which caters to consumers and no on premise solution. That leaves the next largest enterprise fax provider: Biscom. Biscom is the #1 Production Fax company in North America. By offering both FoIP on premise fax servers and Internet fax services with an identical interface, Biscom enables enterprises to make the most intelligent decision on when to use their in house servers and when to switch to the pay as you fax hosted service. Biscom doesn t care whether the implementation is on premise, hosted, or a hybrid system. All the fax service administrator has to do to implement the Hybrid Fax Platform is simply select the Use the FAXCOM Anywhere service to send faxes check box when configuring the FAXCOM Queue. The FAXCOM Queue then has the built in intelligence to optimally distribute outgoing faxes between the fax servers. In fact, the FAXCOM Queue can load balance up to 128 different FAXCOM Servers, regardless of whether the servers are installed locally or hosted in the cloud. To the FAXCOM Queue, each fax server appears the same as an IP addressable machine. Biscom s Hybrid Fax platform is activated by only two mouse clicks. Biscom offers every one of the ten benefits listed above. Unlike many other fax server vendors, Biscom s integration with Microsoft Active Directory is native and direct, so enterprises don t have to synch up a second database, and can pull data and policies directly from AD, with no worry about synchronization delays or errors. Biscom supports in house customized fax application development with seven different APIs, and an SDK that includes easy to follow sample code. Biscom implements automated fax reception through its Advanced Fax Routing (AFR) option that can deliver incoming fax documents directly into a workflow and can extract metadata from documents using OCR or barcodes as an audit trail and for later search and retrieval.

9 9 Healthcare represents more than one third of Biscom s overall business and two thirds of Biscom s top hosted cloud based fax service clients, many of whom have adopted Web services for real time secure communications with their customers. Biscom supports more than 3,500 healthcare client organizations, including Dana Farber Cancer Institute, Acclaris, Partners Healthcare, Massachusetts General Hospital, Erickson Retirement Communities, Glidewell Laboratories, Shields Healthcare, ZOLL Medical, Boston Children s Hospital, Mercy Health Systems, North Shore Medical Center, and leading health plans and medical device firms. A Biscom API tool set facilitates health IT vendor integration to securely route prescriptions, medical records, lab results, clinical trial research, claims, prior authorizations, and medical images. Some of the best performing and most innovative providers and payers use Biscom through tight integrations with the largest health IT systems, including GE Centricity, McKesson, Siemens, Meditech, Epic and others to faxenable their EMR, eprescription, practice management, radiology, laboratory, urology, and other applications. Company: St. Anthony s Medical Center Services: Medical Services Location: St. Louis, MO CHALLENGES: Manual faxing of 25,000 faxes, month Errors caused orders and patients to be sent to wrong locations Legacy fax machines meant tracking and auditing were not available SOLUTION: Biscom Fax Server & Workflow RESULTS: Improved productivity, eliminate manual faxing over legacy system Reduced costs and paper Eliminated lost orders via fax Biscom s Advanced Fax Routing, Workflow, and DocFlow applications enable multiple hospitals and Integrated Delivery Networks to eliminate paper and inefficient manual processes for scheduling procedures and specialist appointments or records management applications. Biscom s fax servers and hosted fax service offer instant access to faxes and right from a user s desktop for accelerated claims processing, medical handling, and other management activities. Health organizations are able to manage confidential protected health information (PHI) in a secure, yet easily accessible, electronic format for compliance with government privacy regulations, such as HIPAA, or to achieve governmental meaningful use financial incentives. Hospitals can digitize documents straight from fax for immediate input into EMR, eprescribing, and content management systems. They can also directly send and receive a variety of documents and images across all areas of a healthcare organization: admitting, coordination of benefits, eligibility documentation, health plan premium payments, healthcare claims and status, plan enrollment, referral certifications and filing, radiology reports, treatment plans, lab and test results, payment and remittance advice reports, invoices and purchase orders. An example of one health IDN that has implemented a medical test ordering and scheduling workflow from Biscom is St. Anthony s Medical Center in St. Louis. With more than 4,000 employees, St. Anthony s Medical Center provides a range of inpatient and outpatient medical, surgical, diagnostic, emergency, and behavioral health services to more than 225,000 patients annually. A key element of St.

10 10 Anthony s operations consists of coordinating physician orders for such services as MRIs, X rays, and We used to get a lot of complaints CAT scans, within the main medical campus and a about having too many numbers number of off campus locations. In the past, an order was faxed to the appropriate destination, After implementing Biscom s fax and too many lost orders via fax. where, upon arrival, the patient was matched with solutions, user complaints his or her order, the test conducted, and the results plummeted and we haven t had uploaded to their medical record system. Unfortunately, a great deal of confusion and frustration resulted when orders were faxed to the wrong desti enhanced our credibility internally any missed orders since. This nation. With legacy fax machines, human error was as well. A lot of our savings are inevitable when handling a volume of 25,000 fax soft, but to me, that s priceless! pages per month. Neither the sender nor recipient could verify an order s status and audit trails were Sherry Chilton, Director of Admissions, impossible. St. Anthony s was in danger of violating HIPAA regulations by sending sensitive patient St. Anthony s Medical Center information to the wrong places. The medical center needed a fax solution that was auditable, simpler, more effective, and more economical. St. Anthony s turned to Biscom for the solution. Biscom installed a FAXCOM fax server, providing electronic faxing to all personnel. The fax server resulted in paper usage reduction and assistance with HIPAA compliance. Then Biscom began the intelligent routing of faxes based on content vastly simplifying the ordering process. Physicians could now set up appointments for any test at any location by sending a fax to a single fax number, consolidated from the 18 fax numbers they were using previously. St. Anthony s went from getting many complaints about lost faxes, to amazement at how simple the process became. To simplify tracking and auditing, Biscom implemented its Workflow Enterprise application. This powerful tool extracts data from faxes via OCR or barcodes and identifies the fax through such metadata as time sent, sender s number, and fax length. Any worker can search using a variety of criteria (date, time, location, patient s name) and instantly view images of the original document. A whole new level of accountability was created. Biscom s legendary direct customer and technical service also made a huge difference. The hospital thought it would take months to build the system and the applications, but Biscom moved forward very quickly. Biscom explained how everything would work and always delivered on exactly what they promised, according to Sherry Chilton, director of admissions for St. Anthony s Medical Center. Chilton also notes that we haven t had any missed orders since the implementation. After an initial roll out to 18 departments, Biscom s solution has spread to more than 40 departments. Physicians and case managers are using the system to communicate directly with insurance companies via we haven t had any missed orders since the desktop faxing. Satisfaction levels for physicians, patients implementation. and service providers have improved dramatically, said Chilton. A lot of our savings are soft, but user complaints have

11 plummeted, and to me that s priceless! 11 Biscom is a secure document delivery software company that was founded 26 years ago, and has been an enterprise fax and secure file transfer innovator ever since, holding six patents with one patent pending. The company was the first to field an enterprise wide fax server that worked with every environment, including IBM, UNIX, Linux, Banyan Systems, and Apple, in addition to Windows. Biscom was also the first fax vendor to come out with a secure file transfer offering, Biscom Delivery Server. And it is the only vendor offering digital fax, a highspeed, securely encrypted, completely IP based software solution for sending and receiving high resolution color images in just seconds including medical/dental radiographs, and lab test results, over the Internet. And Biscom provides stellar support for its customers. The company is known for the highquality US based direct customer and technical support that it has provided to enterprises for its entire history. Biscom will walk any enterprise through the implementation process and make sure that the on premise, hosted, or hybrid fax system works for them. Biscom s direct support is also in direct contrast to other fax server vendors who provide support only through their resellers or from non US workers. Biscom is a company whose customers do not dread calling customer support. Many clients have remarked how nice it is for a company to have such knowledgeable, polite, reliable and responsive representatives. Biscom goes the extra mile for its enterprise customers. Conclusion Fax continues to evolve the fax machines and hardware fax servers of yesterday can now be completely transformed with advanced functionality provided by computer based enterprise fax software. Whether lower telecom costs, elimination of supplies, virtualized software to eliminate hardware, systems integration, process automation, green footprint, hybrid solutions, security, or anywhere/anytime mobile access, today s fax software technology offers significant cost, productivity, and security benefits for mission critical enterprise applications. ABOUT BISCOM Founded in 1986, Biscom pioneered the fax server and hosted on demand cloud fax marketplaces. Biscom has provided many of the world s largest companies with secure communications solutions, most notably its awardwinning enterprise FAXCOM Server and FAXCOM Anywhere hosted cloud enterprise fax solutions, Hybrid Fax Platform, Biscom Digital Fax, File Conversion software, and Biscom Secure File Transfer and Collaboration products. ABOUT DAVIDSON CONSULTING Peter J. Davidson is president of Davidson Consulting, a firm that specializes in market research, consulting, newsletter and industry conferences covering facsimile and unified communications. Davidson has covered the fax industry intensively since 1986, when he became the writer of FAXreporter, a monthly newsletter published by Buyers Laboratory, a Consumer Union spin off that tests and reports on office systems. In 1994, Davidson authored a report, also published by Buyers Laboratory, entitled Hidden Fax Costs and Secrets to Savings, which was a best seller among fax machine dealers and corporate buyers.