Why Fax Completion Rate Is the Metric That Matters Most in Healthcare

One of the first metrics I look at every morning is our fax completion rate.

I want to know whether our customers’ faxes got where they were supposed to go. If the number moves, I want to know why. After 30 years in the fax industry, I’ve learned that you can measure a lot of things about a fax network, but ultimately one question matters more than most:

Did the fax get there?

In healthcare, the answer can have consequences far beyond the technology itself. The fax might contain a referral, a prior authorization, a lab result, a medical record, or an order needed to continue a patient’s care.

I watch completion rate closely for a business reason, too: WestFax only gets paid for completed faxes. If a fax doesn’t complete, our customer doesn’t pay us. We have a financial incentive to perform.

But there’s a much more important reason.

As a technology provider, we’re several steps removed from the patient. My team isn’t in the exam room. We’re not the physician making the diagnosis, the nurse coordinating care, or the pharmacist filling the prescription. Most days, we’re looking at networks, software, routing, security, and completion statistics.

I remind our team that behind those statistics are real people.

Our healthcare customers are providing care that can save someone’s life. We’re fortunate to partner with them by making sure the information they depend on gets where it needs to go securely and reliably.

I think about it personally. If it were someone in my own family waiting for care, I’d want the healthcare system to work as well as possible. I wouldn’t want a referral delayed because a fax didn’t arrive. I wouldn’t want an order sitting somewhere because a transmission failed. I’d want the right information in the right provider’s hands when they need it.

Fax is still a significant part of how that information moves through healthcare.

That’s easy to lose sight of when you spend your day working on the technology behind it. I don’t want our team to lose sight of it.

We’re not the ones delivering the care. But we have a responsibility to the healthcare organizations that are. If they trust WestFax to move information that supports patient care, our job is to make sure that information gets there securely, intact, and as reliably as we can.

Why Does Fax Completion Rate Matter in Healthcare?

Healthcare fax isn’t usually casual correspondence.

It’s part of a patient care workflow.

A referral needs to reach a specialist. A prior authorization needs to reach a payer. A records request needs to reach HIM. An order needs to reach the organization responsible for fulfilling it.

When the fax doesn’t complete, the workflow stops.

Someone then has to discover the failure, figure out what happened, resend the document, call the receiving organization, or find another way to deliver it. At scale, even a seemingly small difference in completion rate can translate into a lot of additional work.

And sometimes the first indication of a problem isn’t a fax error message. It’s a patient or provider asking:

“Did you get the fax?”

Anyone who has worked around healthcare fax knows that question.

What Causes Faxes to Fail?

This is where fax gets more complicated than it looks.

Sending a fax isn’t simply uploading a PDF and moving it from Server A to Server B. A transmission can cross multiple networks and carriers before ultimately communicating with a receiving fax device, fax server, cloud fax platform, or healthcare system.

Along the way, a transmission can encounter:

• Busy signals and no-answer conditions
• Poor line quality
• Carrier routing issues
• Protocol and timing problems
• Incompatible receiving equipment
• Longer or image-heavy documents that are less tolerant of transmission problems
• Incorrect or disconnected fax numbers
• Problems at the receiving endpoint

Increasingly, fax traffic also traverses IP-based networks.

Fax was designed around the characteristics of the traditional telephone network. Moving fax over IP can work very well when the network and routing are engineered correctly. But packet loss, jitter, timing issues, transcoding, and poorly implemented Fax-over-IP can all affect a fax transmission.

That’s why two services that both call themselves “cloud fax” can produce very different results.

What Makes One Fax Network More Reliable Than Another?

After three decades of working on these problems, I’ve learned that high fax completion rates aren’t accidental.

They’re engineered.

At WestFax, we focus closely on four areas.

1. The Transport Matters

The underlying network matters more than most customers will ever see.

We’ve invested heavily in carrier-grade fax infrastructure because the cheapest way to route a fax isn’t necessarily the most reliable way to deliver one.

That’s an important distinction.

Optimizing a network primarily for least-cost routing and optimizing it primarily for fax completion can lead to very different engineering decisions.

And because WestFax only gets paid for completed faxes, our economic incentive is to get the transmission delivered successfully, not simply to attempt it as cheaply as possible.

2. Routing Matters

Not every destination behaves the same way.

Different carriers, receiving systems, and network paths can behave differently depending on the destination. A route that works extremely well for one group of numbers may perform differently for another.

Historical transmission data gives a fax provider an enormous advantage here.

Over time, we can learn which routes, transmission parameters, and retry strategies produce the highest probability of successful delivery to a particular fax number. We are hyper-focused in this area, even to the point of actually calling the intended recipient to help them configure their receiving device.

3. Redundancy Matters

Healthcare doesn’t stop because a carrier or piece of infrastructure has a problem.

A reliable fax network needs redundancy across the components that can affect delivery, including infrastructure, connectivity, and carrier relationships.

Redundancy isn’t particularly interesting when everything is working.

When something fails, it’s everything.

4. Failure Reporting Matters

No fax provider can control every endpoint on the public telephone network.

Some numbers are busy. Some are disconnected. Some receiving systems don’t answer. Some destinations simply have problems.

That’s why reliability isn’t just about preventing failures. It’s also about knowing what happened when a fax doesn’t complete.

A useful failure message should tell the sender enough to take action. “Failed” isn’t very helpful. “Busy,” “no answer,” or another specific disposition gives the sender somewhere to start.

In healthcare, reducing the time between a failed transmission and corrective action can be almost as important as preventing the failure in the first place.

Fax Completion Is a Team Sport

Another side of fax reliability rarely makes it onto a provider’s website.

No single company controls the entire fax ecosystem.

A transmission may involve originating infrastructure, telecommunications carriers, intermediate networks, another fax provider, and the receiving organization’s equipment or software.

I’ve worked in this industry for 30 years, and I know the telecom carriers; I personally know all my major competing fax providers, technology companies, and healthcare vendors operating on the other side of these transmissions.

Those relationships matter.

When there’s an interoperability problem between two networks, the best outcome doesn’t come from spending a week proving whose fault it is. It comes from getting the right engineers talking to each other and fixing it.

I’ve always believed that’s part of our responsibility as a top-tier fax provider.

The customer doesn’t particularly care which network caused the problem.

They want the fax to go through.

So do we.

Reliability Without Security Isn’t Enough

Another half of this conversation is especially important in healthcare.

Getting a fax to its destination isn’t enough.

It has to get there securely.

That’s why I don’t think healthcare organizations should have to choose between reliability and security. A cloud fax provider handling electronic protected health information needs to demonstrate both.

WestFax has achieved HITRUST r2 Certification for our cloud fax service. HITRUST r2 is a rigorous, independently validated security assessment designed for organizations handling sensitive and regulated information.

I think independent validation matters. Healthcare organizations can’t rely on a vendor’s word.

The same principle applies to reliability.

The healthcare organization is trusting us with two things every time it presses Send:

Protect this information. And get it where it’s going.

You have to do both.

Independent Recognition Matters

Every company can tell you its technology is reliable, secure, and easy to use.

It’s more meaningful when someone else reaches that conclusion.

Forbes recognized WestFax in its evaluation of online fax services as the most reliable for fax. I’m proud of that recognition because it provides another independent perspective on something our team has spent years building.

But awards aren’t why we engineer the network the way we do.

They’re validation of the work underneath them.

For me, the real test still happens every morning when I look at our completion numbers.

Why We Built WestFax Around Fax Completion

I didn’t start WestFax because the world needed another way to click “Send Fax.”

I started it because I believed we could engineer fax better.

We designed WestFax around the problems that actually determine whether a transmission succeeds: network architecture, carrier connectivity, routing intelligence, redundancy, interoperability, security, and visibility into failures.

And we’ve kept investing in those things because healthcare continues to depend on them.

Hospitals, health systems, physician practices, pharmacies, laboratories, payers, and other healthcare organizations still exchange an enormous amount of critical information by fax.

The technology behind that fax may be largely invisible to the people using it.

The outcome isn’t.

The document either gets there or it doesn’t.

What Should Healthcare Organizations Ask a Cloud Fax Provider?

If you’re evaluating a fax provider, don’t stop at price per page, uptime, integrations, or a HIPAA checkbox.

Ask harder questions:

• What is your fax completion rate, and how do you calculate it?
• Do I pay for failed fax attempts, or only completed transmissions?
• Can you separate first-attempt success from eventual completion after retries?
• What happens when a transmission fails?
• How specific are your failure dispositions?
• How do you route around carrier or network problems?
• What redundancy exists in your infrastructure?
• How do you troubleshoot interoperability problems with other fax networks?
• How is ePHI protected while it moves through your platform?
• What independent security certifications have you achieved?
• Will you sign a Business Associate Agreement?

Those questions tell you much more about the fax service you’re buying than a feature checklist does.

The Bottom Line

After 30 years in this industry, I’ve learned to focus on the fundamentals.

For healthcare, the outcome is remarkably simple:

Did the document arrive securely, intact, and where it was supposed to go?

Completion rate is one of the clearest measures of that outcome.

The technology underneath fax will keep evolving. Networks will change. Healthcare workflows will change. Eventually, the role fax plays in healthcare may change too.

Until then, healthcare organizations should expect more from their fax providers than an API, a portal, and an uptime number.

They should expect the fax to get there.

That’s what our customers want. It’s what the healthcare providers they support need to deliver the best possible care.

For me, it comes back to something even simpler.

If it were my family, I’d want the information to get there.

That’s the standard I want our team to keep in mind as we build and operate the most reliable fax network on the planet.