As an AI founder, I should be rooting for the death of the fax. I'm not.

Editor’s note: I invited Predoc CEO Nish Hari to make a contrarian case I kept hearing pushed back on: that AI agents will extend the life of the fax machine rather than end it. Predoc is a partner of Second Opinion, and this column is part of that partnership. As always, the argument is the author’s own.

By Nish Hari, CEO of Predoc

Partnered by Predoc is the operating system for medical records: medical record retrievals, document processing, indexation, data extraction and curation, all delivered through one end-to-end service. See Predoc →

I run a company building AI agents to retrieve medical records. You’d think I’d be rooting for the death of the fax machine, like many of my industry peers. Patient advocates and entrepreneurs alike have been pushing to axe the fax, alongside other outdated technologies like pagers and disk drives, for years now.

But I’m not.

The more capable agents become, the more obvious it is: phone and fax may be the most durable interfaces in American healthcare — or at the very least, a bridge to something better.

I was first introduced to medical record retrieval workflows — the “chart chase,” to the initiated — through my wife during her fellowship. She explained how a patient might be in the clinic, and her clinical staff would spend clinical hours calling providers in the patient’s network, faxing HIPAA auth forms, and waiting for the fax queue to show the specific records they requested were received while a patient sat in the waiting area.

And she’s been at some of the largest academic medical centers in the tri-state, all on large commercial instances of Epic, since she was in medical school.

As an entrepreneur with a background in the financial sector, I witnessed a giant industry finally modernizing over the course of a decade. In healthcare, I’m seeing an opportunity to use agents to take on work that has made fax and phone expensive to use for medical record retrieval. Phone and fax can become more practical, even economical and efficient, while we wait for digital exchanges to improve. That will happen, but it will take longer than it might seem.

My take: AI will prolong the life of the fax machine because it makes using them less labor intensive.

The chart chase workflow looks something like this:

• A referral starts as a faxed referral sheet.
• Someone on staff determines which specialist needs to see the patient and collects the specific records required for that visit, based on provider preferences or specialty.
• That could mean two years of bloodwork, six months of oncologist notes, imaging, or records from the referring provider.

The first step to complete this process is often to check the health information exchanges, or HIEs, when enabled, or log into a local hospital EHR with read-only access to click through and export the documents they need. Then the chase begins for records that aren’t available from either digital source. Staff call other offices to request those records, which are eventually faxed over, sometimes after repeated calls. The records that arrive could be 1,000s of pages or even CDs. Those documents are added to a queue to be indexed into the chart.