Short answer: in 2026, a medical practice can no longer base its communications on an analogue fax machine — the copper line is being switched off town by town — but it cannot move everything to MSSanté overnight either, because some of its correspondents (nursing homes, outsourced secretarial services, certain laboratories, hospital departments, insurers, health funds) only answer by fax. A realistic exit comes down to three decisions: keep the fax number by porting it to an online fax service, route incoming documents to a named mailbox rather than a paper tray, and gradually shift professional exchanges to secure healthcare messaging, starting with those that carry the heaviest volume. Budget a quarter, not a weekend.
This is not a theoretical concern. Arcep regularly restates the schedule for shutting down Orange's copper network, batch by batch, up to complete switch-off planned for the end of the decade. For a group practice, that means one morning the fax machine's dial tone disappears — and with it lab results, imaging reports, prescriptions sent to pharmacies, and coverage requests. In other words, the heart of the administrative flow.
Why fax survives precisely where it ought to disappear
That's the paradox of the sector. Fax is criticised for its security, yet it remains the only channel that ticks three boxes simultaneously in a treatment room:
- It is universal. A number is all you need. No account to create, no directory to query, no certificate to install. A nursing home's front desk with no IT staff can reply to it.
- It is immediate and traceable. The transmission report serves as proof of delivery — something plain email does not provide without configuration.
- It is accepted. Many hospital departments, laboratories and organisations still print a fax number on their examination request or coverage request forms.
On the other side, MSSanté — the secure healthcare messaging system run by the Agence du Numérique en Santé — is advancing fast, driven by the Ségur du numérique programme and the rollout of "Mon espace santé". But MSSanté only works between players listed in the national health directory. As soon as the correspondent falls outside that perimeter — an insurer, a company HR department requesting a certificate, a colleague abroad, a medical equipment supplier — fax becomes the lowest common denominator again.
The practical conclusion is therefore rarely "fax or secure messaging", but "fax and secure messaging, each within its own scope". We covered this channel-by-channel trade-off in our comparison of fax versus secure messaging.
Step 1 — Inventory your document flows before touching the hardware
The classic mistake is choosing a provider before knowing what actually passes through. One week of observation is enough, and it can be done by hand.
Keep a simple log, in a hardback notebook placed next to the fax machine, or in a shared spreadsheet if the front desk is comfortable with one:
| Flow | Direction | Weekly volume | Correspondent | Replaceable by MSSanté? |
|---|---|---|---|---|
| Lab results | Incoming | 40–60 pages | Community laboratory | Yes, as a priority |
| Imaging reports | Incoming | 10–20 | Radiology centre | Yes |
| Coverage requests | Outgoing | 5–10 | Health insurers | No |
| Prescriptions / renewals | Outgoing | 10–15 | Local pharmacies | Partially |
| Nursing home correspondence | Two-way | 5–10 | Care facilities | Check case by case |
| Certificates, sick notes | Outgoing | 2–5 | Employers, patients | No |
Filled in honestly, this table immediately reveals the strategy. In the vast majority of practices, 60 to 80% of the paper volume comes from two or three correspondents — typically the analysis laboratory and the imaging centre. Those are the ones to call first: moving these two flows to MSSanté or a results portal makes the paper pile melt away, and makes the question of residual faxing far easier to handle.
Step 2 — Save the number before the cut-off
A practice's fax number appears on prescriptions, nameplates, professional directories, laboratory software and the records of dozens of correspondents. Losing it opens a black hole: documents will keep being sent to a dead number, and nobody will tell you.
The good news: the number is portable. Portability applies to geographic numbers, including those dedicated to faxing, and an online fax operator can take it over to deliver incoming documents as PDFs to an email address. The detailed instructions are in our guide on keeping your fax number after the end of the PSTN.
Three points of caution specific to the healthcare sector:
- Never start the porting process during a busy period. Switching during a vaccination campaign or an epidemic week is a bad idea. Aim for a quiet stretch, and warn the laboratory and the imaging centre about two weeks in advance.
- Keep the old machine active until confirmation. During the overlap, check every day that both channels are receiving.
- Run a test transmission from outside — from a partner pharmacy, for instance — and check that the PDF arrives legible, in the right mailbox, with the correct timestamp.
Step 3 — The weak point isn't the line, it's the receiving tray
Professional confidentiality is almost never breached in transit. It is breached on arrival.
A fax machine sitting in a corridor, in an adjoining waiting area or on the reception counter continuously spits out named results in plain view. The CNIL has repeatedly pointed out, in its guidance for healthcare professionals, that documents containing health data must be received in a space with restricted access. The Conseil national de l'Ordre des médecins takes the same line on sharing documents between colleagues.
What that means in practice:
- Replace the paper tray with email delivery. An online fax service delivers a PDF to a named mailbox: nothing is left lying around physically. It is the fastest confidentiality gain of the whole operation. Our receiving a fax page explains how it works.
- One mailbox per purpose, not one catch-all inbox. Lab results have no business landing at the same address as supplier invoices.
- Lock down the workstations. A consultation screen visible from the counter cancels out the entire benefit. A privacy screen filter costs little and solves the problem in thirty seconds.
- Dispose of existing paper properly. Thermal prints and photocopies piled up in binders don't go in the bin: a cross-cut shredder rated P-4 at minimum is the expected standard for health data.
Step 4 — Digitise properly whatever still goes out by fax
An illegible report arriving at a colleague's office means a phone call, a resend and sometimes a misreading. Outgoing documents deserve as much attention as incoming ones.
The multifunction fax machine is no longer necessary once you move to online fax: what you need is a good scanner. For a practice handling letters, prescriptions and forms daily, a compact document scanner with automatic feeder is a clear upgrade on the old all-in-one: duplex in a single pass, direct PDF output, minimal desk footprint. Low-volume practices get by perfectly well with a mobile scanning app, provided three settings are respected:
- Black and white or greyscale mode, never colour — fax does not carry colour and the conversion degrades contrast.
- 200 to 300 dpi. Below that, handwritten figures in a dosage become ambiguous; above it, the file balloons for no gain.
- Tight framing and a neutral background. A handheld photo taken on a dark desk produces black areas that come out as blotches.
Our article on illegible faxes details the most common faulty settings.
Finally, the cover sheet is not an administrative flourish in healthcare: it is what tells the recipient the document is covered by professional confidentiality and asks them to alert the sender in the event of misdelivery. It must state the sender, the recipient by name, the number of pages and a confidentiality clause.
Step 5 — Check the number, always, twice
The vast majority of fax-related confidentiality incidents in healthcare come down to one wrong digit. A 7 typed instead of a 1, and a blood panel lands with a tradesperson or a private individual who never asked for it.
Three safeguards, in order of effectiveness:
- A centralised address book in the fax tool, populated once and verified, rather than manual entry on every send. By far the highest-return measure.
- Double-checking before validation for any document containing health data: the number displayed on screen is read aloud by a second person whenever possible.
- Reviewing the transmission report. A fax "sent" to the wrong number shows up as a success. Only checking the number actually dialled in the report catches the error — and makes it possible to react quickly.
If a confirmed misdelivery involves health data, GDPR logic applies: qualify the breach, record it in the internal register, and notify the CNIL within 72 hours if the risk to individuals is not negligible. Our guide on fax and GDPR walks through the procedure.
A three-month migration timeline
| Period | Action | Owner |
|---|---|---|
| Week 1 | Log incoming and outgoing flows | Front desk |
| Weeks 2–3 | Contact the laboratory and imaging centre to switch to MSSanté | Lead practitioner |
| Week 4 | Choose the online fax provider, open the account, test | Lead practitioner |
| Weeks 5–8 | Request number porting, overlap period | Provider |
| Week 9 | Update prescriptions, nameplates, directories, letterhead | Front desk |
| Weeks 10–12 | Remove the fax machine, purge its memory, destroy paper archives | Practice |
The item most often forgotten is the last one: a multifunction fax machine keeps the most recently scanned pages and the log of dialled numbers in its internal memory. Before any trade-in, resale or disposal, a factory reset is mandatory, and the hard drive must be removed on professional models. We cover this in our article on the end of life of the fax machine.
Frequently asked questions
Is a fax still compliant with medical confidentiality in 2026?
Yes, provided it is properly framed. Professional confidentiality, as set out in the French Public Health Code and Criminal Code, does not prohibit any particular channel: it requires that the document reach only the authorised recipient. A fax received in a named email mailbox, sent to a verified number and accompanied by a cover sheet stating confidentiality meets that requirement far better than an openly accessible paper tray.
Does MSSanté fully replace fax?
For exchanges between professionals listed in the national health directory, yes — and that is the direction of travel. For everything outside that perimeter (insurers, employers, suppliers, foreign correspondents, organisations not yet connected), no. The coexistence of both channels remains the rule in most practices.
Should you keep an analogue line "just in case"?
No, and in any event it will become impossible. Once the shutdown batch has been announced for your town, the copper line stops working on that date. Maintaining an analogue subscription alongside an online fax service simply doubles the cost without adding reliability — and an ATA adapter plugged into a router doesn't improve matters either, since fax copes poorly with VoIP compression.
What should you do with faxes already received on thermal paper?
Scan them if they need to be kept — thermal paper fades within a few years and becomes illegible — then destroy the originals securely. Retention periods depend on the nature of the document, not on the channel: medical records follow their own rules, accounting records ten years.
How many pages does a practice still receive by fax?
After shifting the laboratory and imaging flows to digital channels, most general practices drop below ten pages a week. That is precisely the volume at which an online fax subscription, with no hardware or dedicated line, becomes markedly cheaper than maintaining a fax machine.
Key takeaways
- Fax is not disappearing from healthcare in 2026: it is changing medium, from the analogue machine to email delivery.
- Start with an inventory of your flows: two or three correspondents account for most of the volume, and moving them to MSSanté solves 70% of the problem.
- The number can be ported — it's the only way not to lose documents from correspondents who never update their records.
- The confidentiality risk is on arrival, not on the line: a paper tray in an accessible area is failure number one.
- Verifying the number before sending and reviewing the transmission report prevent almost all accidental disclosures.
- Allow a full quarter and an overlap period: a rushed switch on the eve of the cut-off always costs you lost results.
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