Short answer: in 2026, a medical practice, a retail pharmacy or a clinical biology laboratory no longer needs a fax machine sitting on a shelf — but it still needs a fax number that answers, because some of its correspondents (hospital departments, imaging centres, nursing homes, insurance authorisation departments, medical device suppliers) still publish nothing else. The switch comes down to five decisions: port the existing number to an online fax service before the copper network is cut off, route incoming documents to a shared practice mailbox rather than to a practitioner's personal inbox, move everything that can be moved to secure health messaging, write a retention rule for received documents, and notify your correspondents in writing. Budget six to eight weeks, not one morning.
The trigger is not regulatory, it is physical. Arcep is publishing the shutdown schedule for Orange's copper network batch by batch, town by town, and each wave takes with it the analogue lines on which fax machines have been running unnoticed for twenty years. For a group practice that receives surgical reports and lab results every morning, the failure is invisible: the machine stays on, the light stays green, but nothing arrives any more. And nobody notices until the third irritated call from a colleague.
Why healthcare is the last stronghold of the fax
The French medical sector has digitised an enormous amount — the claim form, the Carte Vitale health card, the shared medical record, the electronic prescription — and yet fax survives there better than anywhere else. Three very concrete reasons.
Published directories are incomplete. A front desk trying to reach a specific hospital department often finds a switchboard number, a secretariat fax number, and sometimes a generic email address that nobody guarantees is monitored. Fax remains the channel known to end up on a printer that someone is actually watching.
Secure health messaging only covers part of the field. The MSSanté secure health messaging system, run by the Agence du Numérique en Santé, connects healthcare professionals to each other and, since user accounts opened up, to patients as well. It is today the reference channel for transmitting health data. But it does not talk to parties who are not healthcare professionals: insurance administration departments, authorisation managers, medical equipment rental companies, employers' HR departments requesting a certificate, legal guardians, court registries. Those parties still print a fax number on their forms.
The asymmetry of urgency. A practitioner who needs a report before a 2 p.m. consultation is not going to wait for an account to be opened on a portal. They ask for a fax. The channel survives because it is the lowest common denominator between two organisations that have never set anything up together.
Key point: the question is not "should we keep the fax?" but "what residual volume must remain reachable, and by what means". For most practices, the residual volume amounts to a few dozen pages a month, which no longer justifies a dedicated line.
Step 1 — Take stock of what actually goes through the fax
Before choosing a solution, you need to know what you are replacing. The exercise takes a week and is done with a pencil, on the fax machine itself.
Put a notebook next to the machine and record, for each incoming and outgoing page: the type of document, the correspondent, and whether another channel existed. Most practices discover four families:
| Flow family | Typical example | Alternative available in 2026 |
|---|---|---|
| Incoming results and reports | biology, imaging, hospital discharge summary | secure health messaging, laboratory portal, diagnostic centre API |
| Outgoing administrative requests | prior authorisation, pre-approval, prosthesis quote | the organisation's online form, electronic registered mail |
| Care coordination | transmission to a nursing home, to a home care service | secure health messaging if the correspondent is registered, otherwise fax |
| Non-healthcare third parties | insurer, employer, landlord, legal guardian | fax or paper mail, rarely anything else |
The first two families empty out almost entirely within six months if you take the trouble to write to your correspondents. The last two justify keeping a reachable number. It is this evidence-based picture, not a hunch, that should dictate the subscription you choose.
Use the inventory to check the state of your paper workflow as well: most practices that abandon the fax machine still need to scan documents daily, and a duplex scanner with automatic document feeder does more for a front desk's paperless transition than any software. A model that produces multi-page PDFs directly will spare you tedious manual assembly.
Step 2 — Port the number before the cut-off, not after
This is the most expensive and most common mistake. A practice's fax number appears on printed prescriptions, on nameplates, in hospital directories, in colleagues' prescribing software, in hospital departmental protocols. Losing it means becoming unreachable for correspondents you will never be able to notify individually.
Porting a geographic number to an online fax provider works, but it requires two conditions: the line must be still active at the time of the request, and the contract holder must match exactly the entity requesting the port. A number in the name of a practitioner who has retired, in a shared practice company that has since changed legal form, means three extra weeks of correspondence.
An order of operations that works:
- Retrieve the RIO for the fax machine's line (dial 3179 from that line, or check your operator's invoice).
- Open the online fax account and check reception on a temporary number supplied by the service.
- Request the port of the historic number once everything has been validated.
- Only cancel the copper line 30 days after the port is confirmed, keeping the fax machine plugged in as a safety net.
We cover this mechanism in detail, including the case of 08 numbers and lines on a business router, in our guide to keeping your number after the PSTN shutdown. For practices that prefer to start without porting, opening a brand-new number remains possible: the list of available area codes is published on the supported countries page.
Step 3 — Decide where received documents land
A fax received by email is a health document travelling through a mailbox. This is where most practices unintentionally create their biggest confidentiality risk.
Three non-negotiable rules:
- A shared functional mailbox, never a personal one.
fax@practice-…monitored by the front desk, with access logging, rather than Dr X's personal address — which goes on holiday, changes phone, and sometimes forwards to a consumer webmail account. - Compliant health data hosting. As soon as a provider hosts, on your behalf, documents containing personal health data, health data hosting certification under the public health code enters the discussion. The CNIL regularly reminds us that the data controller is still the practice, not the provider: it is up to you to check, to sign a processor agreement under Article 28 of the GDPR, and to keep proof of that verification.
- No unchecked syncing to a personal cloud. A fax folder that automatically replicates into the photo cloud of a family smartphone is a data breach waiting to happen.
At the front desk workstation, two hardware details make a real difference when you read reports all day long: a screen large enough to display an A4 page at 100% without zooming, and a privacy filter for the screen if the reception desk is visible from the waiting room. That last point is as much about professional confidentiality as it is about ergonomics.
Step 4 — Move everything you can to secure health messaging
Online fax is a continuity solution, not an end goal. For exchanges between healthcare professionals, the target is secure health messaging, and it is best treated as a project in its own right.
What that means in practice: an active CPS or e-CPS health professional card for each practitioner, an address in the MSSanté directory, and above all an address book of correspondents who can actually be reached through that channel. The most cost-effective approach is to do it laboratory by laboratory, imaging centre by imaging centre: four or five correspondents often account for 80% of a community practice's incoming volume.
For practitioners who want to understand the framework before committing, the publications of the Agence du Numérique en Santé on the Ségur du numérique en santé programme and the CNIL's guides on health data are the two sources to read first. A practical guide to the GDPR in private practice also remains a reasonable investment for an organisation without an in-house DPO: it prevents the costly misinterpretations.
Step 5 — Notify your correspondents, in writing
A change of channel that is not announced produces exactly the same effect as a breakdown: documents that stop arriving. Plan three actions, within the same month.
- A template letter or email to regular correspondents: how things now work, fax number unchanged (if ported) or new number, the practice's secure messaging address, switchover date.
- An update of all your materials: printed prescriptions, rubber stamp, nameplate, directory listing, practice website, listings in partner hospitals' directories.
- A one-month dual-running period, during which the old fax machine stays plugged in. It is the only way to spot the correspondents who did not read your letter.
During that period, keep a record of what still arrives on the old machine: that is the exact list of people to call back.
What online fax changes day to day
Once the switch is made, three benefits appear, two of which are not the ones you expected.
Sending from anywhere. An authorisation request can go out from a home visit or from a secondary practice, without going back through the main site. That is useful for practitioners working across several sites and for locums.
Traceability. Every transmission produces a timestamped confirmation report that can be stored with the document in the patient file. Where the fax machine printed an acknowledgement that was thrown away, e-fax keeps the record. It is invaluable for proving that a pre-approval request really did go out before the deadline.
The end of the paper pile at reception. A fax output tray sitting on an accessible counter is, quite literally, an organisational failure with regard to medical confidentiality. Its disappearance solves a problem people had stopped noticing.
Two limitations, however, deserve to be stated. Transmission quality still depends on the quality of scanning upstream: a document scanned in greyscale at 150 dpi can arrive unreadable. And fax, even in digital form, remains a channel that is not end-to-end encrypted: it does not replace secure messaging for sensitive data, it fills a gap when the other channel does not exist.
For practices that scan a lot, workstation stability matters more than you might think: an UPS for your router and workstation prevents you from losing a send queue during a brief power cut, and a lever-arch archive binder remains the simplest way to store the few paper originals that genuinely must be kept.
Frequently asked questions
Is fax GDPR-compliant for transmitting health data?
It can be, under conditions. The GDPR does not prohibit any particular channel: it requires technical and organisational measures appropriate to the risk. For a fax containing health data, that means at a minimum: verifying the number before sending, a cover sheet with no clinical data, an identified recipient rather than a shared tray, and traceability of the transmission. The CNIL has long recommended favouring secure health messaging for these exchanges — fax becomes the documented fallback option, not the default.
Do you need a certified health data host for an online fax service?
As soon as the provider stores, on your behalf, documents containing personal health data, the question of health data hosting certification becomes a serious one. Some practices sidestep the issue by configuring the service not to retain documents on the provider's side: reception by email, immediate deletion server-side, archiving in the practice's own software. Get the retention policy confirmed in writing, and add that document to your record of processing activities.
Will my fax machine work behind a VoIP router?
Sometimes, badly, and rarely for long. The legacy fax protocol copes very poorly with the compression and jitter of IP networks. The T.38 protocol exists for that purpose but assumes it is enabled and correctly negotiated end to end, which is not guaranteed. That is the subject of our article on why T.38 fails: for a practice, plugging the old fax machine into the router is a stopgap, not an end goal.
What should you do with years of printed faxes stored at the practice?
Sort them by type of document, then apply the retention periods applicable to items in the medical record, and destroy the rest through a confidential destruction service. Do not digitise everything "just in case": an archive with no purge rule becomes a compliance problem in its own right.
How much does it cost to keep a fax number reachable?
For a residual volume of a few dozen pages a month, an online fax subscription costs roughly the same order of magnitude as an entry-level mobile phone plan — with no dedicated line, no consumables, no machine maintenance. To test before committing, the sending form available on the home page lets you check delivery to a real correspondent, and the FAQ answers questions about specific area codes.
Summary
- The copper network shutdown, published in batches by Arcep, will cut off analogue fax machines with no visible failure: the machine stays on, nothing arrives any more.
- Take stock of one week of real traffic before choosing: most practices discover that 80% of the volume can move to secure health messaging and that the rest amounts to a few dozen pages a month.
- Port the number before cancelling, in this order: RIO → online fax account → test → port → cancellation 30 days later.
- Have incoming documents land in a shared practice mailbox, never in a personal inbox or a personal cloud.
- Get the provider's retention policy and health data hosting status confirmed in writing, and add it to your record of processing activities.
- Online fax is a continuity channel for non-healthcare third parties: the target for exchanges between professionals remains secure health messaging.
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