Converting to T.38 IP Fax: Healthcare’s Top FAQs

June 28, 2021

The fax machine remains a staple in healthcare offices throughout the United States and Canada. Yet behind the scenes, fax technology has evolved by leaps and bounds.

The latest transformation, T.38 real-time IP fax, offers distinct advantages for healthcare offices, as well as other industries that need secure, reliable service. Read on to find answers to healthcare professionals’ most commonly asked questions:

What stands out about IP fax?

On the surface, Internet Protocol (IP) fax looks similar to a traditional fax system. However, IP fax sends the fax message through the internet, rather than relying on copper phone lines, like legacy analog systems. At Cloudli, we use T.38 real-time Internet fax protocol, which transmits the data in “real time”. T.38 protocol optimizes delivery success, maximizing successful transmissions while minimizing retry attempts. Real-time IP fax provides confirmation immediately, so you’ll know instantly if the transmission failed or succeeded. Cloudli also uses T.38 SIP trunks which allow traffic to move over networks specifically conditioned for fax, enhancing quality, reliability and speed.

T.38 IP fax stands out because it’s the most reliable real-time fax over IP capability. It transmits data directly from sending server to receiving server through a “digital handshake,” without relying on any device in the middle to store and forward the information. That makes T.38 IP fax ideal for healthcare offices that need comprehensive, end-to-end security when faxing sensitive, private documents.

Finally, T.38 IP fax is easily scalable as your practice or organization grows. You can add additional lines and even additional locations easily at the lowest price point in the industry – and without any downtime or disruption of your office.


Join us on Thursday, July 22nd at 2pm ET as two leading Healthcare fax experts discuss how IP Fax can solve Healthcare's top fax pain points.


How does T.38 IP fax differ from other fax technologies?

T.38 IP fax is carried over SIP trunks that support the T.38 protocol. A SIP trunk that does not support T.38 may still carry fax traffic but treats it as voice and, as such, is much more susceptible to network latency, packet loss and jitter. A major study by Dialogic, a popular SIP trunk connectivity software vendor, shows that using T.38 instead of voice SIP trunks improves the delivery success rate by over 30% when small amounts of network impairment is experienced – this represents as little as 0.25% packet loss.

The other common methods of faxing are analog, HTTPS and cloud-based. Analog, the original fax technology, relies entirely on aging PSTN fax lines and requires hardware like a fax board or modem. This solution works for some individuals or small-scale businesses, but reliability and service stand to degrade (and eventually disappear) as telecommunications companies transfer investment from copper lines to digital technologies.

HTTPS (or web-transport) faxing uses the Internet to transmit fax messages, but requires both a proprietary HTTPS Client and an HTTPS Server to move the message from sender to receiver. That “middleman” component makes transmission less secure and adds complication to HIPAA compliance.

Cloud-based faxing offers digital options for sending or receiving documents. In other words, the document can be sent or received (or both) as a digital document. The downsides for healthcare offices are that cloud-based faxing does not address day-to-day requirements like signatures and paper records or orders; and it uses less secure, store-and-forward solutions.

For all of these reasons, we recommend T.38 IP fax for healthcare offices that require the most reliable, secure and sustainable system for transmitting important documents and data.

How does T.38 IP fax keep protected health information (PHI) safe?

T.38 IP fax offers three layers of protection to maintain data security. First, Cloudli’s T.38 IP fax uses AES encryption, which is the only technology that encrypts both IP session signaling and session media (image). Because it’s lightweight, it operates without the heavy traffic overhead that can cause message failure. That means you get both top-level encryption and unparalleled reliability.

Second, T.38 IP fax transmits in real-time, without requiring middleman technology in transit to store and forward information. That means your message cannot be compromised, hacked or dropped along the way. Data goes directly from sending server to receiving server.

Finally, T.38 IP fax provides immediate, page-by-page confirmation of arrival, with no chance of false positives. You’ll know right away if a message fails, or the exact time it arrives safely.

This three-layered security means T.38 IP fax adheres to stringent HIPAA guidelines for the handling of PHI, making your compliance that much easier.


Join us on Thursday, July 22nd at 2pm ET as two leading Healthcare fax experts discuss how IP Fax can solve Healthcare's top fax pain points.


Is T.38 IP fax compatible with my current equipment and systems?

Healthcare offices can’t afford the cost or hassle of switching out equipment or software as technologies come and go. That’s what makes T.38 IP fax so ideal. T.38 is an Institute of Electrical and Electronics Engineers (IEEE) standard-based, technology-agnostic protocol, which simply means it integrates seamlessly with your existing business and communications solutions – including your electronic health record (EHR) ­– and communicates successfully with those on the receiving end.

T.38 IP fax is also highly adaptable in how it functions. For instance, you can replace a single analog line with T.38 or expand to dozens of lines as your needs change. You can connect the T.38 fax trunks to your existing fax devices to mimic your current workflows, or configure your fax servers to populate the fax directly on your desktop. Our Cloudli experts work with each customer to create a customized solution that meets your needs and future goals.

Will converting disrupt the office?

Not at all. Converting to T.38 IP fax is a smooth and quick process that typically involves no downtime or disruption of your business. If you’re currently using analog fax, you will need an analog telephone adapter, which Cloudli includes with its All-In plan packages. After that, it’s essentially a plug-and-play setup.

In most cases, your fax number(s) will remain the same, so the switch will be invisible to your staff and clients. It couldn’t be easier!

The Ultimate Answer

Nearly 90 percent of healthcare offices still use fax to transmit about 75 percent of their documents, according to the Medical Group Management Association. That means fax isn’t going away any time soon and it’s worth your while to invest now in the technology best suited for healthcare’s demanding standards.

To learn more about why T.38 real-time IP fax deserves a serious look, join us for a live webinar on Thursday, July 22nd at 2pm ET, or read our free, downloadable ebook: How IP Fax Solves Health Providers’ Six Most Pressing Technology Challenges. Or, to get your own FAQs answered directly by a Cloudli IP fax expert, contact us to schedule a free consultation.

Tag(s): Fax

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