Manual faxing in a healthcare environment is one of the easiest ways to break all sorts of HIPAA compliance rules. Yet, doctors and hospitals are still some of the most frequent manual fax users and healthcare fax software is often an integral part of any practice. Author Justin Fox (editorial director of the Harvard Business Review Group) recently joked that “doctors and tax guys may be all that's keeping faxing alive.” However, the healthcare profession needs to pay more attention to the increasing risk of HIPAA violations as a result of manual faxing and question whether “keeping faxing alive” is smart. As HIPAA enforcement began to take shape in the 2000s, those early years involved many complaints about violations but too few disciplinary actions. Weak enforcement, poor technology, and legal confusion contributed to a lax approach toward true Protected Health Information (PHI) privacy.