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Sir,—The results from the study by Srikanthan et al and its accompanying editorial regarding the use of fax machines in cardiology stimulated us to relate our own experience.1 2 In August 1987 we implemented a fax network to facilitate communication with residents out of office hours. At the same time we initiated a home thrombolysis programme using a telephone based ECG system that enabled ambulance personnel to transmit an ECG from the home of a patient directly to the hospital. This ECG is interpreted by the resident on duty who decides on thrombolysis treatment. Initially, we felt it necessary for these ECGs to be reviewed by the cardiologist on duty, and faxing them from the hospital to the cardiologists’s home seemed the appropriate solution. At that time fax transmission used the same telephone line as oral communication. This was very unwieldy and for many minutes oral communication was blocked by fruitless attempts to fax the ECG. We addressed this problem by installing a second telephone line in the homes of all supervising cardiologists, and running a course “how to manage a fax machine” for nurses and residents. We realised then it was necessary to install a foolproof fax facility.
In the following years fax machines became more user friendly and found their way in to all levels of the hospital organisation. Currently, residents and nurses handle fax machines with ease and confidence. Fax machines have proved especially valuable for the less experienced residents in their communication with the supervisor on call. While the fax machine is transmitting ECGs, simultaneous and swift review of these with the resident is possible. Annually, many hundreds of faxes are sent, contributing to the accuracy of the diagnosis and improvement of patient management, particularly regarding thrombolytic treatment.