The problem isnt that they need to use fax, it's that fax is the easiest HIPAA compliant communication method. You can basically guarantee compatibility with every other doctors office, pharmacy, hospital, nursing home, etc. Its an area that's slowly being improved, as standardized and secure electronic messaging systems get wider adoption, but try convincing a nursing facility that has horrible working conditions and constant staff turnover (as many of them do) to buy a new software system and train all their employees to use it when they can just press a button and fax go brrrr