~7 in 10
US hospitals used mail or fax to send and receive summary-of-care records in 2019 — still the single most common method.
Government dataSource
Fax Usage Statistics · 2026
The fax machine was supposed to die in 2020.
Here's the data on why it didn't.
A citable reference on who still faxes and why — pulled from government data, industry surveys, and market research. Every number below links to its primary source. Use them, quote them, cite the page.
Last updated · Jump to full sources or how to cite.
Key fax statistics at a glance
43%
of US hospitals were "routinely" interoperable across all four exchange domains in 2023 (up from 28% in 2018). The gap is what keeps fax alive.
Government dataSource
2020
the year a US regulator publicly wanted every doctor’s office to be a "fax free zone." It did not happen.
Government policySource
8,000+
fax machines the NHS still owned when the UK banned it from buying more and ordered a full phase-out by March 2020.
Government policySource
~400
formal objections Japan's central ministries filed after being told to stop faxing by end of June 2021. The effort stalled.
News reportSource
70–89%
of healthcare providers report still using fax across various industry surveys (figures vary by survey and definition).
Industry surveySource
$4.47B
projected size of the global fax services market by 2030, up from $3.31B in 2024 (~5.15% CAGR). Growing, not dying.
Market researchSource
Healthcare runs on fax
The clearest picture comes from the US federal health-IT office (ONC). In 2019, about seven in ten hospitals used mail or fax to send and receive summary-of-care records — 71% for sending and 68% for receiving — making it the single most common exchange method, ahead of every electronic alternative. [Government data]
That has not been replaced by seamless digital exchange. By 2023, only 43% of US hospitals were "routinely" interoperable across all four exchange domains — sending, receiving, finding, and integrating records electronically — up from 28% in 2018. A wider 70% managed all four domains at least sometimes, but routine, dependable exchange is still a minority. [Government data] That gap between "sometimes works" and "always works" is precisely the space fax fills.
Why does the gap persist? Different EHR systems frequently cannot exchange records directly, so fax becomes the universal fallback that every provider can reach. It sits inside HIPAA-familiar workflows staff already trust, and a faxed record carries recognized legal standing with a transmission confirmation many offices treat as proof of receipt. When the digital path is uncertain, faxing is the path of least resistance.
Share of US non-federal acute-care hospitals. Bars draw on two different ONC surveys (years noted); shown together to illustrate the gap, not as a like-for-like change.
Still used mail or fax for summary-of-care records71%
71% of US hospitals — 2019 (ONC Data Brief No. 54)
Routinely interoperable across all four exchange domains43%
43% of US hospitals — 2023 (ONC Data Brief No. 71)
Governments tried to kill it — and missed
United States, 2018. At the ONC Interoperability Forum, CMS Administrator Seema Verma challenged developers to "help us make every doctor's office in America a fax free zone by 2020." [Government policy] The deadline came and went; fax remained the most common way hospitals moved records.
United Kingdom, 2018–2020. The NHS was banned from buying fax machines from January 2019 and ordered to phase them out entirely by 31 March 2020 — at a time when it still owned more than 8,000 of them. [Government policy] Reality lagged the mandate: by September 2019, research suggested only about 42% had actually been removed. [News report]
Japan, 2021. The central government told ministries to stop using fax by the end of June 2021. It was met with roughly 400 formal objections citing security and workflow concerns, and the effort largely stalled. [News report]
Three governments, three deadlines, three misses. When a technology outlasts coordinated efforts to ban it, the demand underneath is worth taking seriously.
The market is growing, not dying
If fax were truly on its deathbed, the money would show it. Instead, market-research firm Arizton estimates the global fax services market at $3.31 billion in 2024, projected to reach $4.47 billion by 2030 — a compound annual growth rate of about 5.15%. [Market research]
The growth is not coming from paper machines. It is coming from cloud fax and hybrid services that keep the universal reach of a fax number while dropping the hardware, phone line, and paper tray. Organizations are not abandoning fax so much as moving it to software — which is exactly why the numbers keep climbing rather than collapsing.
Industry surveys of providers point the same direction: depending on the survey and how "using fax" is defined, somewhere between 70% and 89% of healthcare providers report still relying on it. [Industry survey] [Industry survey] Treat these as directional vendor/industry figures rather than precise government counts — but the direction is unmistakable.
Why fax survives
Legal and signature standing
A faxed document with a signature is widely accepted as legally valid, and fax carries decades of established standing in medical, legal, and financial records. Switching to a new channel means re-litigating that acceptance.
Delivery confirmation as proof
A fax transmission report tells the sender the pages went through. Many offices treat that confirmation as proof of receipt in a way an unacknowledged email does not provide.
Security perception
Because fax rides the phone network point-to-point and avoids third-party mail servers, many workflows regard it as acceptable for sensitive documents — a perception that keeps it embedded in HIPAA-conscious settings.
Universal interoperability
When EHRs cannot talk to each other directly, fax is the lowest common denominator every provider can send to and receive from. It is the fallback that always works, which is exactly why it is hard to remove.
Cite this page
Writing about fax and need a citable source? Please use the reference below. This page is kept up to date as new government data and surveys are published — republishing these stats with a link back to it is welcome and encouraged.
XenFax, "Fax Usage Statistics (2026): Who Still Faxes, and Why," xenfax.com, updated July 18, 2026, https://xenfax.com/fax-statistics.
Methodology & sources
Every statistic on this page is tied to a named primary source below. We deliberately separate three kinds of evidence, because they do not carry equal weight:
- Government data and policy (ONC data briefs, CMS, gov.uk) — the strongest anchors, based on official surveys and announcements.
- Industry / vendor surveys — useful and directional, but sponsored or collected by parties with an interest in the answer; treat the 70–89% provider range as an estimate, not a census.
- Market-research estimates (Arizton) — modeled projections, not measured counts.
Note on the headline hospital figure: the "~7 in 10" mail-or-fax statistic is from ONC Data Brief No. 54 (2019 survey data); the 43% routine-interoperability figure is from the newer ONC Data Brief No. 71 (2023 survey data). They come from different survey years and are not two readings of the same measure.
| Statistic | Source | Tier | Link |
|---|---|---|---|
| ~7 in 10 US hospitals used mail or fax to send/receive summary-of-care records (71% send, 68% receive), 2019 | Office of the National Coordinator for Health IT (ONC/ASTP) | Government data | ONC Data Brief No. 54 — Hospital Use of Certified Health IT (Feb 2021) |
| 43% of US hospitals routinely interoperable across all four exchange domains in 2023 (up from 28% in 2018) | Office of the National Coordinator for Health IT (ONC/ASTP) | Government data | ONC Data Brief No. 71 — Interoperable Exchange of Patient Health Information Among U.S. Hospitals: 2023 (May 2024) |
| CMS aimed to make every doctor’s office a "fax free zone by 2020" (Aug 2018) | Centers for Medicare & Medicaid Services (CMS) | Government policy | Speech: Administrator Seema Verma at the ONC Interoperability Forum (Aug 6, 2018) |
| NHS banned from buying fax machines (Jan 2019), full phase-out ordered by 31 Mar 2020; 8,000+ machines then in use | UK Government (gov.uk) | Government policy | Health and Social Care Secretary bans fax machines in NHS (Dec 2018) |
| Only ~42% of NHS fax machines removed by September 2019 ('Axe the Fax' progress) | Practice Business | News report | What happened to 'Axe the Fax' in the NHS? (Sept 2019) |
| Japan ordered ministries to stop faxing by end of June 2021; ~400 objections filed; effort stalled | The Japan Times | News report | Phasing out faxes faces fierce resistance from Japan's bureaucrats (Aug 9, 2021) |
| 70–89% of healthcare providers report still using fax (varies by survey) | Communications of the ACM | Industry survey | Alive and Well, As a Matter of Fax |
| 70–89% provider fax-usage range (corroborating industry survey) | Konica Minolta Business Solutions | Industry survey | New Facts About Fax in Healthcare |
| Approximately 70% of healthcare providers continue to use fax (industry writeup) | Altera Digital Health | Industry survey | Why healthcare still relies on faxing — and why it's a problem (Apr 2025) |
| Global fax services market $3.31B (2024) → $4.47B (2030), ~5.15% CAGR | Arizton Advisory & Intelligence | Market research | Fax Services Market — Global Outlook & Forecast 2024–2030 |
Fax statistics — frequently asked questions
What percentage of hospitals still use fax?
The strongest government figure comes from ONC (the federal health-IT office): about seven in ten US hospitals used mail or fax to send and receive summary-of-care records in 2019 — 71% for sending, 68% for receiving — making it the single most common exchange method. Broader industry surveys of healthcare providers (not just hospitals) put usage in the 70–89% range, though numbers vary by survey and by how "using fax" is defined.
Is fax still used in 2026?
Yes, heavily. Fax never disappeared: the most recent federal data shows only 43% of US hospitals were routinely interoperable across all four electronic-exchange domains in 2023, so most still fall back on fax for a large share of records. And the global fax services market is projected to grow from $3.31B in 2024 to $4.47B by 2030 — the technology is migrating to the cloud rather than dying.
Why do doctors still use fax?
Three practical reasons. First, interoperability is still incomplete — different electronic health record (EHR) systems often cannot exchange records directly, so fax is the universal fallback that every provider can send to and receive from. Second, fax fits established, HIPAA-familiar workflows and carries recognized legal standing for signatures and records. Third, a fax transmission produces a delivery confirmation that many offices treat as proof of receipt. Faxing is often the path of least resistance, not a nostalgic choice.
Is fax more secure than email?
It is a perception as much as a fact. Fax travels over the phone network as a point-to-point transmission and does not sit on third-party mail servers, which is why many healthcare and legal workflows treat it as acceptable for sensitive documents. But a paper fax can also sit in an open tray for anyone to read, and misdials happen. Modern cloud-fax services address this by encrypting documents in transit and at rest and delivering them to a secure account rather than a shared machine.
When will fax die?
Not soon on current evidence. Every major government effort to kill it has missed its deadline: the US wanted doctors' offices fax-free by 2020, the UK ordered the NHS to phase out fax by March 2020 (only about 42% of machines were gone by September 2019), and Japan's 2021 push drew roughly 400 objections and stalled. With the fax services market still growing into 2030, the realistic outlook is a slow migration from paper machines to cloud fax rather than an outright end.
If the data has you needing to actually send one: XenFax lets you fax without a machine.