OrthoVirginia Integrates Epic with Biscom Fax

OrthoVirginia, Virginia’s largest independent Orthopedic practice and an Epic EHR customer, used to spend a significant amount of staff time analyzing and resending “failed” faxes – ones that never reach their intended recipients. By working with Biscom, OrthoVirginia was able to reduce the time staff spent chasing down missing clinical documentation by 88% and streamline the process of faxing through the system. “Healthcare is a time sensitive industry. It’s painful when faxing doesn’t work. It’s integral to internal and external workflow processes,” shared Ted Kraje, Senior IT Systems Engineer for OrthoVirginia. “Insurers need documentation to approve coverage. Lawyers are expecting releases of information turned around quickly for cases. We have to pass preoperative information like EKGs, allergy lists, and anesthesia info to surgical centers or surgeries can’t move forward.” OrthoVirginia has more than 215 providers and 1800 employees in 39 physician offices, MRI facilities, outpatient surgery centers, and physical therapy clinics. The group practice has locations throughout Virginia, including Richmond, Lynchburg, Fairfax, and Virginia Beach.

High Fax Error Rate Impacts Patient Care

“When I was hired, the organization was in the process of merging four separate regions across the state into OrthoVirginia. We were working to consolidate and develop common processes and systems across all the offices. Each region had its own legacy systems, different EMR/EHR systems, and, for fax, a mix of traditional fax machines, PRIs, and a lot of analog lines.”

At first, managing fax was a nightmare for Kraje and his team. On average, only 93.3% of the 37,000 outbound faxes sent each month from the system were being successfully delivered within 24 hours (or about 112 failed faxes a day). “The support staff could spend a whole day working on the failed fax queue and still not successfully resend or resolve all the failures. We never finished working the issues,” explained Kraje.

Strong Epic Fax Integration Improves ROI

But that situation changed with OrthoVirginia’s implementation of Biscom’s enhanced integration of fax with Epic. “We chose Epic for our EHR, and we knew Biscom had a good relationship with Epic and a tight integration with the system, so that made it the logical choice for fax,” said Kraje. “The biggest impact is that the percentage of successful faxes has skyrocketed. We are running a 98.6% successful fax rate now – that’s only 24 failed faxes a day that need to be tracked down manually.”

“That increase is a huge time saver. We don’t have multiple people at the help desk spending up to four hours a day tracking down failed faxes, resending them one by one – barely keeping their heads above water. Now it is one person spending 30 minutes a day to make sure faxes get through, giving us an eight-times boost in productivity. Resending all our ‘busy’ failed faxes takes just a couple of clicks in Biscom, for example. The rest of the team can focus on other important support issues,” offered Kraje.

Eliminating Paper Fax Saves Money and Trees

Implementing the fax solution from Biscom also allowed OrthoVirginia to send and receive faxes electronically, rather than printing reams of paper and then scanning them as they had done previously.

“The amount of paper costs alone that we’re avoiding probably pays for my salary. I’m not the ‘Lorax’,” said Kraje, referring to the well-known environmentalist of Dr. Seuss stories, “but geez, we must be saving trees. And then there is overall time efficiency. Every time you have to print to paper, it slows your business process down. Not having to take that step is a huge time saver. And that’s not even factoring in our employees that work remotely.”

Intelligent Fax Server Reduces Costs

Kraje continued, “Another component of the time savings is the ability to easily consolidate multiple faxes into a single fax. That’s really easy to do with FAXCOM. So, for example, if you are responding to a release of information request and you want to send (a) two different things from two places in Epic, (b) a document from some legacy application, and (c) an electronic form, you can include that all in one fax. We’re not sending four faxes with four cover sheets anymore – we are sending one.”

Kraje also explained how the system helped reduce long distance telephone bills. “Least Cost Routing is another out-of-the-box financial benefit. OrthoVirginia offices exist across Virginia in multiple area codes. Biscom has this excellent functionality called Least Cost Routing, or LCR, where if I needed to send a fax from my office in Central Virginia (area code 434) to a fax number in Northern Virginia (area code 703), it wouldn’t need to send a long-distance call from my local fax gateway. Instead, Biscom would route the outbound fax to our fax gateway in the 703 area code, and then make a local call.”

Simple Fax Server Configuration

Kraje and his team found that setting up Biscom’s fax solution, including the integration with Epic, to be a fast and smooth process.

“Honestly, the software implementation was easy. FAXCOM was very simple to configure. I always watch software consultants like a hawk when they are configuring their system. With Biscom I watched how they set up the first couple of queues and then took over and finished the rest. The more time-consuming part of the project was working with end users to help change their processes from ‘Print to Paper’ and manually faxing to ‘Print to fax’. Change is always hard for folks. In my experience, in a successful software implementation, you shouldn’t need to spend the majority of your time configuring the software – you should spend the majority of your time working with users and helping them adapt to the change.”

Kraje also shared a personal perspective on the importance of a reliable and well-supported fax solution. “My mother recently had knee replacement surgery and was in a lot of pain beforehand. I can’t imagine how she would have held up if that surgery had been delayed over late or lost paperwork. When something impacts faxing, it’s like living in a nightmare.”


OrthoVirginia | Biscom





Boston, MA



  • Too many different fax systems 
  • Lower reliability of prior system caused too many problems
  • Staff spent too much time looking for and responding to failed faxes
  • Biscom FAXCOM with Epic Integration
  • Single consolidated fax management solution from Biscom, integrated with EPIC EHR 
  • Reliable fax solution from Biscom significantly decreased failure rate
  • 8X improvement in productivity 8X improvement in productivity 


Biscom is just one of those systems that is simply stable — I call it run mode. It doesn’t need constant attention.

Ted Kraje

Senior IT Systems Engineer, OrthoVirginia