On this page Medplum provides a first-party integration with eFax Corporate to send and receive faxes directly from your healthcare application. Faxes are stored as FHIR `Communication` resources, enabling seamless integration with your clinical workflows. ### Medplum Team Setup Required This integration requires setup by the Medplum team. [Contact us](mailto:info+efax@medplum.com?subject=eFax%20Integration%20for%20Medplum) to enable eFax for your project. Planning this integration? The [Messaging & Communications Decision Guide](/content/docs/decision-guides/messaging/index.html) walks through requirements questions and FHIR modeling decisions for messaging — thread structure, routing, and external channels — use it alongside these docs. ## Overview The eFax integration allows you to: - **Send faxes** from FHIR `Communication` resources via the `$send-efax` operation - **Receive faxes** and store them as `Communication` resources via the `$receive-efax` operation - **Test connectivity** to verify your eFax API configuration ## Prerequisites Before using the eFax integration, you must have: - The eFax integration enabled on your Medplum project (contact the Medplum team) - eFax API credentials configured as project secrets ## Configuration ### Project Secrets The following secrets must be configured in your Medplum project: | Secret Name | Description | | --- | --- | | `eFaxAppId` | Your eFax application ID | | `eFaxApiKey` | Your eFax API key | | `eFaxUserId` | Default eFax user ID for system-level operations | ## FHIR Operations ### `$receive-efax` - Receive Faxes Poll for and receive faxes from eFax, creating `Communication` resources for each new fax. Depending on how you configure your eFax account, you can call this operation on the system level, on an Organization level, or on a Practitioner level. For the simplest setup, if you only need one fax number, **we recommend calling `/fhir/R4/Communication/$receive-efax`** to start. | Endpoint | Use Case | User ID Source | | --- | --- | --- | | `POST /fhir/R4/Communication/$receive-efax` | Clinic-wide shared fax | Project secret `eFaxUserId` | | `POST /fhir/R4/Organization/{id}/$receive-efax` | Department/location fax | Organization's eFax identifier | | `POST /fhir/R4/Practitioner/{id}/$receive-efax` | Individual practitioner fax | Practitioner's eFax identifier | ### Resource Configuration For practitioners or organizations to send/receive faxes, add their eFax user ID as an identifier: ```json { "resourceType": "Practitioner", "identifier": [ { "system": "https://efax.com", "value": "" } ], "telecom": [ { "system": "fax", "value": "+15551234567" } ] } ``` ### `$send-efax` - Send a Fax Send a fax from a `Communication` resource. | Endpoint | Description | | --- | --- | | `POST /fhir/R4/Communication/$send-efax` | Send a fax from a Communication resource | **Request Body:** A `Communication` resource with: - `medium` containing code `FAXWRIT` from system `http://terminology.hl7.org/CodeSystem/v3-ParticipationMode` - `payload` with either a `contentReference` to a `DocumentReference` (recommended) or an inline `contentAttachment` containing the document to fax (PDF, JPEG, or PNG) - `sender` reference to a Practitioner with eFax identifier - `recipient` reference(s) to resources with fax numbers in their `telecom` Recipient fax numbers must be in **E.164** format: a leading `+` followed by the country calling code and the subscriber number (for example, `+1` for US/Canada, then the number: `+15551234567`). eFax requires this country code; a local number without it may fail or route incorrectly. ### Example: Sending a Fax ```typescript import { createReference } from '@medplum/core'; import type { Communication, DocumentReference, Organization, Practitioner } from '@medplum/fhirtypes'; // Assuming you have a MedplumClient instance and the sender's Practitioner profile const profile = await medplum.getProfile() as Practitioner; // Step 1: Upload the file and persist it as a DocumentReference (creates a Binary resource) // so the faxed document is tracked in the chart, not just embedded on the Communication. const attachment = await medplum.createAttachment({ data: file, // File object from input contentType: file.type, filename: file.name, }); const documentReference = await medplum.createResource({ resourceType: 'DocumentReference', status: 'current', author: [createReference(profile)], date: new Date().toISOString(), content: [{ attachment }], }); // Step 2: Create the recipient Organization (fax value must be E.164: + and country code) const recipient = await medplum.createResource({ resourceType: 'Organization', name: 'Acme Medical Center', contact: [{ telecom: [{ system: 'fax', value: '+15551234567' }] }], }); // Step 3: Create the Communication with proper references const communication = await medplum.createResource({ resourceType: 'Communication', status: 'in-progress', category: [{ coding: [{ system: 'http://medplum.com/fhir/CodeSystem/fax-direction', code: 'outbound' }] }], medium: [ { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/v3-ParticipationMode', code: 'FAXWRIT', }, ], }, ], sender: createReference(profile), recipient: [createReference(recipient)], payload: [{ contentReference: createReference(documentReference) }], }); // Step 4: Call the $send-efax operation await medplum.post(medplum.fhirUrl('Communication', '$send-efax'), communication); console.log('Fax sent successfully!'); ``` ### Communication Resource Structure The samples below show the `Communication` resource only. For outbound sends, the fax number used by eFax comes from the **recipient** resource’s `telecom` and must include the country code in E.164 form (e.g. `+15551234567`), as in the `Organization` recipient example above. ### Outbound Fax (Sent) ```json { "resourceType": "Communication", "status": "in-progress", "identifier": [ { "system": "https://efax.com", "value": "fax-12345" } ], "medium": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationMode", "code": "FAXWRIT", "display": "telefax" } ] } ], "sender": { "reference": "Practitioner/sender-id" }, "recipient": [ { "reference": "Practitioner/recipient-id" } ], "sent": "2025-01-15T10:30:00Z", "category": [ { "coding": [ { "system": "http://medplum.com/fhir/CodeSystem/fax-direction", "code": "outbound" } ] } ], "payload": [ { "contentReference": { "reference": "DocumentReference/document-id" } } ] } ``` ### Inbound Fax (Received) ```json { "resourceType": "Communication", "status": "completed", "identifier": [ { "system": "https://efax.com", "value": "fax-67890" } ], "medium": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationMode", "code": "FAXWRIT", "display": "telefax" } ] } ], "recipient": [ { "reference": "Practitioner/recipient-id" } ], "sent": "2025-01-15T09:15:00Z", "payload": [ { "contentAttachment": { "url": "Binary/received-fax-id", "contentType": "application/pdf", "title": "fax-67890.pdf" } } ], "category": [ { "coding": [ { "system": "http://medplum.com/fhir/CodeSystem/fax-direction", "code": "inbound" } ] } ] } ``` ## Supported Document Types The following content types are supported for sending faxes: | Content Type | Extension | | --- | --- | | `application/pdf` | .pdf | | `image/jpeg` | .jpg, .jpeg | | `image/png` | .png | ## Example Application See the [medplum-efax-demo](https://github.com/medplum/medplum/tree/main/examples/medplum-efax-demo) example for a complete React application demonstrating the eFax integration.