eFax Integration

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 to enable eFax for your project.

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:

• An eFax Corporate account with API access credentials
• 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:

{
  "resourceType": "Practitioner",
  "identifier": [
    {
      "system": "https://efax.com",
      "value": "<EFAX_USER_ID>"
    }
  ],
  "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 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

When sending a fax, you need to create multiple FHIR resources:

1. Binary: The document to fax (PDF, image) - created via medplum.createAttachment()
2. Organization: The recipient with fax number
3. Communication: Links the document and recipient together

Example: Sending a Fax

import { createReference } from '@medplum/core';
import type { Communication, 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 as an attachment (creates Binary resource)
const attachment = await medplum.createAttachment({
  data: file,  // File object from input
  contentType: file.type,
  filename: file.name,
});

// Step 2: Create the recipient Organization
const recipient = await medplum.createResource<Organization>({
  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<Communication>({
  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: [{ contentAttachment: attachment }],
});

// Step 4: Call the $send-efax operation
await medplum.post(medplum.fhirUrl('Communication', '$send-efax'), communication);

console.log('Fax sent successfully!');

Communication Resource Structure

Outbound Fax (Sent)

{
  "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": [
    {
      "contentAttachment": {
        "url": "Binary/document-id",
        "contentType": "application/pdf"
      }
    }
  ]
}

Inbound Fax (Received)

{
  "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 example for a complete React application demonstrating the eFax integration.