Hardware-based encryption provides the best protective barrier for information flowing over public networks. It is unlikely that voice communication would be considered vulnerable in a network carrying health information. Far more vulnerable are facsimile and data communications. Facsimile machines are ubiquitous and cheap. It would be difficult to find a business without one.
Many individuals also possess a fax machine.
New Internet services are evolving that provide facsimile and e-mail gateway services. It is not difficult, technologically, to develop other sorts of facsimile gateways. It is rare that someone would consider protection of facsimile communications. As paper-based systems are prolific and will take considerable time to phase out, and that it is very simple to provide fax gateway electronic information transfer systems, it seems logical to consider this service in an Electronic Health Records system. What is required though, is a means of authenticating fax users and protecting the information conveyed over public telephone networks.