The client is a leading not-for-profit health system in the Northeast United States, affiliated with a prestigious academic medical institution and recognized for clinical excellence, innovation and education. With six hospitals, a wide network of specialty and ambulatory centers, and physician practices spanning multiple states, it delivers highly coordinated care to a vast and diverse population. It ranks among the top five largest not-for-profit hospitals in the United States and balances cutting-edge research with the daily demands of urgent, life-saving care.

Although many assume digital transformation has made faxing obsolete, for this health system it remains critical. Thousands of documents, including lab results, diagnostic referrals and patient records, move through the system daily, many of them by fax. With more than a thousand multifunction printers (MFPs) spread across its campuses and an industry-leading fax server integrated into its workflows, faxing was deeply embedded in operations.

Despite that reliance, the existing telecom infrastructure was buckling under pressure. Inconsistent fax transmissions plagued operations, with a failure rate that would be unacceptable for any business, let alone one handling critical patient information. Investigation uncovered deeper structural issues. Legacy analog gateways, particularly on receiving lines, were among the worst offenders, frequently dropping faxes or garbling transmissions. Many offices still relied on outdated POTS lines, and efforts to migrate them to digital were proving complex and slow.

The consequences extended beyond technical inconvenience. Physicians who were not users on the organization's internal system were not receiving lab results. Referrals for imaging were being lost. Critical health updates were not arriving in time or came through illegible. For patients that meant delays in care; for providers it was a growing source of frustration. Faxing, once a background process, had become a frontline concern.

To overhaul this critical piece of its infrastructure, the organization turned to Cloudli's T.38 encrypted fax SIP trunks. Behind the scenes, Cloudli replaced the unreliable SIP trunks and provided a cloud-native telecom backbone, while integrating seamlessly into the system's existing MFP and fax server architecture. End users noticed no change to their workflow: faxes were sent and received as usual, with the vital difference that they worked.

The migration was efficient. In a single afternoon, Cloudli's fax solution was turned up and transmissions were being processed immediately. Deployment was led by Cloudli's fax specialists, who partnered closely with the hospital's internal team to align the solution with fax server best practices and to resolve persistent issues related to the organization's previous carrier. Each fax sent now logs a detailed success or failure report, giving senders visibility to track transmission reliability and troubleshoot if necessary.

The results arrived quickly. Within a week of implementation, failure rates began to drop, and after two months both outbound and inbound failure rates had fallen substantially. When a batch of inbound numbers was migrated to Cloudli's system, failure rates plummeted to near zero within two weeks, and the organization's failure rate remains stable at near zero today. The scale is considerable: more than 1 million outbound and close to 1 million inbound pages each month, with volumes still growing as more departments convert MFPs and POTS lines to Cloudli-supported fax server deployments. Cloudli's HIPAA-compliant encrypted transmissions and cloud-first design give the system a single point of contact and a resilient solution.

• Fax failure rates began to drop within a week of implementation and now hold steady at near zero
• Inbound numbers migrated to Cloudli saw failure rates plummet to near zero within two weeks
• Faxes delivered on the first attempt, cutting retries, transmission time and usage inefficiencies
• Recipients no longer receive multiple copies of incomplete transmissions
• Staff spend less time troubleshooting and patients receive timely care with no communication gaps
• Solution turned up in a single afternoon with no change to end users' workflow