Until recently, whenever local hospitals discharged patients to members of the accountable care organization Quality Independent Physicians, fax machines began screeching and rumbling. The hospitals needed to ensure doctors' offices scheduled post-release visits within the government-mandated 14 days. And practices needed to determine the types of services patients required, from home health nurses to residential care. But the ACO realized that its old-school method of communication needed to change. Faxes easily get lost, misdirected, or unread, noted Tom Samuels, CFO and CIO of Quality Independent Physicians, in an interview.