Christy,
I think this may be easier than you think. Once you bring scanned (and faxed) docs into "imported items", the program will ask if you want to have someone sign-off on them. Obviously you do not want this to happen for registration materials, but you do want a sign-off for labs, radiology reports, etc. When you import the first group, select as "Item Type", "Non-medical; no sign-off required", and the item is imported. Put the import into any other "Item Type" and a message is generated to whomever you want to do the sign-off. I think this should be much easier than involving admin and Outlook.
