I have my staff put all labs/reports (which come in as PDFs) in a folder on the server called "reports to review". When I get a chance, I review each, enter my comments on it with a red comment box (I use Adobe Standard that came with my scanner), highlight and copy that message, and paste it to a message in AC to my nurse. I save the file, and move it to a folder "to import", from which my receptionist gets it to import into the chart. In fact, I have all things needing sign-off to first be viewed by me from the "to review" folder, then moved to the "to import" folder. This makes it easy to do a mass sign-off of the imported items, as I've already looked at them. I always hated having the inbox cluttered with the sign-off items to review, and this solved the problem.
My nurse saves the AC message to the chart when the patient is notified, and stamps the PDF file with "notified" stamp;
This way, the labs and comments are easily viewed (can view the PDFs in their native program while working on the AC chart), and the message is also permanently saved to the chart.
