Working with our local Quest lab, there was a separate program installed on the server. It automatically contacts Quest at specified intervals and "gets" the HL-7 files. Then periodically ( once or twice a day) any one of the providers will go to file ->import/export -> labs and x-rays on the main screen of AC. This grabs the files, and imports them into the inbox of the correct provider. The provider will then select the lab, click "pull labs" form his/her message screen, review it and sign off. We go one step further; we print the lab to the UpDox print interface, and send a copy to the patient portal with explanation. Our patients greatly appreciate this.