I send a summary of the visit and CCD after every visit to the Updox patient portal. No paper is needed for this. The patients receive my specific directions and expected follow-up. This connects them to the free patient portal that is provided by Updox. Anyone uninterested in this information, just has to ignore the email that directs them to the portal. The portal keeps a record of which items the patients have read. For some of our elderly patients who are not "connected", we send their info to their children's email. This is only done at their request and permission, of course. This improves communication all the way around.