The staff imports patient-related faxes into AC which then goes into their charts. I review my inbox and send orders to the staff. These comments are attached to the import. You could also have the staff import letters into AC, your personal faxes to your email, and testing can be left in Updox for you to review/respond and send to patient through the portal and import it into their charts at the same time.
There are many variations. I have tried a few different combos. When I am not in the office but still want to keep up with my mail, I do have them leave it in Updox because it is quicker for me, rather than going into AC through my VPN.