Melanie,
both updox with AC--and not technically emailing--as emailing connotes non HIPAA transmission of info, the only time i email is to send a patient a notice to the portal and since the portal is password protected on both ends and uses encrypted messaging is HIPAA compliant so I have trained my nurse and myself to use the term "secure messaging" instead of "emailing"
It has been a tremendous time saver and if the patient does not open the message in a week my nurse gets a message and then sends them a reminder on how to utilize the portal by mail, and once folks are trained it is quite the time saver, initially some upfront extra work for the nurse but a time saver in the long run.