Dr. Godbole,
You bring up three points.
1. Cost: if you are a high volume fax recipient (sounds like you qualify), then keep your own fax line. Have the faxes come through your line to an MFC which takes the digital file (tiff) and drops it in a folder on your computer. Have them dropped in the file that is "picked up" by Updox. None of those files count as faxes. So if you receive 5000 faxes, Updox counts that as 0 towards your total. (You can choose a fax board or not, as pointed out above; one is not needed for this savings). Your faxes sent do count towards the Updox total (if you send them through Updox).
2. Work flow: if that workflow is better for you, then stick with it. One of the complaints about EMR's (ryanjo champions this one) is the transition of "clerical" work from the staff to the provider. As you describe it, your work flow reduces that. Keep in mind though that the total time spent (you plus MA) is significantly more your way than with the alternative. You will also be using a lot more paper and ink.
3. You invite a patient to the portal simply by sending a message to their email. They get a password and then log in.
