I know several practices have the patient get the labs ahead of a visit, and certainly this makes sense in terms of efficiency. My problem is that I frequently don't know what labs I am going to want until the visit, necessitating a second draw if I do this. To get even close seemed to require a chart review, making me do the same job twice. Even the simplest things... say, an annual wellness exam, or followup on methotrexate therapy... often have some other issue thrown in to complicate matters; certainly often enough that I just could never get this system to work, and I rely instead on UpDox to send the lab results with comments to the patient after the visit. So, the question from me is this: How do you all make the "lab before visit" work?