Home Forums Faxing from AC

from what i was told, we need to have special software to fax out directly from amazing charts. because we are speciality practice, we fax out a letter after every visit to the primary that has referred the patient to us.

we are trying to see if getting the software is worth it, or if there is a way around this. can anyone share their experience with this?

UPDOX is the solution our office uses, it allows bidirectional routing of incoming faxes into your AC and outgoing faxes from your AC notes. Think there is a link in the interfaces pull down in AC for more info. Price is 39 dollars/ m, and has reduced our paper shuffle to vitrually nil.

Dave Condon, D.P.M.

We use microsoft fax or Brother fax (from the Brother MFC). Actually, I somewhatlike MS better because it keeps an audit trail of what was sent, or what failed.

podski: when i present this to the docs, would you say that this has cut the cost of paper? any ink savings? i am certain that would be the determining factor.

doctorWAW: i have microsoft and i am currently able to fax from my works, but not from amazing charts. do you guys move the letters to microsoft works and then send them out? i am unable to find a way to fax from here.

as far as i am concerned, the key is to go as paperless as possible. having just purchased all new equipment, however, i don't want to get greedy. however, if savings are noticed, it may be worth it.

We use JOYFAX. It is Server/Client based fax software. It will use your Fax modem on any computer you want in the network. You buy Server and Number of clients you need (probably the number of computers using AC in the practice, so all the users can use fax features).
It will eleminate the need for any paper. All incoming and outgoing faxes are saved in the computer, and can be imported as PDF to AC.

thanks everyone for the responses.

is JOYFAX very expensive? what about when we get faxes over the fax machine (labs, refill requests, etc)

Patricia,

I use Updox here at our office. We are saving on ink toner & paper for the fax machine. I like it as it integrates with AC but does cost $35/month for 3 users. Updox price would also depend on the number of faxes/month. The basic rate comes with 500 pages/month. If you used Updox, you could get rid of your fax line and that would save you some money as well.


Certainly a MFC would work too. You'd have the initial investment of the machine (if you don't already have one), but you wouldn't have the monthly expense like in Updox.

I wish all our specialists would fax us letters after seeing our patients. I'm lucky to get 10% of any consults.

MFC? please forgive my shocking lack of computer software information.

we try and get the letter to pretty much any physician that has a hand in the patient's care and in some cases, that is 2+ doctors. we used to mail out each letter, but now i fax them. trying to cut down on cost and time - so i can figure out AC.

Go to www.joyfax.com and get details. There is only one time charge and you own the software. I just looked at it. There is $85 for the server (for one fax line) and one client. Each additional client is 39.95.
There is no limitation on number of pages sent or recieved. You use your Land line for Fax. You can create contact directory and send same Fax to multiple recipients and many more features. I liked many features of Updox but that is expensive.
Try the website and see what you like. They may let you a trial version for free.

MFC is used to describe multipurpose fax machines:

Multi-function Center: ie copy, fax, scan

Brother is a major maker of MFC's (there are others) and usually come with Paperport which is a fax management solution as well. Many on the boards here use Paperport. If you get an MFC, you could "print" to your fax machine and fax things out.

I agree that an MFC (if you are in the market to begin with) is the way to go. Any "fax server" as JoyFax or others are fine. You do basically need a fax server to fax effectively from the desktop. Most MFCs like Brother, HP, Dell, Xerox, Muratec have MFCs WITH a fax server in them. Not to be picky but the three terms are MFP (Multifunction printer), MFC (Multifunction copier), and a-i-o (All-In-One). Personally, I still like MFP the best, but it's really not that important. We have been down the Brother road a million times, but just so you know the company is allergic to PDFs and simply refuses to fax to PDF. Only TIFF. Yes, the Paperport software can covert it to PDF rather quickly, but I don't understand it. If you can find a Muratec, then you are all set.

Yes it has cut the cost of paper, but then again paper is cheap. Ink is a bigger savings. We try not to use much of either of them.

I can fax directly out of amazing charts simply by saying print to fax or print to brother fax. Next comes a box (or series of boxes) asking for telephone number and such. I do not create an intermediate step.

I use a slightly different system than most users. I use a Mainpine fax modem. The driver directly outputs faxes to PDF. There is no TIF intermediate as with Brother/Paperport combo. Wendell is right about the ink savings. We used to order ink every 2 months. Now it's more like 6 months to 12 months. We get over 1500 faxes a month, some of those are 30-60 pages. It looks just like a printer/integrated with windows fax console/windows fax and scan. Since it's integrated with windows, you can control permissions, i.e. fax administrators, fax users, etc. The price was around ~350-400 for it. But due to the high volume of faxes we receive, I opted for it. Almost went with another US Robotics fax modem, but we used to get complaints all the time about that modem i.e. faxes not sending, being received, duplicates, etc.. It paid itself off rather quickly.

Brooktrout here.

Brooktrout is a terrific fax modem as well. Quite expensive though ha. You can't go wrong with either one. They both have really high success rates. Mainpine support is really good too.

We use Updox and are happy with it, but there are other good solutions.

The first (easy) step is to "flip the switch" that turns your faxes from a piece of paper to a file on your computer. While you are at it, be sure to turn off the ringer on your fax machine; the silence is striking.
Then work towards a paperless office. You probably won't go all the way, but it is a worthy goal. You are aiming to have only two types of paper in the office, toilet tissue and dollar bills.
The savings in paper and ink/toner will definitely come. Harder to quantify (but in my opinion, greater in value) is the savings in staff time through increased efficiency. This should be what really drives the change.

Agreed with Sandeep. I just thought the name was cool.

Jon, if I weren't set up with F.A.P. and all that, I would likely move to UpDox. Plus, when I first started with AC, UpDox was packed with OneBox and it was rather confusing.

thank you!! everyone is very helpful! i have lot of research to do, but there is most certainly a light in the tunnel.

If you want to go "paperless" why are you using fax (paper on the other end) and an acre eater of hard drive space with stored images?

One of the "meaningless use" criteria is electronic sharing of information with other providers. IMHO we ought to insist that all EMR products can exchange or get on board the HIE (Health Information Exchange) soon.

AC will import an XML from another system but only as an imported xml file. It won't populate the demographic data or recognize an existing patient, and add just the new data. (If you have a program that does let me know.)

Thanks Richard,

I was ready to do HIE 11 years ago, and it still isn't set up. I am sure that everyone here would love to electronically meet in the middle somewhere, but the fact (right now) is that when I send something Certified Mail or password protect a PDF, 25% of doctors can't open it.

My MFP is capable of faxing via the Internet, but the other person has to have the same capability.

I think if we do it on our end, they should be able to do it on theirs, and they don't need an EMR to do it. And, hard drive space is even an issue.

We have been testing GFI Fax Maker. So far it has been great the only problem is when you print from AC... AC like to create multiple print jobs instead of just one, so you have to do a little work to combine them so it will go out as one fax. as far as receiving we went the GFI's recommended hardware and it works fine.

-Dog

Hello all
Picking up this thread. I use Updox but, because of the volume of faxing we send and recieve, is costing me around $70 monthly. I am thinking of switching to faxing through a server or an MFC. My question is do any of those other solutions allow for a direct import interface into patients in AC the way Updox does? That is the major convenience that's making me continue to pay for Updox.

Thanks

You can hook an incoming Fax line to a fax machine that generates files, and then have those files go into(by configuration or by hand) into the auto-upload-to-Updox folder.

You get the Updox functionality without having to pay for your incoming fax barrage.

Indy, in playing devil's advocate, I wonder if you are saying it could be done, or that it is reasonable to do it that way. Consider that you would now have to purchase and maintain a fairly sophisticated fax machine and figure out the configuration or pay staff to do the additional step. Unless this is a fun project for someone there seems to be very little benefit to avoid $70 a month. Seems better to just skip the morning latte if that is the issue.

David - you raise an interesting question; from what standpoint to answer the question itself.

In my professional practice, "Can it be done?" and "What do you recommend?" are distinctly different questions, and we get paid to answer one, generally both. Not surprisingly, the answer is often YES it can be done, and NO we don't recommend you do it that way.

So my first inclination is to answer how something might be done, regardless of whether I would recommend it. After a few years of getting to know several folks here, and how they operate their practices, perhaps I should give my advice as to the opportunity cost/benefit as well. I will defer to the community if there is a strong preference for one or the other.

As Khaled indicates, Updox provides a significant value for a practice in being able to directly import faxes into a patient record that can be flagged for signoff at the same time. I have yet to see a practice that wouldn't benefit from using Updox, but some folks see saving $35 as a big deal, and that is their value judgement.

Since we do cost analysis for most SMB to enterprise projects, I'll use your question to illustrate how we would cost-model this decision.

Tasks where Updox impacts productivity:
Filing incoming faxes:: without Updox you view the document, find the patient in AC, and if it is a paper document, you have to scan it in. Then you import it into AC. If it is a paper document, you now have to destroy that document.
Filing incoming faxes with Updox:: you view the document in Updox, start typing the patient name until it matches, select the category, the provider to notify, and import it from Updox.

Lots of practices do this during the morning "coffee time" in batch mode, then on and off during the day. If the person that does this is part-time, there is a more direct cost-benefit [less hours worked], but in most cases that I have seen, this is a full-time person. Another direct model is if there is a staff member being paid extra hours/overtime to catch up with paperwork - again, less likely, but possible.

Let's use $9/hour for a staff member - it may be more or less in your community, so adjust as necessary. The reality of employees is that their loaded costs, especially at the lower end of the pay scale, is 100%; thus that employee's time is costing you $18/hour. That still doesn't include cost to supervise, but that is buried in overhead [and often your free time].

Now we need to estimate the time savings:: I have heard from staff members that switched to Updox that they are 2-3 times as fast importing, but let's be conservative and estimate a 30% improvement. The next question is how many faxes does your staff do in an hour. A conservative estimate would be one every two minutes, so 30/hour. That means your unit cost per imported item is .6 without Updox, .46 with; a delta of $.14. That means that once you have handled 260 faxes in a month, you have gotten your cost return on Updox. If your staff is 50% faster, 180 faxes.

Another area to model is patient communication through the patient portal; let's use the use case of sending out normal lab results. If we stipulate it takes 5 minutes to print the lab results, print a form letter regarding the results, address, stamp, and mail, then we compare that to a minute [or less] to send the send the lab results with a template letter through the portal, we have a 5-to 1 ratio. Cost differential per portal message is $1.2. That means you have to send out 30 portal messages (disregarding material costs) before you get your Updox value.

The strongest way to cost-model is differential revenue, but because it is currently unrealized, it is more subjective. IIRC, David's gross revenue target is $140/hour, but let's stipulate $100/hour to be conservative. If by using Updox in your practice your staff is able to be more efficient, or handle some correspondence in your stead, you need 21 more minutes in a month with a patient, in the higher case , 15 minutes in a month to get your Updox value.

So by any objective measure, Updox makes business sense, but everyone practices differently - YMMV.

Well said, Indy.
Along those lines, a big issue we encountered when going electronic was the shift of clerical duties from low-end employees to providers. I used to go to my inbox, pick up a lab slip, initial it, and put it in my outbox. We left a message on a phone service for the patient. Now, of course, I have to import the lab, open it, interpret it, print to UpDox patient portal with a note, sign it off (three mouse clicks). I counted some 20 mouse clicks to import, notify patient, and sign off. The same for faxes. Not a very efficient use of my time, but unavoidable if I need to personally see and comment on the data.

I would likely be using UpDox if it weren't for FAP. I remember working with Andrew Barbash, M.D., Neurologist who helped found UD. This was over eight years ago when it was still in its infancy, and if I recall correctly, you had to use OneBox, which made it very confusing. Andrew even came out and personally visited with Adam and me at Adam's office. I don't think anyone has more energy or hyperactivity than he does.

David from Fairbanks

How many clicks does it take to ? AC needs to start looking at the click ratio...that is what makes this program unappealing...especially if you want to use the decision support section. My hands and fingers hurt...AC should come with a certificate for a weekly/monthly massage....

Todd,

I have talked about this ad nauseum. As part of a developing team (of two), my programmer hammers that home constantly. Decreasing mouse clicks is huge. I could point out at least ten without even thinking.

I think AC needs a new GUI -- same as when it decided. Also, Outlook, is the prototype for having new windows open in the same overall program which increases speed and keeps it nice and tidy. Only the new email pops up another window.

I guess, given I don't use UpDox nor import items, it is hard for me to compare. But, with F.A.P. (I know -- sorry to bring it up again), it takes mouse clicks for the whole process.

The fax comes or scan comes into the inbox automatically, is named and categorized by the staff. I click on it to open it, interpret the labs, click on the email icon at the top, which then loads it, select a staff member, write what to do at the bottom, then send it.

One more mouse click to import it.

Lots of good points being made here.

First, anyone considering how to handle document management (faxes in and out, scanning, etc) should take the time to read Indy's post. Finally, someone took the time to run the numbers. Yes, Updox costs $35 a month...but you save more than that in staff time. As he notes, he significantly underestimates the time savings with each Updox import, so the overall savings is actually much greater.

Second, his earlier point "hook an incoming Fax line to a fax machine that generates files, and then have those files go into (by configuration or by hand) the auto-upload-to-Updox folder" is more than just a theoretical construct. You can do this with a fax machine OR with inexpensive fax software. All of our incoming faxes are automatically converted into emails before being brought into Updox. This happens automatically and seamlessly without us even seeing it. The impact of that: emails are not counted by Updox so NONE of our incoming faxes count in our monthly total, and we stick close to the $35 minimum.

Bert, I know you and others looked at Barbash's product which relied on Onebox. The current product is completely different...it might have even benefited from a name change as people who knew the old one might incorrectly think they know this one.

As to counting clicks...I am with you, Bert...I am a BIG proponent of reducing them. It is one of the reasons that I prefer Updox; it saves MANY, in my experience. The issue of "more clicks for the providers and less for the staff"...that is a separate topic which thus far seems to be an inherent characteristic of EMR's.

I spoke with Andrew by text and email this evening. He no longer works much with UpDox, although he is involved in a million other projects.

He did give me the name and email of the lead developer of UpDox. Andrew stated he may be interested in becoming a member in the vendor status and field questions and ideas.

Is this something others would want me to pursue?

incredibly well stated Indy!

yes Bert I would.
I had interaction with another office using UpDox, in particular the patient portal. It was incredibly easy to use.

furthermore, given Indy's excellent cost/benefit analysis, it makes sense to use UpDox. I didn't like that it was tied to OneBox, which made it very confusing. If they two are separate, I'm going to consider using UpDox.

Please let me join in the "WE LOVE UPDOX!" party! How much is my staff's happiness measured in dollars? Now add the patients who are head-over-heels with the patient portal. I am in a suburban setting where people are measuring their doctor's ability to stay current in medicine with their ability to master technological advances. The portal has caused as big a revolution in my practice as switching to e-prescribing did 9 years ago. The joy (yes joy) of electronic faxes is just the tip of your savings. Now add the new patients that are attracted to your practice! $$

Thanks everyone for the feedback.

We have setup multiple practices on Updox, never even seen the OneBox name, so I believe that is 'ancient history'. I thought I would get some rotten tomatoes for a cost-modeling side-bar; the reader can easily take a wild guess what I have been doing this weekend.

Now that I have actually run the numbers I would make the argument that UpDox makes sense for the Patient Portal alone.

One of the things that we have been recommending to Providers is that from a business-modeling perspective, that the one thing that they can do is focus on NOT practicing 'phone-medicine'. You don't get paid for it, it inhibits you seeing patients that you are getting paid to see, and some of that communication can be handled through the patient portal. [I will interject here, as was pointed out in Tahoe, that if you live in a rural community where your patients know your home phone and your dogs' names, this will be much harder - with a loving nod to my favorite mule-skinner]

In the event that someone wants to run the numbers for their practice, just send me a PM with you specific numbers, and I'll run it through the spreadsheet this I built this AM. I hacked mine into the bottom of another project that was already up on my screen; I'm sure Gino builds better spreadsheets

Thanks Indy but OneBox is far from ancient history.

Bert, I meant specifically as applies to an UpDox implementation.

Oh