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I've been using Updox for several months now primarily as a 'scan into AC' system. I find it pretty convenient to let faxed labs and Xray results come in on paper, review and sign off on them by hand and THEN scan them into AC with the 'signed off' box checked.
I am thinking of forwarding my fax number to Updox and have all my faxes go to the cloud but am concerned about 2 things:

-cost: Updox charges (how much?) after the first 500 faxes. We get 5000 a month!
- work flow: having to 'hover' over the document to read it, then click 3-4 times to write on it and sign it and then click a few more times to 'send' it to the patient's chart? Currently, all the above clicks are done by my MA.

Also, about the patient portal: how do I get my patients to do the initial sign up and setting up of their account?

Instead of writing on labs/xray reports, hand signing them and importing them, why don't you just scan them in and signed them off through AC? In our office, xray reports are received via fax (UPDOX) then they are filed and sent to the provider to sign them off. From there I can write an rx, send orders to the staff, make comments etc.

5000 faxes a month seems a lot. Who are you mainly getting them from? Labs/radiology? If you are getting a lot of labs faxed to you, have you considered purchasing an interface if one is available? This has been more than worth the investment in saving staff time.

To get your patients to do the initial sign up for the portal, you have to initate them getting their account. Make sure you get their email and put it in the Demographics area. Then via Updox, compose a message then make sure you use "Relate to Patient", then select "Send to Portal". From there you can send your message or attach labs etc. The patient will get an email letting them know they have a secure message. From there they have to answer a security question to be able to open the email.

Make sure you select "Send to Portal" and not "Send via email"(not HIPAA compliant)

That's a lot of faxes.

Updox charges $10/month for a "fax bundle" that handles an extra 500 faxes. This is half the price the additional faxes would cost. You sign up for them in advance, but you pay for them even if you don't use them, until you cancel them.

You might search this forum for a fax server such as here:

http://amazingcharts.com/ub/ubbthre...pine/Search/true/Re_Fax_Server#Post49532

An old desktop with a fax board could easily handle your load. And the experts are online here for any questions.

You then have your MA upload the faxes to Updox, which is free, and distribute them to AC.

That investment could save you $90+/month.

a.j.,

I just looked at my bill from last month and for 2444 fax pages, my monthly cost was 80 bucks.

Agreed. A lot of people also have those Brother MFC that can work as fax servers too if you're not ready to invest in a faxboard. I'd reserve faxboards for the really heavy users or for people that like the fax center built into Windows.

A.J.

What efax services provide that your own fax server won't...simultaneous connections from multiple senders. It's easy to tell the offices still using a single telephone line based fax system...our faxes to them fail repeatedly because their fax is bogged down with somebody sending a large chart. (Even though UpDox tries repeatedly to send the fax.) Their "savings" costs us money in having to repeatedly retry the fax to them.

From your side? Watch your staff having to send a fax, then scan it (or .pdf it), then save it to the patient's chart. Compare that to the time they spend in UpDox, where it is compressed into a single process. (Where a few extra clicks can also send to the patient's portal account, another fax number, an email, etc.)

Try Updox for a month. I bet you'll never go back.

We have the Brother MFC and use it for our faxing in/out. Saves a lot of paper because our faxes come in digitally and then our front desk sifts thru the faxes and imports them to the patient charts. Also no printing on faxing out because everyone can connect to the fax thru the network and fax anything out from a patient's chart.

I am still looking into Updox. There seems to be more edits and maybe more ease of importing to patient charts(?). Your very limited on edits with the MFC and occasionally the front desk will import to the wrong chart. Also, when our fax is busy receiving, faxing or importing the faxes into the pc it won't pick up another incomig fax. And then there are the other features that Updox offers like the patient portal, ect.

This is where fax boards are better than fax machines. We have no problems receiving even hundred page faxes. They process the transmissions very quickly so there is little lag time. They are designed for very heavy usage. I estimate $150-160 dollars (receiving only) a month for us with UpDox. I'm not sure if sending counts against your limit. If we were to use UpDox, it would be mainly for the portal.

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.

Thanks for the mention, Jon. Sometimes it seems all my whining goes unnoticed.

Of course, with these transitions comes the eventual lower costs due to decreased headcount. Well, maybe not always.

Speaking of decreased headcount, we used to have a doc posting on this board who claimed to have absolutely no staff. Total one-man show. Said he could do it with AC, a billing program, mobile phone with VM, video-cam in the waiting room, etc.

Well, that is the fundamental idea of the Ideal Medical Practice model using VERY LOW overhead. Some folk do this. Or they were doing it.

The way I see it, your time is better spent (and more valuable) doing physician-related activities. That's why almost everyone has staff to handle the calls, scheduling, etc. You probably make more money seeing more patients rather than scheduling patients/sorting faxes/doing your own IT work.

Basically true, but salaries can be a huge expense. The EMR itself, if properly made and used, and priced reaonably, can really provide a cost savings by just eliminating paper, paper charts, file cabinets and the salaries associated with "maintaining/using" these items. Now, add in Online Appointment Scheduling,and you can vastly reduce the need for someone to schedule appointments (reduce, not eliminate). Use automated email (or automated phone, but I prefer email) to remind patients of their appointments instead of having a staff member call. In general, us technology to handle things more efficiently and less costly than the staff that is available. If you reduce it enough, what is left may be best just done by yourself. At least try to reduce your staff to just one, or possibly 2 people. If dealing with insurance companies, one of those people will deal with billing issues. If not, well, you just eliminated that too.

AJ:

I don't use updox for all the faxes....i let PT groups and docs offices send to a different E-fax number...one that costs me 56 bucks a month...and i only allow labs and radiology groups send directly to the updox number...i have talked to the managers of the ones we deal with and they don't use a cover sheet for it either...

We just started using Ring Central efax service. It cost $35 a year and you have unlimited cloud fax service. We usually have around 500+ pages monthly easily. the efax comes in as PDF and our staff can save the PDF fax directly into AC. We also have our own dedicated fax line out that we use our brother MFC to do this. I think updox is good but costly on the fax side. Plus I hate having to be "charge extra." if we go over our fax page limit. HTH

Hey, when I went to their website, all I saw was $39.99/year for unlimited. Link

http://www.ringcentral.com/plansandpricing/ringcentralfax.html

Is there a page that I didn't see?

James,

Sounds like you are happy with Ring Central. Updox charges you for incoming & outgoing faxes. It can add up quickly.

If you have a Brother MFC, you can leave it connected as your fax machine. You can set it up to have incoming faxes saved to the "SEND TO UPDOX" folder and they automatically get imported into UPDOX and will not count against your incoming faxes.

Just an FYI

I'd love to have it set up like Marty explains. My problem: Updox logs out if left open and not used after about an hour or so. No faxes available from the SEND TO UPDOX folder until I log into Updox again. I asked Updox customer service if I could stay logged in -- they claim that they have it set up to log out if unattended -- because of HIPAA!

Funny, AC and about a zillion other programs don't have a problem staying logged in.

John,

You just need to install Updox Central, and you that will solve your problems. The Updox support has the how-to page. Or, let me know and I can remote in and do it for you.

Indy,

Can you explain the advantages of Updox Central? I was confused when I read about it recently.

I don't think Updox has done a decent job of explaining Updox Central... what it is, what it does, and how to configure it.

With their help, I set it up, but I am still not sure what it does for us.

At this point, it does not address the problem that John mentions above.

Nonetheless, I still go with the set-up that Marty suggests. It provides a significant cost savings.
John , here is how I look at it: yes, Updox closes (which is stupid) and yes, that prevents the faxes from coming into Updox for viewing. But the faxes are still coming into a folder on your computer, and opening Updox immediately allows you to view them. Look at it this way... with your current setup, if Updox is not running, you cannot see the faxes until you start it up. The same is true with the configuration I am using.

Jon is correct: I have Updox Central running and faxes can be saved to the SEND TO UPDOX folder as Marty says. But no upload when Updox closes due to inactivity on the fax computer. So other computers using Updox don't have access to incoming faxes. I haven't tried changing the computer running Updox central to the same computer with the SEND TO UPDOX folder, so I'll try that.

I did also try to have my fax machine email the fax to my "(practice name)@myupdox.com" address. It works even if Updox is inactive. However, it adds an email cover page which can't be removed when the fax is imported into AC. I also reported this to Updox. Their response could be summarized as "so what".

I really like Updox, and would never give it up, but there still are issues.

Jon,

Basically UPDOX CENTRAL allows you to print to updox on a PC that doesn't have updox installed. As an example of what it does, we have a computer in the draw station. If a result for some reason wasn't in the chart, the staff would log into the lab website, would print out the results (on paper) and they would then get scanned into Updox for import into AC.

Now all that happens is the lab gets printed to Updox Central, no need to scan anymore.

Thanks Marty, I'm going to try your setup, very helpful!

Tried it, had my faxes saved to the SEND TO UPDOX folder on the computer running Updox Central. The faxes only upload to the Updox workspace if Updox is logged in on that computer. Once Updox times out and logs out, faxes just sit in that folder until someone logs into Updox on that computer. Am I doing something wrong?

John, that is the way my system has been working. If we are doing something wrong, I would love to know what it is.

Have you configured the auto-upload directory in Updox Central? Is it running as a service? (this is what allows it to run all the time)

Properly configured, it will upload 24/7/365.

It is running as a service. As to properly configured... Updox sent me instructions which were difficult to follow so I called and they walked me through it (or actually logged in and did it themselves- I don't remember which).
If I go to the server, I do see it running as a service at all times.

John,
Indy figured this out for me; the key is that you must have Updox Central installed on the same computer where the incoming fax file resides. I installed Updox Central on that machine and have it running as a service, and it looks like the faxes are brought into Updox, even when Updox is not turned on. It is apparently fine to have Central running on more than one machine.

Thanks Jon & Indy!

Pretty sure JBS calls he concierge line sometimes just to hear us answer.

He knows all of this, he just likes the Ritz treatment.