Kevin,
I do not recall if you direct import HL7 lab results, but I like the labs in this format much better than PDF. For several reasons, I do all of my direct imports first thing in AM through AC, eyeball results, and send to Updox inbox, then have a templated letter in AC "here are your results, see you in a few days" and send to Updox inbox 3-4 days before visit. My nurse will then send on through portal. I usually have 3-5 labs, and takes less than 5-10 minutes. The nice thing about HL7, is the option to graph out over time, such as LDL or HgA1c's and since projecting on TV, patients really like getting results in portal, and better yet seeing the graphs at office visit.
For incoming normal mammograms or paps, my nurse has a templated normal mammo or pap letter she attaches and sends to patient portal and AC inbox at same time, so then I sign off later (for abormals she does not do this).
The other nice thing about secure messaging received in Updox inbox, my nurse will copy and paste this and her response in AC patient chart which shows up as message and keeps it well organized. I like these features so I thought I would share, but this may not work for you and if not, I hope you get it figured out.
Having over 750 patients using the portal now, even though it was labor intensive up front we are definitely seeing the significant improvement in efficiency with less phone traffic. I think patients like communicating better than with phone as well.
I hope this helps.