How Gastro Center of Maryland Got Its Staff Out of the Fax Inbox.

It's Monday morning at a GI practice in Columbia, Maryland. Over the weekend, 247 faxes have piled up in the gGastro inbox as unlabeled PDFs. An insurer asking for records on fifty different patients, the cardiology clearance a patient needs before Thursday's colonoscopy, etc. Nobody knows what is inside until someone opens each one, works out who it belongs to, finds their chart, picks a category, types a description and files it. This takes about eleven minutes per fax.

Every GI practice has this inbox. It has become accepted as a cost of doing business.

Gastro Center of Maryland is a high-performing and fast-growing GI group with eleven locations and more than thirty providers across Maryland and new centers opening in Virginia and Pennsylvania. A practice growing that quickly has to scale for the fax queue that grows with it. “We like being an early adopter, but not the first one,” Deena Thomas, their VP of Operations, told us in our first meeting. They started with one workflow, the fax queue. Ten weeks later patients.app had filed its ten-thousandth fax, and the practice had moved on to asking what else it could do.

Faxes are still how healthcare moves information.

For a GI group that means referral letters, pathology, radiology, records requests, prior authorization decisions and clearance notes from cardiologists and PCPs. At Gastro Center of Maryland it adds up to around 5,000 a month.

The practice runs on a single EMR, gGastro, and every fax lands in the same place. As Deena explained when we first met, “It goes into a bucket and manually we have to go in there, label the patient, attach it to the chart.”

The cost isn't only the hours. Triage is a hard job with high stakes: hundreds of documents, every one of which needs the right patient, category and a description someone else can rely on. Done by hand at that volume, mistakes happen and cause problems downstream. A fax filed to the wrong chart, or never labeled, is a cardiology note the pre-op team doesn't see. A referral that sits unopened for three days is a patient who has gone elsewhere. “This person sent us one note, but it references something else in the patient's history, and we don't have that information,” the operations team told us. “Those are the patients that are getting pulled off the schedule.”

patients.app works inside gGastro. There is no integration project and no new system for staff to learn. Every five minutes, an agent works the fax list.

For each fax it reads the pages, finds the patient, and confirms demographics before it touches the chart. It picks the category from Gastro Center of Maryland's own list and writes a one-line description.

“I can barely do it with my brain,” BK Hewitt, the coordinator who ran the rollout, said when we walked her through it, “so I'm impressed that you built a brain to be able to do it.”

The rails mattered as much as the brain. If a staff member gets to a fax first, the agent stands down. If the date of birth on the fax conflicts with the chart, it is never filed. Everything it does is auditable.

The agent started reading the live inbox on July 14, 2026, three patients at a time, with our team checking every output. Two days later it filed fifteen faxes under supervision without an error. On the night of July 22 it ran on its own for the first time and filed 27 charts without a single incorrect write.

Over the 30 days that followed it filed 3,846 faxes. 3,699 of them - 96% - reached the chart with nobody touching them first. That same week BK wrote to tell us she had asked staff to spend less time labeling faxes. By late September the count had passed 10,000.

The practice noticed in the places that matter. The medication and dose now written on every prior authorization fax was “super helpful.” As BK told us when the ten-thousandth fax went through, “It's making a huge impact here.”

GI practices don't have fax strategies, and the fax tools built into EMRs clear a fraction of the queue. The queue is there, and the practice is always running behind with it.

What's different now is that the queue can be worked by software inside the EMR the practice already uses. You don't need to staff someone labeling incoming faxes.

For Gastro Center of Maryland the fax queue was the start, and they didn't wait long to ask for more. They now use patients.app's pre-procedure clearance screening: a one-page summary of what was found about the patient and what is still unknown, filed back into gGastro. “Even just this page saves probably five hours of somebody sitting on hold and trying to figure out who the right doctor is,” BK said when she first saw it. Next is a screen for the EUS cases they are bringing in-house.