In mid 1997, ISI was contacted by Roche regarding their "Zenepax" CRF electronic submission. Roche's internal CRF management system was used to do the scanning. CRF page indexing was done on the visit level only. Each TIFF file contained a single visit for a specific patient. Roche was asked by the FDA to provide CRFs in PDF format. What Roche discovered was that the process of converting existing TIFF files to PDF files is not as simple as they had originally anticipated and that it takes a long time using the traditional manual processes. ISI received Roche's TIFF files on a CD-ROM with index information, including the mapping of TIFF images and patient visit numbers. Keywords were also provided in ASCII file format for each patient. ISI imported the TIFF files and index information into CRFScan™, our CRF management software, which was then used to publish the PDF file submission complete with all required bookmarks. ISI processed 130,000 pages with 18,000 bookmarks in 15 work days, completing the project in under one month. This project is an example of how we can integrate our products and services with an existing imaging system or internally created process. We can import from any existing system into our CRFScan™ system. In most cases, only minor programming is required to import the data from an existing system.