Cloud Practice Management System EHR/EMR - Reviews

Thank you, Mia!  I'm glad you've found the information useful.  I'd love for you to share what you end up doing and whether you're satisfied with the product you choose.  One thing I can't offer is a variety of perspectives ane experience with all of these solutions, so I'd love for others to share their experiences.  Best of luck with your plunge!

Hi Sara,

Great question. You're finding yourself in the same position as almost everyone I speak with. The only difference in the stories are the specific features in question. Essentially, none of these programs have every feature someone may want and so the difficult decision becomes which features are non-negotiable and which can be set aside for now.

There is certainly some significant time savings that can be gained in having fully integrated credit card acceptance. Unless you stay below $499 in charges with Argonaut, however, you're going to end up paying more for the service than you would through a service like Square however. One thing to consider is whether that additional cost is worth the minor time savings. In the end, it's not that difficult to enter what someone has paid in most of these other systems.

I'm curious what it is that makes the credit card integration the integral decision point for you?

Sara, it's definitely prudent to consider how long a company and product have been around. I don't know that I would rule out a brand new company (look at how new Square is, for example), but it's certainly a consideration, especially with something like this. If it makes any difference, however, I'm pretty sure CounSol and TherapyNotes are very similar in age, both started within the last couple of years.

I think they both have a nice clean interface. Almost all of these apps, including CounSol I believe have either a free trial period or a 30-day money back trial period.

Hi Denise,GUI/UX = Graphic User Interface / User Experience.  You can read more about it in this blog article.
Many of the features mentioned and reviewed here are more fully explained in the previous articles of the series.

I've not heard of Confidant. It appears to be traditional software (i.e. installed on your computer) so it wouldn't be included in this series. I may do a future series on traditional software depending on if it continues to hold its own against these cloud-based solutions.

I completely understand what you mean about sifting through all of these solutions and the aging effects!

Hi Rachel,
The PayPal widgets work well. I use one on this site for the Feature Matching consultation and have used it on other sites as well.

One caution about cloud-based scheduling systems like Schedulicity: Many are not HIPAA compliant. I'm guessing that clients have to use real names, phone numbers and perhaps even an address to schedule appointments. That's PHI being stored on servers. You'd need a BAA with the companies and, ideally encryption to ensure HIPAA compliance. The only one that maintains HIPAA compliance that I'm aware of is FullSlate.

That said, I've not asked those companies if they will sign a BAA, but am doubtful. If you've found differently, I'd love to hear about it!

Thank you for dropping by and sharing your comments on CounSol. While I was as thorough as I could be in my reviews, it absolutely helps everyone to hear from other users as well. It's especially good to hear from someone that uses their secure video feature since I didn't have the opportunity to test that.

I'm curious to hear where you got the information regarding them de-identifying health information. There's nothing mentioning this on their web site. In addition, when I was reviewing it and had an opportunity to have them troubleshoot an issue I was having, it was clear that they did indeed have access to the client information. Further evidence that they have access is the email appointment reminders that they send. While they don't send any PHI in the email, the email address itself is considered PHI.

Regardless, HIPAA is pretty clear that if you are transmitting PHI to or through a vendor, a BAA/BAC is required. I have read that there is a legal grey area if the PHI is always encrypted and the vendor never has access to the data. However, it is exactly that, a grey area, partly because there has been no case law to explore it.

There are additional reasons to have a BAA/BAC, connected to the requirements HIPAA lays out regarding having documentation of your risk assessment, data security, etc. Another grey area, current wisdom on this is that if you have a BAA/BAC with a vendor it puts the onus on them to have done those things, especially if you request such documentation.

CounSol has reported that they are open to signing a BAA/BAC, so it would seem the prudent move for every covered entity to be sure they have one.

S, (can we call you "S"?) :)

The informed consent question is something I encourage you to run by a lawyer to be sure. My understanding is that it typically suffices to have a general statement addressing the fact that you do share limited PHI with vendors for the purposes of fulfilling your duties (like for taking notes, filing claims, etc.). I doubt you need to spell out exactly what data points you share, but should be willing to explain them should a client ask.

On the credit card front, I completely understand your confusion. Each of these products is continually announcing up and coming features. With things moving at such a rapid pace, it can be hard to keep track of who has announced what.

Hi Lori,
Thank you for your positive feedback and your questions. There have been a lot of changes in the last 23 years so I imagine you've worked hard to keep a successful practice that long. Here are some answers to your questions:

1) I don't have a well formed opinion about Therapist Helper. I've never used it. I've heard mostly positive reviews of it from others. Since it is a "traditional" software product, I won't likely be looking into it any more closely any time soon. Unless, of course, they develop an online version.

2) In my conversations with staff at Therapy Appointment, they have acknowledged its need for a facelift. While they have said they hope to address it, they've offered no guarantees or timelines with regard to such an effort. That's definitely disappointing since they are at the forefront with regard to features.

This may not be news to you, but I'll offer a word of warning anyway. Be sure, when seeking recommendations and reviews that you consider the relationship the source has with the product. Goodtherapy.org, for example, has advertising partnerships with many other web sites and vendors. There's a potential conflict of interest there since it makes good business sense for them to offer recommendations for products they already have a business relationship with. That's not to say the recommendation is without value. Just something to be aware of.

Thank you again for your feedback!

An update on Practice Suite. In taking a closer look, I found that you can discover their pricing by clicking on the "Sign Up" button. While their Billing Software (essentially insurance claim filing) is free, their EHR/Practice Management piece is a whopping $199/user/month. AND there are setup fees. That pretty much rules it out of getting a review since I'm currently focused on reviewing applications that are affordable for mental health practitioners.

Denise,

Thank you for continuing to share your experiences with myself and the readers. It sounds like your impressions are very similar to my own and it's good to hear that you were able to find a good match!

*wielding my virtual machete*
Rob

Kathy,
Thank you for sharing your thoughts on Valant. I had hoped to do a complete review of it, however, they would never commit to pricing that was competitive in the market I was reviewing. I definitely got the impression they were willing to negotiate individually. That you were able to do this, will be good information for many. Others would prefer to have that information up front and will likely rule them out on that basis.

Thank you for sharing!

Hi Rick,
PracticePro Therapy is on my radar. I've spent some time with it and also talked with some of the people there. It's definitely currently geared toward power users. One of the reasons I'm holding off on doing a full write-up is that they report that they are making some significant changes sometime in the near future. Significant enough that it would have a pretty big impact on my review.

As the system is now, I don't think it would make it into the top picks, however, depending on what happens in the next revision that could change. I'm not prepared to get into detail about my reasoning yet. However, I will say that two initial concerns I have are the price point and the fact that they require a one-year contract that automatically renews if they aren't given proper notice. The potential customization and other features may lead to those being non-issues depending on how the product develops. One thing to note is that it's brand new. They only launched 4th quarter of last year so they are likely adjusting to initial user and market feedback. The product shows a lot of promise and potential for one that is so new.

Hi Adam,

Thank you for the great question! Of the top three, I believe CounSol is the only one that didn't have a Superbill last I checked. One of the things I'm considering is publishing feature grid for all of these. There are some challenges associated with that, the primary one being keeping it up to date.

In the meantime, if you need help narrowing your choice down based on a set of features you are looking for, you might consider my feature match service

Sara,

Thank you again for sharing your experience. It sounds like all three of the top picks offer SuperBills along with many of the others in the list.

Rob

Hi Erika,

When I was provided a demo of Valant, I was impressed by many of its features and also identified some areas that needed improvement.

But that has little to do with why they don't have a full review here or are in the "Not Likely Contenders" category. This initial set of reviews focuses on solutions that are affordable for solo and small private practices. While the people at Valant initially indicated to me they were considering pricing that would make it more workable for such a market, they ultimately didn't follow through.

The truth is that many of these programs will help providers become more organized and profitable. At the time of these reviews, however, Valant did not offer a price point that was competitive with the rest of these solutions. Nor did it offer significant features that made it worth the increased price.

Hi Janella,

I have heard of LuxSci, however they do not offer an integrated practice management system. As you noted, they do have encrypted email and scheduling applications, but that isn't enough for them to fit in with the reviews here.

I may cover utility applications like that in the future however.

I just received an initial quote on pricing from QuicDoc. It's definitely not a viable option for a solo practitioner at $189 per month. They offered a significantly reduced per user quote for 28 clinicians, so it might be worth pursuing if you have a large group. I'm not sure I've seen anything in its feature set, however, that would make it worth the extra cost. It will remain on my "to be investigated further" list for now.

TheraSoft does have an impressive demo. At the time I did the original review it carried a $400 set up cost along with $79 per clinician and no price breaks for multiple clinicians. It was also an additional $30 per clinician for electronic insurance claims. They've since dropped the setup fee and cut $10 off the monthly fee, but if you need to file insurance claims, that still makes them significantly more expensive than the other contenders.
In addition, their banner seems to continually imply that the pricing is temporary. They seem to update it each month to say you have to sign up by the end of the current month to get this pricing. As of right now, it still says you have to sign up by 2/28/2013. I'm not sure why they wouldn't just stick with the pricing long-term instead of advertising it as a deal.

I'm hoping to get a closer look at the program soon in order to determine if the added expense brings with it added features/functionality. At that time, I will definitely update my review.

I've also confirmed the new pricing and will be meeting with them next week to get more details. Look for a complete review some time in the next month or so. In the meantime, I'd be curious to hear how you feel it compares to some of the apps I've rated highest. Also, have you actually used their product or just viewed a demo?

Hi Katie,

Thank you for the positive feedback. I'm glad that reviews have been of help to you and wish you all the best!

Hi Nathilee,

Thank you for taking the time to post your appreciation. I'm always grateful to hear from people who have found them helpful!

Hi Mike,
If you search this page for "Delphi" (Ctrl+F on PC, Squiggily+F on Mac), you'll see a comment I made a couple of months ago. I'm working on parsing some of that out into a separate page.

Hi Sig,

These reviews are currently focused on cloud-based practice management systems. Neither Theraquick nor Therapist Helper currently offer a cloud-based solution (read more about the difference between cloud based and traditional software here)

As for Penelope, thank you for bringing that one to my attention as I wasn't aware of it. I've put in an email to them, but am initially skeptical as they have no pricing listed on their web site. Most solutions who don't clearly list their pricing on the web site tend to be much more expensive than the solutions listed here. I'll let you know what I find out!

Barbara,
Great question! Yet another app that is in my "applications that aren't already reviewed list". There are multiple reasons Kareo isn't here. The short version is, unless you're only using it for the most basic of features, it's going to cost you $299 per clinician per month or more.

Like Practice Fusion (who they have a partnership with), they draw you in with the Free product. However, if you want features like Scheduling, Appointment Reminders, or Patient Statements, you're immediately bumped up to the $299 per clinician per month plan. Pretty steep jump, right?

You may want to also read this related article: http://www.tameyourpractice.com/blog/does-your-ehr-vendor-sell-your-pati...

Hi Tom,

Bear in mind that my ratings assume a very general stance. The top rated programs are such as they offer a feature set that will appeal to the widest array of users/practices. They are not, however, the best choice for everyone. Many times, in completing my Feature Match Report for clients, I recommend something apart from those three. This usually happens for practices that have specific specialties, or a specific feature combination they definitely want.

As for records, I very briefly cover your questions in my Miscellaneous article on these systems, under Data Portability. I strongly encourage you to ask your question of any system you are considering using. The answer will vary from system to system. Some give you complete control over export of all of your data. Others make you jump through hoops to get it. As for TherapyNotes specifically, you can export your client data, but notes can only be exported in PDF format. So, while you can potentially import your client data directly into a new system, you would have to upload your notes as attachments (or store them another way).

Tom, as discussed in my series article on Notes this is definitely a feature to look for. Most of these programs do provide this capability. They do so in different ways so it's definitely something to evaluate during any demo or trial period you engage in.

Reviews of both will be posted next week!

Thank you for providing your feedback! Hearing from users of these products is valuable not only to me, but other readers.

I'm curious. Several people, including yourself have indicated that Therapy Partner now has additional features like Progress Notes. Yet a) I don't see any indication of those features on their web site and b) when I contacted them to inquire about this, they never replied.

Am I missing something on the web site? Is it possible they are utilizing a separate, partner product for those features?

Hi Erik,

The needs of any particular practitioner or practice vary so widely that I don't offer general recommendations for specific situations without first getting a lot more information.

If you'd like a more detailed recommendation, I offer a Feature Match Report that will take your specific needs and preferences into account. It may also save you a significant amount of research time.

Apart from that, my reviews obviously cover a lot of ground and will hopefully allow you to narrow it down. Hope you are able to find a great fit!

Hi Celeste,

I'm glad to hear you found the information here useful! Please come back, let us know what you chose and how it went. It's always valuable to hear from a wide array of users!

Hi KK,

My review in the works of simple practice is available in the Member's section, which is free with subscription to the newsletter. If you don't mind waiting, it will probably be added to this list within the month.

Thank you for the update, Erin. I'm hoping to do several updates and additional reviews in November and Practice Suite is definitely on the list. $350 is pretty high for set up considering many of these applications have no/minimal set up fees. Will be interesting to see if the functionality is worth the expense.

Hi Jamie,

I can tell you that, in my scouring of the Internet for systems, I have come across a couple that were specifically targeted to OTs and Speech Therapists. Because I've been focused on more general applications, I haven't included them and, unfortunately can't recall any of them. If your primary concern is billing multiple codes and having a solid billing system, you still may find one among those I've reviewed that meets your needs, however.

Hi Jack,

I agree with you that outcome measures will be increasingly important as more attention is paid to efficiency, effectiveness, and cost savings in the health insurance realm. BestNotes is the first system that comes to mind as far as having Outcome Measures. Not many others have it at this point. There are standalone systems for it, but that doesn't help if you want something integrated.

As in most cases, the decision usually comes down to prioritizing features.

Hello,

Excellent question. This particular page that includes a compilation of brief reviews was originally posted in September of 2012. I make an effort to regularly update reviews of each application, especially when major updates are made.

There are some applications delving into outcome measures, however, for the most part they aren't there yet. Not even most Meaningful Use Certified EHRs are there yet. This will definitely change over the next year or two.

Hi Patty,

Thank you for the kudos and great questions. There are so many detailed features to cover in these systems that I can't possibly include all of them in the reviews. Questions like yours are welcome and often come up with I'm helping clinicians identify the system that will work best with their practice.

Most of the systems do allow for keeping psychotherapy/process notes separately. While there are requirements for providing clients with records (HIPAA, ethics, state/licensure laws), I'm not aware of any stipulation that you must supply them electronically. Most systems do not allow for such sharing but will allow you to print your records either to paper or PDF. Speech integration is another feature that some applications have, while others do not. Often the browser based applications do have it as speech recognition software can integrate with most browsers.

Hi CJ,

There is an initial review of TheraNest in the Member's section. When I first review a product, I place it there for a while and then move it out here to the general post. This allows me to give Member's a "first look", sometimes even putting up reviews that are "works in progress". Membership is free with a subscription to our monthly newsletter.

Thank you for the kudos, Diana! Always happy to hear that people are finding the information here useful!

Hi Lezlie,

An initial review of TheraNest is available in the Member's section. The member's section is free with subscription to our semi-monthly newsletter and includes a first glimpse at upcoming reviews along with bonus content.

Sara,
Thank you for sharing your experience with CounSol!

Hi Jim,

I would LOVE to do a review of TherapyPartner now that they've added these features. Unfortunately, I've made at least three attempts to contact them in order to set up a demo/trial account in the past year and none of my attempts have received a reply.

If you scroll through the comments here (or do a "find" for "therapy partner", you'll see several comments about them, including their new features. I would be very surprised if their newly launched features are as robust and friendly as some of these other applications that have been in development for some time.

I'd love to give you my personal take on it, if they'll provide me the opportunity to. I will say that I've not had this difficulty getting in touch with other vendors. Perhaps as a current user you can have better luck getting them in touch with me so I can do so?

Hi Bill,

Great question! Apart from the immense amount of time it would take for me to also review all of the traditional software options, my most recent blog also addresses several other reasons that I focus on cloud options. There are numerous examples of traditional software products that have closed up shop recently, most likely due to the mass migration to cloud products.

I've no doubt that there will remain a small, niche market for traditional products for a while. The trick is in guessing which products will not only survive, but continue to provide upgrades, new features, and address the ever changing requirements of the insurance industry.

It's also important to note that many, if not most, insurance companies are moving toward requiring electronic claims filing. You may not be able to exercise your choice in that matter for much longer. The good news is that, when submitting electronically, you often get paid much more quickly and, when using a clearinghouse, often deal with far fewer denials.

Hi Kate,

I don't make any specific recommendations outside of my Feature Match or consulting products. There are too many differences between practices for me to make blanket recommendations so I prefer to know enough about a practice before making one. In addition, I've heard too many "horror" stories from clinicians who have chosen an application based on one feature or specific area of a program only to be disappointed later.

I do strongly recommend that people try solutions for themselves before committing to one. Demos almost always look good because they are put on by someone who knows the system very well. That doesn't mean it will "feel" good to you or be a good fit for your practice/work flow.

LeeAnn,
The important thing to note about Software Advice is that my understanding is they work on commission. When they recommend a software to you and you end up purchasing that software, Software Advice receives commission. For that reason, I believe that Software Advice only lists and recommends companies/products that will pay them a commission. There are many applications out there that are a best fit for some practices that I don't believe Software Advice lists on their site. If you look at their list, you can see that many of the possibilities are not there.

Further, I don't believe they have a solid understanding of our market. This can be seen by some of their recommendations for small practices consisting of very expensive meaningful use certified EHRs that are not a good fit for small private practice. In addition to the cost, many of them are very "medical-centric" and are not a good fit for therapists. Again, this may partly be dictated by them getting better commissions from these more expensive applications.

To directly answer your question about these other applications,there are some additional reviews in the members' section of this site. IF I haven't reviewed, or at least mentioned them, they are likely either really new, or are very expensive.

Great question Kim,

I share your opinion that handwriting is less "intrusive" in therapy than typing. I personally hand write my notes (when I take them in session) in a Samsung Galaxy Tab 10.1 tablet. But these are psychotherapy notes and I simply leave them in handwritten format.

There are some very expensive (medical-centric) EHRs that I've heard have incorporated handwriting recognition. There are also some Windows based tablets (Fujitsu in particular makes one) that have handwriting recognition software built in that will integrate with many different applications.

Finally, there are many third party applications for both iOS and Android that provide handwriting recognition and claim to integrate with most other applications.

I'm not currently aware of any affordable mental health-centric EMR/EHR that comes with this feature, however. If someone else finds one, I'd love to know about it!

Hi Mobina,

Since wecounsel is not a Practice Management System, I have not investigated it closely. There are a plethora of offerings similar to wecounsel where a company provides the opportunity for counselors to provide online counseling. So many, in fact, that it would be difficult for anyone to adequately review them all.

The primary benefit of such a system would be if it has a solid directory that draws clients in for you. Otherwise, it's typically possible to get all of their features at much less expense. A further consideration, especially for those in the United States, is that few of these directories seem to pay close attention to the lack of licensure portability across states, so the bulk of responsibility for legal and ethical practice remains with the clinician.

I'm aware of TheraManager. When I first started publishing reviews, I was unable to successfully schedule a demo with them. Last year I contacted them for an update about pricing and features and put off further investigation due to their pricing and other factors. It's important to note that they a remote-server application, and therefore not web browser based. I hope to re-visit their application this year and potentially complete a full evaluation.

Hi Tanya,
You can read my thoughts about Dr. Chrono (along with several others) in the Members' section of the web site. The only cost of membership is subscribing to the Tame Your Practice newsletter.

Hi Megan
Currently it is mostly only the Meaningful Use Certified EHRs that include ePrescribing, though there are a couple of notable exceptions.

Thank you for bringing PatientTrac to my attention. I will take a look. Unfortunately, at first glance, it looks significantly more expensive than most of the other options available, "Monthly prices range from 300.00 to 1900.00 USD depending on the size of the facility."