I hear from a lot of therapists who are interested in using an electronic health record (EHR) or practice management system but are worried the software will be difficult to learn and the task of transitioning records will be time-consuming.
Some of these fears are valid. I’ve assisted two large agencies in massive transitions from paper to EHR and the projects took over a year and were full of mistakes, headaches and a few expletives. However, that experience gave me some great insight into how to avoid these common mistakes.
And yes, most of the headache is 100% avoidable!
The expletives, too.
So I thought I would outline for you some of the common mistakes clinicians make when using an EHR and how to avoid them in your private practice. It won’t make the EHR you choose perfect, but it will make your experience of it much more enjoyable.
No matter how excellent and customizable the EHR or practice management system, it will never be exactly like your paper files. Larger record systems are meant to simplify and also apply to a broad group of people, so they typically use common ways of doing things. For most clinicians, this is fine, but if you have a particular way of completing intake paperwork with clients, for example, that will likely need an adjustment.
Before signing up for an EHR, consider what parts of your practice systems are non-negotiable. Choose just 1-3 non-negotiable items, since a longer list may make it difficult to find something you like and is also likely to close off opportunities for efficiency of which you may not be aware.
Some of the big things to consider are intake paperwork, notes and billing. If you have a notes template you love and created on your own, then you’ll want to make sure the system allows for customized notes templates, like SimplePractice. If most of your clients use their insurance, you’ll want an EHR that submits claims and provides an easily printed super bill.
Using a system that was originally created for medical professionals
You can avoid some hassle by making sure you choose an EHR that is built for your specific profession. For example, some systems available to mental health clinicians were originally created for medical doctors and psychiatrists. While there is some crossover in our needs, most therapists and counselors do not need many of the “extras” that are necessary for a medical practice.
You may be thinking, “Well, why not have as much as possible? It doesn’t matter whether or not I actually use that portion of the system.” I disagree. Strongly disagree.
As soon as you begin using an EHR that requires you to overlook certain aspects and ignore sections, you set yourself up for mistakes. Since you are used to ignoring section 3, sections 2 and 4 can also be more easily missed. And when you want to go back and review your notes later on, it is difficult to sift through what is meant to be blank and what is not meant to be blank.
Lastly, if you ever plan to add clinicians to your practice, training is a nightmare as soon as you start to say “Ignore this section but always complete this section.” It is much better to have a simple practice management system that is easy to navigate and highlights what is important.
Not trying the system out ahead of time
The biggest problem with trying something completely new is that you don’t know what you don’t know. Without a little experience, it’s difficult to even think of the scenarios that may arise.
One way to easily avoid the hassles related to the problem above is to try the EHR out ahead of time. Most will allow you a trial period so you can feel what it is like to use the system on your own. This is crucial to determining what will work best for you, as well as planning for anything you may need to adjust before making the full switch.
You will want to do more than just peruse the different features. Go in and add a new client as if someone were coming in for their first session. Write an assessment and treatment plan (abbreviated versions, at least). Write a note or two and time how long it takes to navigate in between the different sections of the online file.
This is how you’ll discover things like whether or not it is complicated to write a note for a couple or family (most EHR’s like SimplePractice require you to add both members as individuals but can then link the individuals in a note). You’ll also see things like whether or not you’re required to include a diagnosis on notes or treatment plans, or how intuitive and flexible the treatment planning is.
This is something I never would have thought of until actually being part of the internal EHR support team at an agency. Allow me to explain…
Regardless of how computer savvy you are or how comfortable you feel with the EHR, you’ll need to contact customer support for an issue or question at some point in time. Many clinicians become frustrated during this interaction because the support team often asks a lot of questions that seem obvious or unnecessary. Now, a good customer support representative will be kind and explain the reasons if asked, but this frequently makes for a longer conversation than the clinician originally planned.
As an example, here’s an amusing take on the “original” customer help desk:
To avoid this frustration, here are some things to remember when dealing with customer support:
- Take a screenshot. Sometimes our language using the system is different from what the developer uses, so take a screenshot whenever you are on the page that relates to your problem, or when you receive a notice/error message. This allows customer support to identify exactly what section applies to your question.
- Try to explain your problem in just two sentences. A lot of times we will provide the backstory about why we’re encountering a problem but the best way to get help quickly is to narrow down exactly what you need, which can usually be described in 1-2 sentences.
- Avoid clinical language. While EHR’s such as SimplePractice do have clinicians on staff for consultation, most of the people offering support are more familiar with the system itself than clinical practice. For example, they may not be able to help you with what language to add in your directions to clients about accessing information in a client portal, but they can give you very clear steps about the process and how access works so that you can determine the best method to inform your clients.
Lastly, remember that connecting with colleagues is always a great way to get support with any of these issues. Make sure to reach out to other counselors who are using EHR systems so you can share ideas and troubleshoot the clinical aspects together. And then you’ll be able to pay it forward as you become an EHR pro yourself.