Tips for changing EHRs

For mental health providers, the EHR is the backbone of their practices. A comprehensive EHR, or Electronic Health Record, is the base of operations for record storage, documentation and forms, scheduling, financial transactions, and insurance billing. Finding the best possible fit between your business’s needs and an EHR’s attributes helps ensure a successful and profitable business. If you are already using an EHR that no longer fits your needs, finding a new platform and migrating your information may feel like a daunting task. As a private practice psychologist and business owner for almost two decades, I have made this switch a couple of times, most recently to Sessions Health. In this article, I’ll walk you through my experience and share the tips I’ve picked up along the way.

Psychotherapist looking for a new EHR

Looking for a new EHR can be stressful, but knowing what to look for can make the process much smoother.

Why use an EHR?

As a practicing psychologist and business coach, I am aware of no laws requiring the use of an EHR. Notes can be hand-written, stored in a locked file cabinet in a locked file room. However, the pros to an EHR outweigh paper. An EHR offers:

  • Functionality: an EHR does far more than store static documents.
  • Ease of Access: an EHR with patient portal integrations provides secure communication with clients, effortless file sharing, paper-free intake for new clients, appointment self-scheduling, and access to records from anywhere with an internet connection. .
  • Ease of payment and billing: integrated payment provides one-click payments to encrypted credit cards, tracks charges and payments, creates invoices, superbills, and claim forms, and stores insurance information.
  • Ease of Storage: Record storage requirements vary depending on your state, and may vary for child and adult clients. Paper file storage builds up fast, requiring space at your expense, then the expense of shredding documents. EHRs entirely eliminate these issues.
  • Environmental Impact and Cost: Using paper inarguably has a large environmental impact. Trees must be harvested, processed into paper, packaged, and shipped. Costs of using paper include repeated purchasing, use of copy machines and copy supplies, use of mailing services for paper products, and, as stated above, file storage space and costs. An EHR is clearly a better environmental choice.

Finding the right EHR for your needs

When selecting an EHR for the first time, or looking to migrate from your existing platform, there are a lot of features to consider. For many, a starting consideration is cost. When I recently moved to Sessions Health, I did so due to a significant price increase with my prior EHR. I investigated several EHRs that were a good fit for my budget, then took them on a test drive to see what worked well for my business. To help you out, here’s a spreadsheet you can access to explore features of EHRs as you interview them. Follow along as you explore the following features.

Features to consider

  • Security is a primary consideration. Storage should be HIPAA compliant at a minimum, and share additional security features. Look for this information front and center when considering an EHR.

  • Ease of use and customer support. Consider how quickly you will be able to get help and via what means. Ask your colleagues for their experiences. Consider how intuitive the platform is as you work through a free trial. Create pretend clients and move through scheduling, documenting, and generating bills. Are there tutorials and guidance to help you get started?

  • Migration. If you are already using an EHR, consider the process of moving over your existing files, including archived clients. Also consider what the process is if, at some point in the future, you need to move to a different EHR: will you have support in this process and will it be free or cost you?

  • Documentation and forms. These are the heart and soul of your EHR. They should be easy and intuitive to use. Schedule your free trial at a time when you can take advantage of it and experiment with pretend clients. Include yourself as a client to experience this from the client-side of the patient portal. Upload and download documents and consider access from both your main computer and mobile devices.

  • Calendar and scheduling. Many EHRs are built around the calendar. This provides easy access to scheduling, charts during appointments, and past notes. From the calendar, you may record new notes, and initiate billing. Calendar syncing–such that your EHR calendar automatically populates your personal calendar and vice versa–is often an important feature, especially if you use referral services that allow new clients to auto-schedule. Also consider if the system allows for email or text appointment reminders to clients, and allows clients to self-schedule with your permission.

  • Patient Portal and Communications. A secure patient portal allows you to communicate with clients without needing to use encrypted email. Portals can also allow client completion of forms with electronic signatures, sharing of documents securely, and scheduling and canceling appointments..

  • Financial Records/Billing Integrations. Examine how an EHR will work with your billing needs, including ease of recording payments, integration of credit card charging, simplicity of generating invoices and super bills, ease of entering third party payments, ability to submit insurance claims and processing of insurance payments. Consider the integrated financial reporting options and how these will support your accounting.

  • Subscription Cost. Look at your budget for the year and how your chosen EHR will work within this budget. Consider the number of users and all the features needed (if any have an additional cost). When I switched over my platform, I quickly realized a yearly savings of $768 a year as a solo provider, compared to the increased fees of my old EHR for the features I needed. Sessions Health offered me the most bang for my buck and saved my business a significant amount.

Making the switch

While it may seem daunting to migrate to a new EHR, my experience transitioning to Sessions Health was not particularly difficult. Here are the steps that I followed.

First, I familiarized myself with the platform as best as I could and reviewed all of the functions I needed as part of my “interview” process. (Use my spreadsheet to help with this; found here!) Next, I scheduled a time to conveniently make the switch. I wanted an overlap between my old EHR and my new one for at least a week, so I scheduled this in the last week of my old EHRs billing cycle. I planned for a time when I would not be seeing clients so that I wouldn’t risk double-documentation or lost information.

I exported the data from my old EHR, which was quite easy to do, with a zip file emailed to me within a few hours. Your mileage may vary depending on your current EHR and how they work. To load this into Sessions Health, I just needed to add the zip file to my uploads and then let the system admins know it was ready for importing. The import took about a day, was free, and imported my client documentation for all active and inactive clients. I then randomly pulled several charts as quality control and was pleasantly surprised: no problems.

A few things did not automatically import that I had to do manually, which Sessions Health alerted me to in advance: I had to change status from active to inactive on all inactive clients, and I had to add any appointments that had not occurred yet to the new calendar. Pro tip: configure your automated email appointment reminders before adding new appointments to the calendar so that the correct information will go out to your clients–for me this included customizing my emails to send folks my telehealth link. I also manually entered account balance information.

Practice forms need to be manually transferred. This was the most time consuming aspect of the transition. I managed it by having my old EHR open with the forms accessible. By opening my old forms in “edit” mode, I was able to copy and paste text and use the forms builder in Sessions Health to make new forms or to customize some of their existing templates. I also downloaded PDFs of all my old forms from my old EHR and created a folder on my computer to store these for future reference. Another item that went into this folder: financial records. I pulled my tax records from my old EHR and downloaded the reports, and pulled yearly financial records. These spreadsheets are now stored on my local disk in the event that I need them.

The only form I needed to have clients re-do was the authorization form for electronic payments. As an encrypted form, credit card numbers do not transfer over. I also had to configure Sessions Health to integrate with my stripe account in order to initiate credit card charges from the EHR.

Speaking of the documents folder, I had accumulated quite a number of client handouts in my old EHR. I spent some time downloading all of them from my old EHR and then uploading them into the new EHR. While I could have done this as needed, I felt it was worth the time to rebuild my library up front.

The final step was configuring my patient portal and alerting my clients. This required sending an invitation to each client to authenticate their patient portal. To reduce confusion, I alerted clients of this in advance through my old patient portal, then sent an invitation to the new portal (toggling a button in their charts allows access). At the same time, I was able to send out a new credit card authorization form for integrated payments.

The process was made easier via ongoing dialogue with Sessions Health support, with very responsive replies, as I made the migration. Based on my experience making the switch and using the platform this past week, I’ve been very happy with my decision to move.

What questions do you have about choosing an EHR or making the switch? As a private practice coach and consultant, I love supporting practice owners, launchers, and dreamers. Join my free FB community Intentional Private Practice–Community FB group, and I’m happy to answer your questions! You’ll also find more information about all things practice related in my book, Intentional Private Practice Workbook.

About the author: Dr. Kimberly Dwyer is a licensed psychologist, private practice business coach and consultant, and author. She practices in Denver, Colorado, and via telehealth in all PsyPact states. Learn more and access free practice building materials at www.drkimdwyer.com.