Electronic health record (EHR) choices

How early career psychologists can streamline their practice with electronic health records.

By Rebecca A. Clay

Allison Splaun, PhDWhen Allison Splaun, PhD, decided to open a private practice in Charlottesville, Virginia, in 2015, she got some good advice: Start the way you want to continue. For Splaun, that meant investing in an electronic health record (EHR) system from the get-go.

A colleague’s experience helped convince Splaun an EHR was the way to go. “She was keeping notes in Word, accounting documents in Excel,” Splaun remembers. “She was creating it all from scratch and trying to keep track of everything.”

Not Splaun. Thanks to her $39 a month EHR, she has everything she needs in one place — clients’ contact information, progress notes, treatment plans, schedule, billing and more. “Everything is automated,” says Splaun. “It’s a much simpler way of running a practice.”

An EHR is not the same as practice management software, which is a package of electronic services designed to help offices run efficiently. For example, these products can schedule appointments, organize important documents and manage finances. An EHR, which can be a stand-alone product or a component of a practice management software package, is an electronic version of a patient’s medical history that is maintained by the provider over time, and may include the key administrative clinical data relevant to that person’s care under a particular provider. The EHR may show the patient’s demographics, medical history and laboratory data.

The system makes it easy to download selective portions of treatment records to share with other providers. It automatically reminds Splaun to fill out progress notes completely and keep an eye on patients who are suicidal or otherwise at risk, features that Splaun says “reinforce good clinical skills.” And it keeps her “cozy” office free of the clutter of paper records. One downside? “The progress notes, treatment plans and intake forms tend to be very template-based and don’t allow for much customization,” she says.

Consider these tips for choosing and using an EHR:

Tyson Bailey, PsyDShop around. Decide what features you need and what budget you have, then consult colleagues, use the listserv of APA’s Div. 42 (Psychologists in Independent Practice), check out the software review website and visit vendors at APA’s convention. For Tyson Bailey, PsyD, a partner in Spectrum Psychological Associates in Lynnwood, Washington, the decision was easier: The practice simply opted for the EHR offered by the web-based company it uses for its insurance clearinghouse so the two systems could “talk” to each other. The only drawback is that the system was designed for medical providers, so “there’s a ton of fat … that doesn’t have anything to do with us,” says Bailey.

Try it out. Ask for a test drive. Many companies offer free trials, says Splaun, who tried a few systems to see which was most user-friendly. “Different EHR systems offer different features, so it’s important to find one that’s a good match for the needs of the clinician and his or her practice,” she says. But be sure to narrow down your options before you start testing systems, she adds. “They all require a bit of a learning curve, which makes it a challenge to try out too many systems,” she says.

Protect clients’ privacy. Security is a key concern you must deal with as you select an EHR system, says Bailey. Make sure the company you choose is reputable and research its security protocols, he suggests. Also, be sure to have a signed business associate agreement with the vendor so you’re complying with the Health Insurance Portability and Accountability Act.

Make the most of your system. Use your EHR to keep abreast of how your practice is doing, suggests Splaun. She runs regular reports that reveal how much she’s earning, top referral sources, the percentage of clients who cancel appointments, outstanding invoices and the like. “It helps me keep track of everything,” she says.

In fact, Splaun’s EHR experience has been so positive that her friend is now making the switch. Says Splaun, “It’s just really nice having everything under one umbrella.”

This column is geared toward early career psychologists working in practice settings. "Running start ... to a great career" features topics typically not covered in graduate school and includes tips and advice from psychologists.