You Get What You Pay For
by Leigh-Ann Renz, 1.8.17
We continue encountering practices who are have tried to utilize a free EHR - only to find out that 1) it's not designed for mental / behavioral health; 2) it doesn't do what they need; 3) it doesn't grow with them; 4) it's not inexpensive!
Not Designed For Mental / Behavioral Health
Most of the free programs - and sadly, many other "mental health EHRs" - weren't designed for mental health at all! The vendor realized that they could capitalize on the behavioral health market and offer a slice of their regular medical system with just enough mental health terms to sell it.
Granted, some of these offshoot programs are excellent: well-designed, efficient, and you can tell they brought in behavioral health consultants to legitimately address the needs of our industry. However, many of them are slapped together: you can see that they're poorly designed, and you can tell that the unique needs of behavioral health weren't truly considered. They still have a medical-centric feel and don't really fulfill.
They may have put the right titles in the program, but it's not the powerful cockpit needed for effective behavioral health treatment. The necessary processes are only partly covered, and the agency must then implement manual work arounds to accommodate for incomplete functionality which impacts staff time and resources.
Doesn't Do What You Need
At the end of the day, there are 2 crucial elements to EHR success: the program itself - and how you use it. Practice management systems for behavioral health run the gamut of every bell + whistle under the sun - to incredibly basic. And whether a system "does what you need" depends entirely on your unique specifications.
If you're a single provider or very small practice that doesn't want electronic billing, one of the free programs might work great for you. But most practices, even small ones, are moving beyond the "notes and calendar only" stage: they've outgrown that basic functionality and have learned through experience that electronic practice management offers amazing benefits, despite the inevitable challenges. Plainly put: the majority of us want electronic insurance filing and administrative + reporting tools, affordably.
The other crucial piece to consider with EMRs is Customer Service. Think about how frustrated you feel when something on our computer doesn't work and you can't figure it out. You want help, from someone who knows the program inside and out, immediately. Unfortunately, most of the free programs offer dismal Client Support.
And we're not just talking "help: my mouse won't work!" here - when you consider that mental health EHR support can involve insurance denials, revenue cycle issues, authorization management, and HIPAA-protected patient information - not having prompt, professional, and responsive customer service can cost you, big time!
Software is only as powerful as your ability to use it; and having dependable customer service for training and support is invaluable. Consider what it's worth to you to have prompt, reliable help when you need it: someone picking up the phone and staying on with you until your questions are answered and your need resolved. When it comes to customer service and free EHRs, you get what you pay for!
Doesn't Grow With You
Let's be honest: the biggest hurdle of EMRs is the initial implementation. It takes time, money, labor, learning, and incredible focus to switch systems while maintaining a running pratice. It's kind of like painting a car while the vehicle's moving! For any type of practice management program worth its salt, this initial investment is necessary to long-term success.
But it's not fun or easy, so why would you want to repeat it?! Any time you buy into a mental health EHR that doesn't factor in your long-term growth, you're setting yourself up to go through that intense process again, because inevitably you'll outgrow it and need something with more functionality. Most free EMRs offer rudimentary features, meaning that any amount of growth in your practice will require you to repeat those initial hurdles.
Consider investing in a system that grows with you: where you can begin a basic level of functionality but turn features on as your needs evolve. While there aren't many programs like this on the market, they exist - and can save you immeasurable time, money, and headaches down the road!
It's Not Inexpensive
One of the most popular free programs offers notes and calendar functionality for free, but electronic billing is done through a separate vendor and charged. At last count, the price tag was "starting at $159 per month". When you consider that this is a very basic program that offers virtually no customer service, the "free" program has now become more expensive than other options that offer much better functionality and stellar Support.
Additionally, most of these EMRs are free because they have advertising on your program and sell your client de-identified client data. While that doesn't bother some providers, it makes others nervous and protective of their clients' information, even if the PHI has been stripped.
The EHR you choose is the backbone of your ability to service clients and get paid. A well-thought-out EHR is an investment in your business. What is your time worth?
The bottom line is: free doesn't mean inexpensive. Trying to utilize a program that doesn't grow with you, doesn't really offer what you need, and wasn't designed with mental + behavioral health in mind might actually cost you a lot in the long run. While some clinicians are perfectly fine with a basic program (and more power to 'em!), many providers and practices are better served by a mid-level program. You get what you pay for!