What EMR to use in solo private practice?

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reca

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Scraping my fellowship plans and deciding to jump into the real world after graduation. I’m hoping to set up a cash practice while moonlighting on the side. Going to give it a year and then switch to insurance if cash won’t cut it.

wondering what EMRs people have had good experience with? Luminello and Charm are the two I’ve heard of the most but wondering if there are any others I should consider?

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I am a proponent for Luminello.

High five. Congratulations on deciding to take plunge. Once you taste the freedom... it will be so hard to go back!

I think you should create your own private practice thread, or re-name this one to be your thread. Post your questions here, and detail out how you are progressing step by step. Congratulations!
 
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I'm a fan of Luminello. It's user-friendly and has a lot of built-in features like billing, credit card processing, eRx, patient portal, and labs.

Good luck with the practice!
 
Bump

Looking at EMRs right now for my new solo private practice. Kareo, Valant, Luminello, Charm, ICanNotes...... So many options

Leaning towards Luminello. Did they ever introduce text message alerts for patients?
 
I decided to go with Charm but ended up getting so frustrated with their abysmal customer service that I switched to Luminello.
 
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Is there a good thread on here for costs associated with starting a private practice?

edit: I see the sticky thread, any updated info associated specifcially with costs?
 
Ugh apparently Luminello still doesn't have an appointment reminder feature. I don't see how such a basic feature can be skipped in a platform.

My other top choice Valant just seems kind of clunky to me. Either looking at 3rd party apps for text message appointment reminders or keep looking at other options for EMR
 
It has an electronic reminder feature to send a luminello message, within its secured portal/messaging system.

Only a small fraction of people "need" text messaging. If you use google voice, you can make note of those people, have a separate release for texting them, and then just use google voice to manually type a text message reminder.

I've only had one patient get angry with lack of text message, but honestly their blaming me for missing an appointment, I'm glad they 'fired' me.

In summary, I'm okay with not having a text message feature.
 
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It has an electronic reminder feature to send a luminello message, within its secured portal/messaging system.

Only a small fraction of people "need" text messaging. If you use google voice, you can make note of those people, have a separate release for texting them, and then just use google voice to manually type a text message reminder.

I've only had one patient get angry with lack of text message, but honestly their blaming me for missing an appointment, I'm glad they 'fired' me.

In summary, I'm okay with not having a text message feature.
It's not a need, but this seems a perfect way to help remind people. At the end of the day, the modern world is very taxing on our brains and everyone can use a little bit of help from automated reminders (for actually important things like doctor's appointments, not for saving $4.20 on auto insurance).
 
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It has an electronic reminder feature to send a luminello message, within its secured portal/messaging system.

Only a small fraction of people "need" text messaging. If you use google voice, you can make note of those people, have a separate release for texting them, and then just use google voice to manually type a text message reminder.

I've only had one patient get angry with lack of text message, but honestly their blaming me for missing an appointment, I'm glad they 'fired' me.

In summary, I'm okay with not having a text message feature.

I still would like a text message reminder feature as that is the only way I ever remember to go to my dentist appointments.

I am hopefully going to start seeing patients in my solo practice on March 1st so I need to decide on an EMR soon.
 
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I still would like a text message reminder feature as that is the only way I ever remember to go to my dentist appointments.

I am hopefully going to start seeing patients in my solo practice on March 1st so I need to decide on an EMR soon.

Charm may have that but if you go with Charm, you should start setting up the EMR today. I don't think it's possible to overstate just how bad customer service is. Just upgrading to the paid plan from the free plan took me three weeks and repeated emails.

Actual exchange I had with their customer service rep about setting up eprescribing:

"Hey my e-prescribing still hasn't been set up yet."
"Ok"
"? Can you help me out here? It's been two weeks now"
"No, not really."

Wish I was kidding, this is verbatim how it went.
 
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Charm may have that but if you go with Charm, you should start setting up the EMR today. I don't think it's possible to overstate just how bad customer service is. Just upgrading to the paid plan from the free plan took me three weeks and repeated emails.

Actual exchange I had with their customer service rep about setting up eprescribing:

"Hey my e-prescribing still hasn't been set up yet."
"Ok"
"? Can you help me out here? It's been two weeks now"
"No, not really."

Wish I was kidding, this is verbatim how it went.

That sounds terrible thanks

I have demos with Valant, DrChrono, and ICanNotes tomorrow. Hopefully one of them clicks with me bc I’m ready to open ASAP.
 
I did 1 hour demos with both Valant and DrChrono today. Was not impressed with DrChrono at all.

Valant does seem nice, I used it in one office briefly but not beyond doing some follow up notes. They do seem expensive and started out at $210/month + $35 for tele + a couple other fees. He dropped to $180 by end of meeting. I am sure I could get a little lower than that as well.

Luminello is much cheaper, need to demo that still. I think it will come between Valant and Luminello. My overhead is pretty low $700/sublease in a therapy practice + liability insurance + small stuff.

I already have some workers comp adjustors emailing me weekly to see when I am open so they can send me some evals and a pretty large referral network.
 
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Do the EMRs allow easy integration of screening questionnaires so PHQ9s, GAD7s, ASRS, Wender Utah etc etc can be filled out by patient before visits? Is it well integrated? If they don't have a screener, can you manually make one?
 
I've been using Luminello and I really like it except for doxy.me which they use for telehealth so I am using Zoom. They have integrated screening questionnaires (PHQ-9, GAD-7, Vanderbilts, MDQ, CGI, ASRS) and forms and you can create your own or have them help you create one as well. I've demo'd Valant, DrChrono, Kareo, IntakeQ, Charm, Simple Practice, and Practice Fusion and they weren't a good fit for me and my practice.
 
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What did people do in terms of treatment agreements for patients in private practice? Any templates that were helpful? Need a malpractice lawyer to review them or OK not to?
 
The general practice policies get E-Signed within Luminello.

But I don't have a long winded treatment agreement.
 
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What did people do in terms of treatment agreements for patients in private practice? Any templates that were helpful? Need a malpractice lawyer to review them or OK not to?

I looked at others around me who had them publicly available on their website and just conglomerated all of the ones I thought were helpful. I looked at my malpractice resources for decreasing risk and what they recommended be on the initial form. I looked at Luminello's sample practice agreement.

I then thought to myself what I wanted in terms of how I want to handle scheduling including intakes/follow-ups, after hours urgent concerns, how many days ahead I wanted to be notified for cancellations and what happens with no shows/late cancellations, what my fees are including the parameters for me to charge if I do work outside of the appointment, how I handle prescription refills, how I accept payments and when they are due and how I handle late payments, and otherwise basic boilerplate language about record keeping/insurance (for example, I don't take Medicare/Medicaid).

I then had a call with the risk management of my liability insurance company for a virtual practice survey so they can look over my intake process.

Then after a few patients, I'm revisiting these policies to make sure that everything aligns with how I want my practice to be and I've changed the practice agreement twice so far to clarify what I want a bit more.
 
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Well after doing demos for Valant, DrChrono, ICanotes, and Kareo I finally got around to doing a Luminello demo and chose that platform. Besides the reasonable price it is very user friendly and specific to psych.

I am opening March 1st as cash pay in an area with high demand hoping to fill up fast
 
What about practice fusion?
It's OK. I use it in a free clinic I'm at sometimes. It's very much OK. Easy e-prescribing once it's all setup, browser based, basic text notes, appropriate alerts, etc. Add-ons add up in terms of cost, but the base cost is reasonable. Little things annoy me, but it gets the job done. It was down for a period during the AWS outage which was chaotic, but they said they are looking into ways to avoid it in the future. I think it's fine, but Luminello seems to offer more and is more psych specific.
 
I know this is kind of an older thread but since I know people are still wondering about the best software services/charting etc for a private practice and also how to handle things like intake forms I thought I'd share my experience with what works and doesn't and what has changed in the landscape since I started my practice in 2017.

When I started, I looked into a BUNCH of different options for charting/EHR and settled on Luminello for charting and eprescribe. At the time, I think it was the best option and I still use it now. However, Luminello seemed overly clunky to me for intake forms, scheduling and billing and in private practice inefficiency is the kiss of death so I used other software solutions for that, most notably IntakeQ for intake forms, which blew any other software out of the water (also really useful for gathering credit card authorizations for billing, having patients submit rating scales, etc). Over time I hobbled together a collection of different software services that worked for me.

HOWEVER, I mentor a group of early career private practice psychiatrists and what I hear from others is that the practice management software now available from IntakeQ (branded now as PracticeQ) is even better than Luminello, including for charting patients notes, which is a new feature they added since I started. I have moved my scheduling and billing over to IntakeQ and continue to use Luminello for charting and eprescribe, but for people who are starting their practices now I recommend using IntakeQ/PracticeQ right out of the gate for everything except eprescribe. I bet at some point they'll add eprescribe, but for now what people I know are using is IntakeQ plus something like iPrescribe for eprescribe.

To sum up, here are the software solutions I recommend currently (as of March 2022) if you are starting a psychiatry private practice:

IntakeQ/PracticeQ: charting, scheduling, intake forms, billing (easy to set up auto billing via credit card that is integrated with scheduling - merchant account via Square or Stripe integration), telehealth (integrates w/ Doxy)

Eprescribe: iPrescribe (or similar)

Lab ordering: set up account directly with Quest or LabCorp to order labs electronically. In the meantime, giving the patient a lab order written on a prescription pad (scan and email if needed) works in a pinch when you are first starting your practice.

Phone: Google voice is fine, phone.com or Ring Central good if you want extra features like phone tree or have multiple phone numbers (ie you have an assistant or something like that)

Email: Google Workspace

eFax: SR Fax (integrates with IntakeQ) - unfortunately even though we live in the 21st century pharmacies will still fax you as if it were 1980 so you will need a fax number

Website: Squarespace (do NOT pay someone some crazy amount of money to do your website right off the bat... patients don't really care about the design of your website, they care about the words, and no one else will know how to write your website copy like you will)

I agree with clozareal in terms of how to write your intake forms -- look at others who have their forms on their website and swipe/edit for your purposes. You will NOT write the perfect intake forms right out of the gate so don't try. Just write some good enough intake forms (esp office policies) and then edit/adjust based on where expectations need to be better set up front. The ideal office policies set a proper frame without being overly harsh or rigid. There are no perfect office policies that will prevent you from having to learn the skill of how to set appropriate boundaries when dealing with patients face to face.

I just want to add one last thought on this... there is a concept in the startup world called Minimum Viable Product (a la Eric Ries from The Lean Startup). The idea is don't try to be perfect out of the gate when you are starting a business (and a private practice IS a business), because you will be wasting your time optimizing for the wrong things. Instead, start lean, mean and scrappy and then build what you need after once you have a few patients and have a sense for what systems you need to run everything efficiently. A lot of physicians are too perfectionistic (which is good for medicine, but bad for business). If you learn how to take your "physician hat" off while setting up your business systems you will be more successful.
 
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I spent a bunch of money on a website up front. Even had a handful of patients voice they opted to reach out because of the quality website when compared to others. I believe its worthwhile to invest in a quality site, to further convey professionalism - but to your general point, isn't a requirement.
 
I know this is kind of an older thread but since I know people are still wondering about the best software services/charting etc for a private practice and also how to handle things like intake forms I thought I'd share my experience with what works and doesn't and what has changed in the landscape since I started my practice in 2017.

When I started, I looked into a BUNCH of different options for charting/EHR and settled on Luminello for charting and eprescribe. At the time, I think it was the best option and I still use it now. However, Luminello seemed overly clunky to me for intake forms, scheduling and billing and in private practice inefficiency is the kiss of death so I used other software solutions for that, most notably IntakeQ for intake forms, which blew any other software out of the water (also really useful for gathering credit card authorizations for billing, having patients submit rating scales, etc). Over time I hobbled together a collection of different software services that worked for me.

HOWEVER, I mentor a group of early career private practice psychiatrists and what I hear from others is that the practice management software now available from IntakeQ (branded now as PracticeQ) is even better than Luminello, including for charting patients notes, which is a new feature they added since I started. I have moved my scheduling and billing over to IntakeQ and continue to use Luminello for charting and eprescribe, but for people who are starting their practices now I recommend using IntakeQ/PracticeQ right out of the gate for everything except eprescribe. I bet at some point they'll add eprescribe, but for now what people I know are using is IntakeQ plus something like iPrescribe for eprescribe.

To sum up, here are the software solutions I recommend currently (as of March 2022) if you are starting a psychiatry private practice:

IntakeQ/PracticeQ: charting, scheduling, intake forms, billing (easy to set up auto billing via credit card that is integrated with scheduling - merchant account via Square or Stripe integration), telehealth (integrates w/ Doxy)

Eprescribe: iPrescribe (or similar)

Lab ordering: set up account directly with Quest or LabCorp to order labs electronically. In the meantime, giving the patient a lab order written on a prescription pad (scan and email if needed) works in a pinch when you are first starting your practice.

Phone: Google voice is fine, phone.com or Ring Central good if you want extra features like phone tree or have multiple phone numbers (ie you have an assistant or something like that)

Email: Google Workspace

eFax: SR Fax (integrates with IntakeQ) - unfortunately even though we live in the 21st century pharmacies will still fax you as if it were 1980 so you will need a fax number

Website: Squarespace (do NOT pay someone some crazy amount of money to do your website right off the bat... patients don't really care about the design of your website, they care about the words, and no one else will know how to write your website copy like you will)

I agree with clozareal in terms of how to write your intake forms -- look at others who have their forms on their website and swipe/edit for your purposes. You will NOT write the perfect intake forms right out of the gate so don't try. Just write some good enough intake forms (esp office policies) and then edit/adjust based on where expectations need to be better set up front. The ideal office policies set a proper frame without being overly harsh or rigid. There are no perfect office policies that will prevent you from having to learn the skill of how to set appropriate boundaries when dealing with patients face to face.

I just want to add one last thought on this... there is a concept in the startup world called Minimum Viable Product (a la Eric Ries from The Lean Startup). The idea is don't try to be perfect out of the gate when you are starting a business (and a private practice IS a business), because you will be wasting your time optimizing for the wrong things. Instead, start lean, mean and scrappy and then build what you need after once you have a few patients and have a sense for what systems you need to run everything efficiently. A lot of physicians are too perfectionistic (which is good for medicine, but bad for business). If you learn how to take your "physician hat" off while setting up your business systems you will be more successful.
Squarespace over WordPress? I hear WordPress provides the best SEO
 
Squarespace over WordPress? I hear WordPress provides the best SEO

You are 100% correct that Wordpress is better for SEO (I built my site with Wordpress). The issue is just that for most people Wordpress will have too high of a learning curve out of the gate and people will get discouraged -- plus organic search is really not the best way to get patients given that organic search won't be limited to your licensed state.

HOWEVER if you imagine yourself one day having a media presence and wanting to do things like podcasts, writing books, public speaking, etc then organic search is important, and if you are somewhat tech savvy and open to learning some basic coding skills you will be best served in the long run by using Wordpress. I taught myself how to code websites in residency and I'm extremely glad I did because now I don't ever need to hire this out to someone else.

If you're using Wordpress, I'm talking about the self-hosted version (not Wordpress.com). I use WP Engine for hosting, NameCheap for domain names and Genesis (via Studiopress) for theme.

There's nothing wrong too with starting with Squarespace and then migrating to Wordpress in like 6 months - 1 year after starting your practice (when you will have some $ to hire help if needed).
 
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I spent a bunch of money on a website up front. Even had a handful of patients voice they opted to reach out because of the quality website when compared to others. I believe its worthwhile to invest in a quality site, to further convey professionalism - but to your general point, isn't a requirement.

Yeah I agree a good site will definitely help you -- the basic Squarespace templates are pretty good (no coding required) but at some point you may want something more personalized, in which case hiring is always good. I just wanted to encourage people not to be obsessed about this right out of the gate and feel that they HAD to hire someone to do their website.
 
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