EHR, EMR, & PMS Scoring Criteria

Whether you’re starting a therapy practice, or just trying to improve your existing one, choosing the right electronic health record (EHR) software, electronic medical records (EMR) software, or practice management software (PMS) can be a difficult task. Choosing Therapy can help you make a bit more sense of the many mental health PMS, EMR and EHR options available by providing in-depth, personally researched reviews, as well as multi-category star-ranked ratings of them.

For the sake of brevity and clarity in this scoring rubric, we use the term EHR to refer to both EMR and PMS software, as these terms are commonly interchangeable. Before scoring a mental health EHR, we consider several significant factors. Below you’ll find a list of our EHR scoring criteria, including how we define the key categories and features, what we look for when we rate them, and a breakdown of our star rating system.

Client Management Features

At the core of any EHR are the features that allow a practice to manage client data. These features need to be HIPAA-compliant and secure. An ideal EHR should have an intuitive method for adding new clients to the database, organizing this information, and easily accessing or archiving it. An ideal EHR will also allow for large batches of client data to be imported easily when migrating from other systems. The software will be scored on its ability to handle large amounts of data with limited pain points from users.

Star Ratings for Client Management Features

5-stars – Client data is able to be organized and visualized in meaningful ways. New client information can be added via multiple user flows and is optimized for the types of situations that mental health practices and practice staff will usually be in. Large batches of client data can be imported easily when migrating from other systems. Searching for clients is intuitive and can be accomplished by multiple data points (DOBs, ID numbers, Diagnoses, insurance, etc.). Staff can be given multiple levels of access to client data, and archiving old client data is easy. The system has functions that make auditing for compliance easy and intuitive.

3-stars – Client data is able to be organized and visualized easily, but to a lesser degree, and can only be searched by 2-3 identifiers. Large batches of data may be imported, but only for a limited type of demographic data (ie, names and DOBs, but not insurance data), or the process is difficult. Client data is accessible through only a couple of user flows, and they are intuitively accessible. Staff can be given levels of access, however, the variety in these levels is not as robust. The system has no built-in features for auditing charts.

1-star – Methods for organizing client data are unintuitive and difficult. Large batches of client data cannot be imported. User flows to access client data are limited and are not oriented in useful ways. Staff cannot be given varying levels of access. The system has no built-in features for auditing charts or maintaining compliance.

Client Forms & Intake Management

Managing client clinical intakes and various forms is another core feature that EHRs need to execute well. An ideal EHR will have a large library of included clinical assessments, as well as intake forms for a wide range of clinical populations, an integrated client portal with secure messaging, and the ability to upload forms, as well as create custom forms easily. Higher ratings will also be given to systems that have integrated automations to limit manual work done by a practice in these areas.

Star Ratings for Client Forms & Intake

5-stars – The platform has a fully or mostly automated intake process that uses an online client portal to minimize time spent manually gathering data from clients. The client portal includes a private messaging system that supports attachments and allows clients to complete all intake paperwork and assessments prior to their first visit to the practice. The EHR has a large library of client forms, intake questionnaires, and intake assessments, including the PHQ, GAD, and a trauma screener. Paper documents can be uploaded easily and forms can be faxed or sent to third parties directly from the EHR. The EHR has pre-generated forms for couples, families, and adolescents. The EHR has a feature for editing custom forms or creating them from scratch and editing can be done easily, even by people with limited design or computer experience.

3-stars – The intake process is at least partially automated, and includes a client portal. The portal may be rudimentary and may or may not include a messaging platform. Clients can e-sign and view documents from within the client portal. The EHR has a moderately sized or small library of pre-generated intake forms. The EHR has PHQ and GAD, and perhaps a few other common assessments, but no more than that. It is possible to create custom forms, but the process is cumbersome, difficult, or tedious.

1-star – The intake process is not automated at all, or automated in ways that are not useful. The EHR does not offer a client portal, and documents cannot be signed from within the client portal. The EHR has a very small or non-existent library of pre-generated forms, and either does not have the ability to create custom forms, or these customizations are very difficult and time-consuming to use.

Scheduling & Calendar

Scheduling client sessions in an EHR should be easy to manage and intuitively accessible. An ideal EHR will have multiple views and filters, with the ability to manage availability for multiple providers across multiple locations, with integrations for a client portal and telehealth. EHRs that automatically send appointment reminders and allow clients to schedule or request appointments on their own will also score higher in this category.

Star Ratings for Scheduling & Calendar

5-stars – The EHR has features that automate scheduling and make it easy for providers to manage their availability. Overall, the system makes managing sessions and appointments as easy as possible. Clients can request new sessions from a client portal or schedule sessions themselves. The system’s calendar is readable and has multiple viewing options. The calendar can be easily used to manage availability for multiple providers in multiple locations. The system automatically sends appointment reminders to clients. Features are easily customizable. The system has methods for scheduling group sessions, couples sessions, and telehealth sessions easily. The calendar system takes into account the client’s time zone vs. the practice time zone.

3-stars – The EHR has limited automation features or they are not meaningfully implemented. Calendar and scheduling systems are adequate but are overly complicated or difficult to use. The calendar has multiple views but is not easy to read quickly and efficiently. Setting availability is functional, but not intuitive. Features are not customizable. The system is able to schedule group, couples, and telehealth sessions, but this is not easily done. The calendar does not take into account the client’s time zone but does document the actual time zone in appointment reminders.

1-star – The EHR calendar system is not intuitive and all and is either overly complicated and difficult to use, or is too simplistic and does not contain necessary features. The calendar is rudimentary and has poor readability. Setting availability is not easy to accomplish. The system has no features for setting group appointments, and telehealth functionality is not integrated. The calendar does not take into account client time zones and does not document the actual time zone in appointment reminders.

Treatment Planning & Notetaking

Clinical treatment planning and notetaking features are particularly important aspects of any EHR and should be implemented well. An ideal EHR will have multiple options for customizing treatment plans and note templates. Ideal EHRs should have features that improve and automate the documentation process, and a customizable treatment planner, such as Wiley, must be included or have the ability to integrate easily. We look for EHRs to have a large library of pre-generated treatment plans and note templates that are customizable, as well as the ability to easily create new ones. The ideal EHR will also allow notes and treatment plans to interface well with one another.

Star Ratings for Treatment Planning & Notetaking

5-stars – The EHR includes a wide variety of automated features for making the process of treatment planning and notetaking exceptionally easy. Very little typing and manual input are required by the practitioner, but these features are flexible enough to still allow total control over the output. Top-tier software will include treatment planning automation integrations such as Wiley Treatment Plans. Plan and note templates are highly customizable and offer plenty of pre-generated options for almost any situation a practice might encounter. Treatment plans and notes interface well with one another, allowing practitioners the ability to follow on from previous entries. Templates include areas for commonly used items like safety assessments, safety plans, mental health status exams, etc.

3-stars – The platform offers an adequate library of templates and functions, but might be more limited in nature, or may not interface well with other features. There is likely no treatment planning feature like Wiley, and customization is much more limited than in top-tier options.

1-star – Treatment planning and notetaking features are inadequate and do not improve the workflow of a practitioner. There are no customization options or pre-built forms, or these options do not function well. There are no options for customization, or customization options are meaningless.

Telehealth Features

Telehealth functionality is key in an EHR for a mental health practice. This functionality can be within the EHR, or through easy integration with third-party software. Ideal EHRs will include features that improve the session quality such as screen sharing, text chatting, and document sharing. The ideal EHR will have very few if any, connectivity issues, and the telehealth platform will interface well with the rest of the software.

Star Ratings for Telehealth Features

5-stars – The telehealth platform is exceptionally reliable and fully featured. Client access to the telehealth platform is easy and straightforward, connectivity issues are limited, and there is access to a great number of extras like screen sharing, document sharing, and a chat function. Overall, the telehealth platform integrates seamlessly with the rest of the software.

3-stars – The telehealth software is adequate. It may have occasional connectivity issues, but nothing too disruptive. It may be a bit barebones, but will, at very least, include a screen share function. The platform may not integrate with the rest of the software as seamlessly as the best software does.

1-star – Telehealth platform may be missing or grossly inadequate to perform mental healthcare.

Insurance Billing

Insurance billing can be one of the most intimidating aspects of running a therapy practice, and many EHRs do not make the process easy. The ideal EHR will allow practitioners to handle all insurance billing easily, even if they don’t have prior experience in this type of billing. There should also be clear documentation throughout the entire insurance billing process, and a well-designed dashboard for insurance claims and other data is a must.

Star Ratings for Insurance Billing

5-stars – Insurance billing is effective and requires little manual input from the practitioner. The software integrates exceptionally well with the insurance clearinghouse, and there is likely a dashboard for monitoring the status of claims. The software should offer either free or paid services for enhanced billing support. If the services are paid, it should be a reasonable cost that is worth the expenditure.

3-stars – Insurance billing is adequate, but not as seamless and straightforward as the best options available. Practitioners are unable to easily track all steps in the claims process, and the software may lead to some rejected, or erroneous claims.

1-star – The platform either doesn’t have insurance billing solutions or the solutions it offers are so difficult to use, that a therapist is unlikely to use them.

Client Payment Methods

It is important for clients to have the ability to pay for services in a straightforward and user-friendly way, as well as for therapists to be able to manage those payments effectively and efficiently. . The ideal EHR will have features in place to limit payment-related issues and will ensure that collecting client payments is very straightforward and easy to accomplish. Features included in the ideal EHR will be the ability to process multiple payment methods, integrated card processing, automatic and customizable billing invoices, as well as a well-designed dashboard for managing all of the associated functions and data.

Star Ratings of Client Payment Methods

5-stars – Invoicing and collecting payment is extremely simple and includes options for a wide variety of payment options like debit/credit/FSA/HSA cards, as well as documentation options for cash payments or checks. The software will have straightforward methods for integrating external card processing systems. Refunding clients and adjusting invoices will be clear and simple. The software should also provide options for collecting payment in person, as well as online. If the software has a client portal, clients should have the option to view and pay their bills online.

3-stars – Systems for invoicing and collecting payments are adequate, but lack the same polish, integration, or ease of use of the best options available. Perhaps these platforms have limited options for payment methods – or, they do not store payment methods for future use. Overall, 3-star platforms will allow a practice to manage all client payment management with ease, but may not do so with the same elegance and simplicity of ideal software.

1-star – The client payment system is unusable, or just doesn’t work all that well. It may not interface well with the rest of the system, or perhaps it is difficult to use. Regardless, client payment features of a 1-star system will be so ineffective that practitioners would be likely to prefer cash payment only.

Practice Management & Reports

Reporting and data analytics are often overlooked in mental health practice management software. The ideal EHR platform should offer reports for just about everything from client demographics, to practice cash flow, to client no-show rates. Additionally, practices should be able to easily access and visualize all of this data. Platforms should also allow practice owners a great degree of control over practice management. Ideal features include assigning different roles and levels of

access to staff members, and an internal messaging or task management system.

Star Ratings of Practice Management & Reports

5-stars – The platform offers a wide range of data reports and presents them in a clear and understandable way. It has a dedicated dashboard for viewing this information. The platform offers unprecedented control of administrative settings and allows practice owners a great degree of control in managing either a small or large practice.

3-stars – These platforms may not offer much control of practice management and are likely best suited to small or solo practices. The reporting capabilities are limited, and there are some data categories that are left out that would be essential to have.

1-star – The platform has very limited or absent data reporting functions, and the control over practice management is very limited.

Customer Service & Training

The ideal EHR platform will offer strong customer support and training. Customer support must be responsive and helpful, but there should also be many self-service options to help streamline things and avoid unnecessary emails and other correspondence. Training features should offer a wide range of both written and video trainings and a large amount of community support. EHRs should offer onboarding trainings or webinars to help practices get set up on the platform quickly.

Star Ratings of Customer Service & Training

5-stars – The EHR platform has very responsive customer service representatives, and some of the best will have dedicated support staff for each practice. There should be a very large library of FAQs and training-type articles to help practices use the software. The best platforms will offer video training and live training seminars for onboarding. It should be clear how to get in contact with customer support. There should also be an open forum to allow users to post issues or questions that is searchable to help users find the answers they need.

3-stars – Customer support is adequate, but not very personalized or detailed. A 3-star EHR will offer a more limited amount of training materials, and they may not be organized or accessible in a very intuitive way. There is no dedicated user forum.

1-star – The platform suffers from a lack of support, or customer support is very slow and unhelpful. The library of help articles and videos is very limited, and many problems require a practice to reach out to customer service. There are limited training and onboarding opportunities.

Premium Features or Add-Ons

Many EHR platforms offer premium features or add-ons that may not be relevant to every practice but are desirable to some, such as enhanced or automated insurance billing, premium telehealth services, or business analytics tools. These premium features must add measurable value to the system and should be priced in a way that is relative to the value they add. Premium features should not simply be basic features that the company refers to as “premium.”

Star Ratings of Premium Features or Add-Ons

5-stars – Premium features are actually premium and not features that the typical EHR will include in its base price. Not all practices are going to need these premium features, but practices that do will find them incredibly helpful. They are priced in accordance with their value and would be worth the additional cost.

3-stars – Premium features are too expensive relative to the value that they add, or many of the premium features offered are basic ones that should not require an extra fee.

1-star – The premium features are egregiously expensive and are a company’s way of taking essential functionality and hiding it behind a paywall.

Fit & Finish

The fit and finish of a platform seems like it would not be as important, but poorly designed and difficult-to-read software can lead to practitioners spending far more time working on a simple task or even prevent practitioners from accessing features of the software. The ideal EHR software will be cleverly and intelligently designed to improve functionality and will be markedly more intuitive than other options available.

Star Ratings of Visual Design

5-stars – The platforms are beautiful and cleverly designed. It has an exceptional quality of design that is both pleasing to look at, intuitive to use, and offers frequent improvements to functionality.

3-stars – The software is usable, dependable, and looks nice, but the design is not innovative or does not add any functional value. It is not as easy to use or intuitive as the ideal platform is.

1-star – The platform either looks extremely outdated, or it is just hard to read, and, in some way, the design decreases the functionality of the software.

Relative Cost

The ideal EHR software will be priced competitively with other options available. Any premium features and associated costs should be justified. Ideally, EHR software would offer more functionality than its competitors at a lower cost.

Star Ratings for Relative Cost

5-stars – The software offers excellent value for the cost. It offers more features than its competitors at a lower cost.

3-stars – The software costs are in-line with its competitors and do not add any more value for the relative cost.

1-star – The software is unnecessarily expensive and the features don’t justify the price.

Reliability & Longevity

An ideal EHR should be frequently used and highly reviewed by users. EHRs that have been in service for at least five years, and have been consistently updated and well-reviewed over that timeframe will score highest in this category.

Star Ratings for Reliability & Longevity Category

5-stars – The platform has been around for at least 5 years and has been consistently updated and held in high esteem for the entire time.

3-stars – The platform has been around for at least 2 years. It might have been around longer, but hasn’t been well maintained over that period of time. Maybe it was well-regarded at one point but isn’t as widely used anymore.

1-star – The platform is brand new and hasn’t had many users review it, or the platform’s history is marred by difficult situations or negative publicity.

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This content was last updated 12/14/2022 by the Choosing Therapy team.