Choosing the Right Electronic Health Record (EHR) for Your Private Practice

The key to running any company smoothly is to keep meticulous and clear records, and psychotherapy private practices are no exception. Virtually all businesses today operate with an electronic data-keeping system; paper files don’t cut it anymore. More and more private practitioners are moving toward a paperless practice, which includes a professional Electronic Health Record. And advances in technology have created software programs designed for the unique needs of those in the mental health profession.

An efficient EHR can reduce no-shows, provide instant and secure information to authorized patients, and overall contribute to a well-kept and professional business environment. In other words, a good EHR is nothing to skimp on!

The purpose of this post is not to provide a comprehensive look at every EHR on the market (as there are hundreds), but instead aims to identify important features and criteria in choosing a system and also to analyze some of the pros and cons of a few prominent brands.

Here are a few of the most important factors and features to consider when looking into a new EMH software for your therapy practice:

1) Basic features: these include to-do lists/ task management sub-systems, billing, scheduling, and patient appointment reminders

2) Price (many offer a free 30-day trial with limited features)

3) Client Portal (this would allow your clients to login to view their payment history, appointment history,  schedule appointments, or print out a superbill)

4) Data Reports (a detailed analysis of revenue, percentages, tracking referral sources and history, etc.)

5) Single Provider vs. Multiple Provider: (can multiple people or groups use the same system?  Can records overlap?)

Now let's look at a handful of some popular Electronic Health Record systems:

TheraNest

A major push for TheraNest is that it is workable for multiple providers in multiple locations. It also provides highly detailed analyzed reports to track data over time.

TheraNest does offer a client portal, but it's an add-on, so you have to upgrade and pay more for it. They offer a free 30-day limited trial (though it doesn't include client reminders during that time).

Simple Practice

Simple Practice is one of the most popular EHRs today, with most supporters praising its highly efficient and clear billing capabilities. Whether your customers pay full-fee or with insurance, Simple Practice can make it easy for you to keep everything in order.

While Simple Practice is top rated for a reason, a disadvantage of it is that it doesn't have a feature for multiple providers. And it's customer service reviews are relatively high, though some may wish they offered 24/7 technical support instead of just during business hours.

TherapyNotes

This system is known for its excellent and responsive customer support, user-friendly interface,  high security measures, and low cost. A possible downside of TherapyNotes is its limited billing features, including its inability to monitor secondary billing insurance. It also lacks a client portal.

Click here for a more detailed review of dozens of mental health software systems:  http://www.capterra.com/mental-health-software/

What are YOUR experiences with EHRs? What have you found that you like (and don’t like!) about different systems? I'd love to hear from you!

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How to Make Sure Your Online Photos are Copyright-Friendly

Graphics and pictures are a great way to enhance your social media engagement for your private mental health practice. They add something that words cannot, they show personality, they can break up large blocks of text, and they add visual interest. However, in our Internet age, there is a very real danger of getting into trouble if you use an unauthorized photo. The owner of the image(s) can slap you with a fine or a law suit. It's easy to disregard copyright rules, particularly if you are a small business owner. Some assume that if their blog is not a commercial site or monetized by running advertisements, then they can use any image without fear of legal penalty. And there are millions of blogs out there, so why would anyone care about an image or two you use on yours? The truth is that photo companies have software that crawls the web looking for their private images, and they’re not afraid to get you if you violate their rules. It happens a lot. It even happened to me. Moral of the story? Respect copyright laws.

Here are three suggestions for safely using images on your website:

1) Use a Stock Photography Website

These sites have thousands of images to browse so that you'll be able to find some that portray what you're looking for. There are lots of sites to choose from: Shutterstock, BigStock, and CanStock are some well-known names (I personally use Canstock). This is an investment, but it's a reasonable and worthwhile one. Here's how Canstock works: you sign up for a package of "credits," which are points to use an image. If I were to buy the 100 credit package, I'd pay $50 and would be able to "buy" the rights to use an image with my credits (most photos are 2-3 credits). There are different credit packages available to give you the best deal depending on how often you utilize images. I encourage you to research Canstock and the other companies and decide which one will work best for your business and your budget.

2) Take Your Own Pictures!

Why not create your own images? Maybe you’re a photography buff, maybe you’re not, but nowadays, it’s easier than ever to capture clean and beautiful photos with an iPhone or other simple device. Take a picture of your therapy office, something in nature that inspires you, or anything else that relates to your online presence. Use your imagination (and your common sense!) and tap into your creative side. Best part? No worrying about legal consequences!

3) Use Public Domain Images

There are some photos online that are actually totally free. Yep, the owners have decided that anyone can use them, making them fair use images. Hallelujah! Here are 3 popular sites with great free images:

Death to the Stock Photo I love the tongue-in-cheek name, here. This site actually emails you free images every month. There really are some beautiful ones here, and there's a different theme every month.

Unsplash Unsplash is another one with free, high quality photos. Not quite as many to choose from, but there are always new ones being added, so you might be able to find what you're looking for.

morgueFile Strange name, I know. Here are even more great stock photos where you don't need to worry about licensing or copyrighting issues.

4) Get Permission to Use an Image Through Creative Commons

Sometimes, you find an image on Google that fits perfectly for what you're looking for, but since it's not public domain, you cannot legally use it. In these cases, you may be able to get permission from the owner through what is called a creative commons license. This is a tool to connect someone who wants to use a photo with the person or company that supplies it and help them come to a reasonable agreement that is in compliance with the law. For example, you might be granted permission to use an image on your site, but not on a newsletter or book. It's up to the copyright holder what sort of license they give. Creative commons licenses can get pretty complex; click here for more specific details about it.

So yes, images are becoming increasingly important when you build your online presence, but you must take precaution and protect yourself. Once again, I urge you to take copyright rules seriously in order to avoid landing yourself in hot water. By using these techniques, you'll be able to create visual content for your online presence and keep yourself safe from any expensive and messy copyright violations.

Click here for more about going graphic/ using images to enhance your online presence.

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4 Ways To Use Pinterest To Build Your Practice

Pinterest is a social media platform that therapists might overlook when building their online presence. It may seem more tailored toward foodies, pop culture junkies, or book lovers than for people wanting or providng professional counseling. However, Pinterest can be a valuable way to serve your online community and also get the word out about yourself and the clinical services you offer. Joe Sanock, an LPC who also works as a private practice consultant, explains that “People who go on Pinterest are dreaming about having a new life. It could be a new hair style, a new dress, or a renovation. They are in a mindset of change. As counselors, we fit perfectly into that mindset.” He says that Pinterest is his leading referral for both his private practice and consulting business. Bottom line: Pinterest can work as a great marketing tool for you (read more about Joe's experience here).

Here is some more information and tips for using Pinterest to benefit your practice:

1) Regularly Pin and Re-pin Inspiring and Informative Material 

Make a point to pin and re-pin inspiring quotes and ideas that are relevant to your work as a therapist. Quotes about change and personal development often work best. Try to use quotes that are universal enough to not seem super technical or boring, but specific enough to establish that your niche deals with emotional and relational well-being. Use original material as well as curating existing content.

It’s a good idea to strategically include your name and website links on your graphics or memes (see left for an image I pinned as an example). This can be helpful when you get share and re-pins. It’s more than okay to tap into the promotional side of using Pinterest.

There is of course no cut-and-dry rule about how regularly you should post. But as is the case with any social media platform you utilize, you must commit to make content creation and curation an ongoing thing if you want it to make a difference in your marketing; pinning a new picture or idea once every month is not going to do much for establishing and maintaining your online presence.

2) Optimize Your Bio and Profile

The bio at the top of your Pinterest page is your "hello" to new followers. First impressions are important, and you want to introduce yourself professionally and accurately to your viewers. It should have your picture, a clear description of your speciality, and links to your main website. Optimizing your biography is also good for SEO (making your stuff for findable on the web). See screenshot below for my example:

3) Be Deliberate in Selecting Categories and Board Titles

Similar to your biography, be strategic about your titles, categories and boards; they're more important than you might think. Not only do they give a clear indication of the nature of your material, but they're also good for the search engines because your titles are your keywords. Not every one of your boards must be directly related to the field; it's good to diversify and show your followers that you're a multi-dimensional person. For example, you might have a board of humorous memes.

4) Follow Others in Your Niche

And finally, we come to the social part of the social media of Pinterest. Follow other relevant users. Look at the categories and boards of those who re-pin your stuff and see if they are similar to yours. Engage in Pinterest not just for yourself, but use it as a way to learn more and continue to be inspired. Check out other people's pins as well. And yes, follow to be followed (among other reasons).

So there's some tips to get you started or help you more with using Pinterest. It can be a useful tool to engage with the online community, invite more visitors to your website, as well as build your own professional online presence.

What's your experience using Pinterest for your practice?

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8 Steps to Launching or Relaunching a Psychotherapy Practice

In this guest post, Miranda Palmer LMFT and Kelly Higdon share eight ways to thrive in the current private practice climate. The process of building a successful private practice has changed considerably over the last twenty years. Most therapists we speak with who have been in practice for a few decades started by getting their credentials from an insurance companies. Reimbursement rates were relatively high for the cost of living from the 80s into the early 90s. Things flowed. Maybe they had a listing in the phone book, but back then there was no need for websites, Facebook pages, or Twitter accounts!

Fast forward to now: the financial picture for therapists in private practice has drastically changed, as we are in a time of low or stagnate reimbursement rates combined with an increase in cost of doing business and living.

The old model is simply that, old. It doesn’t work for today, and thus we find experienced therapists with a full practice that isn’t profitable enough to prepare for retirement, and new therapists often feel lost when they ask their mentors for direction and get answers that don’t resonate with the current economy.

We want to simplify the steps required for launching and successfully running a private practice in 2014. Whether you are starting out fresh, have moved to a new city, or need to make some significant changes in your business foundation, these steps will help you get things on track!

1) Develop a clear vision of your life

We tell our clients to do this regularly. We help them reassess and ask them to be accountable for the choices they make that lead them toward or away from that vision becoming a reality. This is your road map. When you begin with a plan for your life, your business can be formed to support that plan. So before you come up with an awesome group therapy curriculum or some other great idea, write down a super clear vision for your work AND home life.

2) Take that vision and break it down into pieces

Having a simple vision, with no basis in reality, can be difficult. How much money do you need to make that vision come to life? What would it take for you to go home at that time each day? Are you preparing for quarterly taxes? Are you realistic about how many clients you can see regularly while avoiding burnout? Are you leaving time for networking and marketing your practice? Leaving time for going to trainings? For being sick? Are you leaving enough time to return client phone calls and be available for crisis situations?

This is where people can get stuck in magical math. If I see 20 clients at $100/hr, that is $2,000 per week for 50 weeks – that’s six figures! YET there are expenses, taxes, real life stuff that happens. Be honest with your capabilities and your needs. Also, be open to the idea of reaching your goals in different ways. You might discover that face-to-face sessions is only a part of the plan. Now go crunch numbers, write down the schedule, and look at the specific pieces that are needed to fully form your vision.

3) Develop a business plan based on your vision and those realistic pieces

Every therapist in private practice needs a written business plan. He/she must know exactly how the fee was developed, how many sliding or pro bono slots there are, how much money is put toward retirement, etc. There is also a bit of research to be done here. Surprised? Sure, people need mental health services, but who and where are they, and what are the holes in the market in your area? Have a clear idea of who you want serve and how you plan to serve them. Write it down; be accountable to yourself.

4) Develop a sustainable plan to let your community know who you are

Notice I didn’t say develop a sustainable plan to let people know your business exists. People decide to work with therapists they know, like, and trust. Being authentic in how you present your private practice to the public doesn’t have to mean complete self-disclosure. Maintain professional boundaries, but don’t be afraid to let your personality shine!

The beauty of our current world is that people can advocate for themselves by choosing a provider who they believe is prepared to help them heal. If a potential client doesn’t get a chance to hear your “voice” and how you practice, how can he/she determine if you are a good fit? How hard is it for you to choose a therapist for yourself? Can you imagine how much more difficult it would be without an advanced degree and a deep knowledge of psychological theory?  Make sure to clearly communicate what unique things you can offer as a therapist.

Be aware of your insecurities and how you demonstrate those to the world. Now is the time to believe in yourself and honestly take stock in what you bring to the table. It is not prideful to share your craft with others. It is necessary in order to build relationships and instill hope in members of your community.

5) Develop and maintain clear business boundaries

Your business is your service to your clients. You may think that the things you are doing on a daily basis are serving your clients, but you need to be honest with yourself. If your business is struggling, it will impact your clinical work. What would happen if your clients talked to one another? Do more assertive clients pay a different fee than passive clients? Do clients with poor money management skills pay less than a client who has better budgeting skills?

Stick to your plan. Go back, and if you start to waver, remember #1 – why you are doing this in the first place? What is the life you are seeking to create? Who are the clients you are seeking to transform? When you break those boundaries, you are holding yourself back from the dreams you have for yourself and from helping your community in a profound way.

6) Streamline your business processes

The best way to do great clinical work is to free yourself up to do great clinical work. Whether this means transitioning to a paperless office to reduce late cancellations or no shows and decrease unpaid balances, or outsourcing your insurance billing so you never have to sit on hold with insurance companies again, find a way to make the business process work efficiently. If you feel like you can’t afford to streamline your process, you need to look at return on investment and/or whether you have set a fee that fully integrates business and overhead costs.

7) Streamline your marketing process

It takes more energy to start from a stopped position. The start of launching or re-launching your practice takes a LOT of energy, gusto, and enthusiasm. Know that it won’t always be as hard as it is in the beginning. Watch what works for growing your practice most effortlessly, and make a way to continue the bare minimum even when you are full with clients to keep things flowing. Maybe that is blogging once a month, speaking a few times a year, or monthly lunch dates with new contacts in your area. If you don’t have time to do some minimal tasks to keep things moving, you need to reassess if you are being honest with yourself about the time it takes to run a business.

Your marketing must align with who you are and your core values. If you don’t want to write a blog, don’t. If you don’t want to speak, don’t. BUT, do something and analyze if it works. If it isn’t working, then tweak it until it works, or let it go and move on to other options. Just because your neighbor gets referrals from Psychology Today doesn’t mean that is what YOU should do. You must only do what is best for your business, not necessarily what is best for others.

8) Celebrate your accomplishments!

Be good to yourself; kind to yourself. There is a lot to learn when starting a private practice. Know that everyone has a learning curve, and seek out a supportive community. However, no matter how awesome your community is, you will be struggling to stay energized and enjoy private practice if you are being unkind to you. Start from the inside out! And don’t be afraid to celebrate all the great accomplishments you’ve made in your private practice.

Miranda Palmer is a Licensed Marriage Family Therapists who is passionate about teaching and empowering other clinical counselors to successfully run a private practice. Visit her site www.zynnyme.com to learn more. 

Kelly Higdon wants to make a difference by sharing her expertise to help clients and business owners reach their full potential. Check out her Business School Bootcamp to learn more.   

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Join my Private Practice Toolbox Facebook group and connect with nearly 2000 therapists around the globe in 2 simple steps: 1) Click request to join the group & 2) Fill out this brief questionnaire before you'll be added to the group.

Need help blogging? Join my ongoing therapist blog challenge!

The Power of Online Presence: Mari A. Lee, LMFT Overcame 'Technophobia' to Become Best-Selling Author

Discover how some very successful mental health professionals use blogging, social media, and other technologies as powerful tools for their therapy practices.   I've discussed in great length ways that my online presence has benefited my private practice. But don't just take my word for it. Many therapists have utilized the power of social media and blogging to get the word out about their practice, establish rapport, and build trust with those in their community. I've asked a few of my colleagues some questions about their experiences (the good and the bad) building their online presence.  This is the first of several interviews where you can learn from the professionals.  My hope is for you to read these and understand even more just how valuable an online presence can be, not just for attracting clients, but for opening up other professional opportunities. Our first featured therapist is Mari A. Lee, an LMFT who specializes in sex addiction recovery.

1)  When and how did you first start putting time and effort into maintaining a strong online presence?

 Nearly 10 years ago when I was first starting out as an intern, I knew I wanted to have a website and better understand how to build my brand. I worked with a coach and a web designer to help me understand the basics. I had a Facebook page and a LinkedIn profile to start.  Over the years, I began to understand even more the benefit of an online presence, so I eventually updated my website and then found ways to refine and streamline my social media.  

2)  Please describe what social platforms you currently use. 

Originally I started with a Squarespace website and a LinkedIn account; I still use both. However, I now have a Facebook business page where I frequently post and receive feedback.  I have a blog as well that I update regularly.  I do have a Twitter and a Google+ account, though truthfully, I don't use them often.  Also, I recently moved my professional email to a gmail account and am really enjoying all of the added benefits from Google mail.  

One thing I love about social media is how it can connect you to others in the field. I belong to 3 professional organizations for my specialization as a sex and love addiction therapist. I participate often and have found this to be an excellent resource to build my reputation and brand, as well as build trusted relationships with other therapists within my specialization.

3)  About how much time do you devote to your online presence?  How do you balance it with your other work responsibilities?  

I am an author, so writing is a first love to me.  I enjoy this practice and find it fun, therapeutic, and exciting to write each day. I write 5 days a week and spend about 30-60 min every morning nurturing my online presence. Though I have a very busy private practice, I really don't find this to be difficult to balance into my schedule.  I think part of this is because writing comes quite naturally to me, and also I have more time to devote to my online presence because I do not have to contend with insurance billing and such.  

4)  What kinds of things do you use to inspire your content creations; what do you write about?

I love this question! The sky is the limit with respect to what I find inspirational. It could be something from my personal life that I feel would be helpful and supportive. It might be a trend I am seeing with clients in my private practice (for example: Boundaries, Assumptions, Gratitude). It could be a poem I have read, or a movie I have seen, a hot topic in current media, a trend, a project I am working on.  

I draw from many sources, and I believe this keeps my writing authentic and "me." That said, it is important to keep the material relevant and fresh. Writing about female business owners in their 50s, might be a bit blah to someone doing a search, but writing about female business owners taking 10 weeks of vacation a year, making six figures, and writing top selling e-books may have more of an SEO draw.

5)  How do you best balance personal and professional in your online activities?  Please give examples.  

I tend to keep pretty tight boundaries on my personal and professional online activities. For example, I have a social media form for therapy clients as part of my intake packet that they sign. I do not allow clients to post to my business Facebook page or private message me. They may read an article, blog and so forth if they choose, but that is it. I do not accept friend requests or professional links from therapy clients on LinkedIn.  I have had a couple of clients attempt to add me as a friend.  When this happens I redirect them back to my policy and process in their next session. Thankfully, I have not had any issues to date with clients overstepping boundaries. If that should happen, I would address this as part of the clinical work.

6)  What is some tangible evidence that your online presence has grown your business?

My practice has grown to the point where I have recently raised my fees in order to reduce my waiting list.  I have been referring out about 15-20 clients per month to other trusted colleagues in my area. However, this is about to change, as I am getting ready to hire 2 new therapists in 2015.  I'd like to keep some of this income under Growth Counseling Services, and my business is telling me that it is time to grow.  I have also increased my income in the last 3 years by 25% and it grows higher each year.  I anticipate 2015 to be a large jump in business/income.  

7)  Besides attracting clients, what other ways has your strong online presence helped you?

I have so enjoyed connecting with other professionals. My amazing virtual assistant and I met via a Facebook professional group, and it is really fun and enjoyable to see colleagues who have become friends posting updates on their latest and greatest and cheering them on!  Additionally, I have been asked to do radio and podcast interviews, my 5-star Amazon book, "Facing Heartbreak: Steps to Recovery for Partners of Sex Addicts" is now the #1 book in the world for spouses of sex addicts, and my e-book for therapists, "The Creative Clinician: Exercises and Activities for Clients and Group Therapy" has been flying off my website store based solely on therapists hearing about this, reading the testimonials and positive posts from other therapists, and then purchasing this resource. In the last year I have been hired three times for paid speaking gigs that paid several thousand dollars each. I could go on and on - the benefits and blessings are innumerable!

8)  What have been some of the biggest challenges you've encountered creating and maintaing your online presence?

I was scared and resistant to learning new technologies.  Miranda Palmer, who is a friend and a colleague, has been one of my biggest supports in being gently relentless (and incredibly patient) in supporting me. Additionally, my virtual assistant Kurt has been a huge help in walking me through some of the unknowns. I always share that if I can figure out how to blog, attend and facilitate webinars, host online trainings, navigate my FB business page, and so forth, anyone out there reading this can. I was the biggest scaredy cat of all!

9) How have you overcome those challenges?

I started out with small, focused goals. For example, I worked on my website a website presence, then updated my LinkedIn profile.  Pretty soon, I began to attend webinars and, then set aside a budget for paid coaching when needed. I hired a tech savvy virtual assistant who walked me through the world of Facebook and Twitter.   The most important thing I have done to help myself is to set aside time to practice each week.  I ask questions, I listen and read, I offer to others any information that I have found helpful in order to give back.  And I try to operate from a place of gratitude. A polite thank you and introduction with an offer to help the other person (instead of just asking for a hand out) goes a long way in the virtual community, and in real life!

10)  What tips or resources can you recommend to help therapists who are new to the online world of blogging, social media, SEO, etc.?

Trust that you CAN do this. Try to lean into your fears and don't bite off too much at a time. Make a list, and start at the top with a website. Even 3-4 pages is a good start. Hire experts and coaches when needed. Don't feel like you have to be the best writer in the world or a published author to have a blog or FB business page. Even posting a few short sentences and including a short video clip or inspirational quote is good enough. Baby steps! And here is my numero uno tip: Operate from a place of respect, gratitude, kindness and good will. People and professionals in the virtual communities and social media will get a real sense of who you are very quickly. If you are snarky, a know it all, or mean spirited, this will translate very quickly to the online world. I try to extend from a positive space and in doing so, attract other focused, joyful, interesting, and successful positive therapists and healers. When I come across a Negative Nellie, Envious Irma, Debbie Downer or Fear Fred, I just bow out politely from those kinds of interactions. You will notice right away within Facebook groups, LinkedIn feeds, professional list serves and Twitter who these folks are; these are the people who lead with fear, dire warnings, and rain on the parade vs. picking up a kazoo, jumping on the float and moving forward. I prefer to surround myself with like-minded, whole hearted, authentic colleagues of integrity who are out there making their dreams come true. Best wishes in creating your online presence.  If this 52 year-old former tech scaredy cat can do it, so can you!

Mari A. Lee, LMFT, CSAT-S 

Licensed Marriage & Family Therapist #47920

Certified Sex Addiction Therapist & CSAT-S Supervisor

Facebook Page: https://www.facebook.com/MariALeeTherapy

Author of: "The Creative Clinician: Exercises and Activities for Clients and Group Therapy"

Author of: "Facing Heartbreak: Steps to Recovery for Partners of Sex Addicts"

    I'm excited to present these therapists' stories about building their online presence.

Stay tuned for more!

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Join my Private Practice Toolbox Facebook group and connect with nearly 2000 therapists around the globe in 2 simple steps: 1) Click request to join the group & 2) Fill out this brief questionnaire before you'll be added to the group.

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