Monday, January 10, 2011

Whats wrong with using your home computer to keep session notes?

Many therapists keep all their practice management information and session notes on their home computer.  Although this can be convenient and a time savings, there are some serious pitfalls unless you are very careful about how you implement this.

What would happen if your computer was stolen right now?
What would happen if your computer got a virus and had to be reformatted?
What would happen if your hard disk died?

Over a million computers are stolen each year! Do you have a backup?  Are you sure?  90% of people who depend on backups have never attempted a restore and are dismayed after a disaster to find out that they had not configured their backup software correctly.  What about HIPAA?  Could the thief get your client data?  Many therapists falsely believe that since they have to enter a password to log into their computer that no thief could access their data, this is wrong.  It is very easy for any computer repair shop to pull a hard disk drive out of a computer and read all of contents without using any passwords.  Credit card numbers, social security numbers, session notes - they could get it all within minutes.
If you are going to use your computer to store your practice information you need to take three very important steps:

  1. Physical security. Buy a computer that can be securely locked with a cable to an immovable object. Many desktop computers have a lock ring that a padlock with a cable can be attached to.
  2. Backups.  You must at a minimum do weekly backups.  Not only is theft a problem but your computer might have a hardware failure or it might get infected with a virus and need reformatting.  Not only must you do weekly backups but you must test your backups by doing a full restore, most people neglect this critical step.  Unless you have done a full restore and verified that your system is fully operational with all the data intact, it most likely is not.  This backup software comes free and standard with apple iMacs (os version 10.5 and later), on windows computers you need to buy separate software.
  3. Whole Disk Encryption. As mentioned before, it is a very simple matter to remove a disk drive from a computer and read its contents even though it is password protected.  The only way to securely store your data is to use whole disk encryption.  For users of Apple iMacs using os X and later, this is easy.  Go to the system preferences panel, click on the "security" icon and set up the "FileVault".  For windows computers adding whole disk encryption can be a much more expensive proposition.
When you have taken those three steps you are secure but its still not nearly as convenient as good web based practice management software for several reasons:
  1. With your own computer, you can only work when you have access to that computer.  You cant work from home if traffic is bad or access notes in an emergency while on vacation.  With web based practice management solution, you can access your practice anywhere you have an web browser.
  2. Time.  Installing software on your computer is notoriously difficult and time consuming. Doing backups and testing them is very time consuming too.   How much is your time worth?  Web based practice management solutions completely eliminate these tasks.
  3. Integration.  Web based practice management solutions can be completely integrated which eliminates duplicated effort.  For example, after a session is complete you can just press a button which charges the client's credit card without entering any additional information.

Whats wrong with notepads and filing cabinets?

Therapists and psychotherapists have used notepads and locked filing cabinets for decades.  There are some obvious advantages to this system as its worked well for a long time.  Its easy, it doesnt require anything other than pads of paper and a sturdy locked file cabinet.  Lets look at the disadvantages though:
  1. Natural Disasters.  Every 90 seconds, there is a structure fire - what if it was your office? Do you have copies of your important files?  Do you have the phone numbers, credit card numbers, and insurance information of all your clients?  How much work would it be to get your practice running smoothly again?  Online therapist practice management software solutions eliminate this problem.
  2. Convienience. What if you want to work on session notes and need information from your filling cabinet to accomplish this but you are miles away from your office?  With some online practice management software solutions you can schedule appointments, process credit cards, and view treatment histories anywhere you go.
  3. HIPAA.  What if the worst nightmare happens, what if your office is broken into?  Locked filing cabinets are notoriously easy to break into.  You might have a good lock but a determined thief will just carry away your entire filing cabinet.  Online therapist practice management software solutions are much more secure.
  4. Time.  Paper pads and filing cabinets take a lot of time.  Online therapist practice management software solutions can save you 3hours a week because of their integrated nature.

Here is an example of a good online therapist practice management solution.