Nowadays, shopping for business software is a lot like shopping for a car. You do a lot of online research; you ask friends and coworkers for their recommendations; and you take some test drives. One thing—besides the price tag—that can ruin the whole experience? You pulling out of the lot with your shiny, new investment—and an uneasy inkling that maybe, just maybe, you got the wool pulled over your eyes.

Of course, when you buy a car and you get that feeling, you talk to folks about it. The same can’t be said for the PT industry, though. Certain software have been duping us for many years now—and yet, we remain silent. That stops today. There are three ways physical therapy software vendors have been bamboozling their prospective customers. Let’s take a closer look.

The Web-Enabled Smoke and Mirrors

True web-based EMR systems store data within secure data centers; nothing is downloaded, installed, or stored on any customers’ computers. Customers then access that data via web browsers (e.g., Google Chrome, Mozilla Firefox, or Internet Explorer) using any device connected to the Internet. Essentially, this is how you use a web-based EMR system:

  1. You visit the website of the EMR system.
  2. You log in.
  3. You conduct your business directly through your secure login on the website.
  4. When you’re finished, you log off.

Web-enabled EMRs, on the other hand, require you to download and install a software platform that then connects to the Internet. As this article explains, “…you still have to install software on your computer, and your computer still does all the processing. However, at certain intervals, the software will connect to the Internet to sync your account and data to the cloud.” This means that like server-based systems, web-enabled ones only allow users to access the program on the computer to which it’s installed. Furthermore, every time there’s an update or upgrade, you’ve got to download and install more stuff. You also must deal with all the security drawbacks of server-based systems (i.e., storing data on local servers and managing all the hardware yourself). Plus, as the above-cited article states, “…your EMR and its data does not update online in real time,” and that’s problematic if you have multiple clinics or different therapists accessing records simultaneously. Individuals could access or alter outdated information, or accidentally save over others’ work.

In addition to coming with all of these significant drawbacks, these EMRs also usually charge per chart or employ pricing structures similar to those of their server-based forebearers, which typically involve upfront expenses, maintenance fees, and the like.

In short, web-enabled systems don’t satisfy the demands of a growing business because they’re ineffective at scaling. Vendors of these systems know that, and that’s why they never just come right out and say they’re web-enabled. Instead, they either a.) don’t specify what type of platform they are, or b.) say they’re “cloud-based” and hope that you—the customer—are none the wiser. Don’t fall for the old smoke-and-mirrors trick. After all, if a company isn’t truthful about its platform functionality, what else are they hiding?

Ask your current EMR or—if you’re shopping around—any systems on your “yes” list the following questions:

  1. Do I need to download or install anything? (With a true web-based system, you shouldn’t have to.)
  2. Does the system need to sync with the Internet periodically to update my online data? (A true web-based EMR is always functioning—and saving your data—in real time.)
  3. Will I need to store any data locally? (With a true web-based EMR, you don’t need to store any data on your computer.)
  4. When it’s time to document, how do I open the EMR? (With web-enabled software, you’ll open the program on your computer, and it’ll connect to the web. With a truly web-based system, you’ll visit a website to log in.)

The “Free” EMR Gimmick

In the world of PT, clinics typically rely on two types of software: electronic medical record systems, which handle documentation and scheduling, and revenue cycle management (RCM), which handles accounts payable and receivable. As this blog post explains, “Sometimes, you’ll see vendors advertising an ‘all-in-one’ solution, which implies the EMR and RCM live within one system…Other vendors will tout an ‘integrated solution,’ which is basically a fancy term for an EMR or RCM system that integrates with other softwares.” For an in-depth discussion of each setup’s pros and cons, I recommend this article.

One major reason to avoid the all-in-one system, though, is its fee model. Often, the vendor will offer the EMR portion of its software for free in order to gain your business. Then, you simply pay for the RCM. But watch the pricing on this “deal”; sometimes, vendors will charge high percentages per reimbursement for billing, which means the more money you make, the greater your vendor’s cut. Your billing software should take the smallest percentage possible, and the money you’d save with a “free” EMR definitely doesn’t make up for an overcharging RCM.

Before committing to any software, make sure you ask about its pricing structure and how it adjusts for your business’s growth. Then, compare it with other systems’ pricing to gauge whether the giveaways really make for a better deal.

The Per-Patient Pricing Hustle

Software costs money. But every system charges its customers in a different way and at a different rate. It’s imperative that you understand your EMR vendor’s pricing structure, because some systems charge per patient visit or chart. And that’s detrimental to your practice’s cash flow. Here’s why: The more patients you generate, the more visits you’ll have or the more charts you’ll create. That means you pay more as your business grows. In other words, you’re punished for being more successful.

Your EMR should work for you and your business, not the other way around. So, instead, look for an EMR solution with a per-user pricing model. Also, investigate whether the company sets different rates for different user types. Finally, look for a system with a cancel-anytime subscription model. This ensures you know what you’re paying for from the get-go—no surprise fees or rate hikes. That’s the kind of EMR system that works for scale.


Now that I’ve essentially shown you the “EMRFAX,” you’re in the driver’s seat—and you shouldn’t have any uneasy feelings or buyer’s remorse as you drive your physical therapy software off the lot. Be well-informed when you shop for EMR, RCM, and practice management platforms; trust your gut; and ask not only a lot of questions, but the right questions. You might not be able to out-sell a salesperson, but you can certainly outsmart ’em.