The Complete Guide to EHR, Practice Management Software & Telehealth

EHR (electronic health record) software handles the clinical documentation: charting, orders, prescriptions, patient portal, clinical decision support. Practice management (PM) software handles the business side: scheduling, registration, billing, collections, reporting. Most modern systems bundle both — Athena, eClinicalWorks, and Kareo all offer combined EHR+PM — but some practices run a separate PM system alongside a specialty-specific EHR. If you're evaluating vendors, ask specifically whether clinical and business features are one integrated database or two with an interface between them.

Expect $300–$800 per provider per month for a cloud-based EHR with integrated practice management, plus one-time implementation costs of $1,500–$5,000 per provider. Some systems (like Practice Fusion) offer free tiers supported by advertising; these work for very small practices but have workflow limitations. Hidden costs to ask about: patient portal setup, lab interface fees, clearinghouse fees if not included, customization hours, and training beyond the initial rollout.

Specialty-specific EHRs (for example, WebPT for physical therapy, TherapyNotes for mental health, Cliniko for chiropractic) typically have better templates and workflows for their specialty out of the box but can lag on general features like patient portals or billing depth. General EHRs work well if your practice mix is diverse or you expect to add service lines. A good decision rule: if your specialty has a dominant specialty-specific EHR that most peer practices use, the network effects (support, templates, integrations) usually justify choosing it.

Only the paid Zoom for Healthcare tier (or Zoom Workplace with the HIPAA add-on) is HIPAA-compliant, and only when configured correctly AND with a signed Business Associate Agreement in place. Free Zoom is not HIPAA-compliant. Many practices assumed they were compliant during COVID because HHS announced enforcement discretion — that discretion ended in May 2023. If you're still using free Zoom or Zoom accounts without a BAA, this is an active HIPAA exposure.

Plan for 60–90 days from contract to go-live for a small practice. Larger practices or those migrating from a legacy system often take 90–180 days. The critical path is usually data migration (patient demographics, problem lists, medications, historical notes), template configuration, and staff training. Rushing any of these is the top reason practices regret their EHR choice — a bad go-live experience can sour a team on a system that would have worked fine with better setup.

Yes, but it's expensive. Realistic total cost of switching for a small practice: $30,000–$80,000 including data migration, implementation, training, temporary productivity loss, and any overlapping subscription fees. Data migration is the hardest part — some legacy systems make it intentionally difficult to export historical notes in a format other systems can ingest. Before signing any EHR contract, read the data portability and exit provisions carefully.

Over-indexing on the sales demo. Demos show the system at its best: pre-populated data, an expert operator, and carefully chosen workflows. The two evaluation tactics that correlate most strongly with long-term satisfaction are (1) talking to 2–3 reference practices your size and specialty who have been on the system for at least a year, and (2) doing a hands-on pilot with your actual staff doing an actual visit — not watching a rep demo. Our EHR Selection Toolkit includes question lists for both.