Common Concerns

This pages gives a summary of common concerns. Whenever possible please see the detailed article in this KnowledgeBase as statements on this pages are just summaries.

General

Does TherapyCharts work on Windows or Mac?

Both. Any computer operating system that runs a modern web browser can run TherapyCharts... even Linux!

Is there a free trial?

No. Because we store electronic mental health records on behalf of others, we need a real customer in order to meet our requirements. There are also screenshots and tutorials available online for your consideration to help with the review process before you choose to sign up.

Is there any software to install?

No. As long as you have an up-to-date web browser running on your computer, you have all the software you need to run TherapyCharts. The first time you run TherapyCharts on a given computer, there will be an extra wait of 5-30 minutes, depending on the speed of your internet connection.

Can TherapyCharts be installed on our own servers?

We do not offer on-premises installations at this time. TherapyCharts is only available as a web-based, Software-as-a-Service (SaaS) product.

Which web browsers are supported? Which do you recommend?

We support the latest version of Google Chrome. We support the current and previous major releases of Firefox, Internet Explorer, and Safari on a rolling basis. Each time a new version is released, we begin supporting that version and stop the previous versions. For maximum security, performance, and to take advantage of TherapyCharts innovations, we recommend always using a modern, up-to-date browser.

TherapyCharts is tested on Firefox 20+, Internet Explorer 10, Chrome 25+, and Safari. Others will likely work but are not officially supported, so if there are problems please switch to either Firefox, Internet Explorer, or Safari. Our developers recommend Firefox or Google Chrome:

• Get Firefox at http://www.mozilla.org/en-US/firefox/new/
• Get Chrome at http://www.google.com/chrome

Can I use TherapyCharts without internet access?

No. TherapyCharts is a web-based psychology practice management and electronic health records (EHR) system. Because it is web-based, internet access is required. When you use TherapyCharts, none of your patient records will be stored on your local computer hard drive. This frees you of the cost, hassle, and liability risk of storing your own records and managing your own back-ups.

I have a bad internet connection that drops out once in a while, can I still use TherapyCharts?

Maybe. First, you might consider speaking with the internet provider about the quality of service, as disappearing internet connections should be highly unusual. Also, internet providers offer "business" class connections that are more reliable then "home" connections and have quicker response times if the internet goes down.

TherapyCharts includes a connection monitor that is active when you are logged in. This verifies that your browser is able to connect to the TherapyCharts servers. If your connection is flaky for small periods of time then you most likely will be able to use TherapyCharts. For example, if you have a progress note open when the internet connection stops working then you can finish typing that note. After the connection comes back, just click save. (There is an lost connection indicator that will appear in the lower right corner over the TherapyCharts graph when the connection is lost.) However, there is no way to access the TherapyCharts system if your internet connection goes down for a extended period of time.

How do I sign my records?

TherapyCharts allows mental health workers to sign various documents using a signing pin. This signing pin helps ensure the authenticity, integrity, and security of the electronic signature.

Don't I have to sign my name in a graphic somehow?

No. Electronic signatures are governed by two primary laws. The federal Electronic Signatures in Global and National Commerce Act (E-Sign) was signed into law on June 30, 2000 and became effective, at least for the most part, on October 20, 2000. On October 16, 2000, Michigan enacted the Uniform Electronic Transactions Act (UETA), which is based on a uniform act promulgated by the National Conference of Commissioners on Uniform State Laws (NCCUSL). UETA is also adopted in 47 other states. Both laws were intended to smooth the way for conducting business electronically by giving validity to electronic records and signatures.

Both E-Sign and UETA provide that an electronic record may be used to satisfy a record retention requirement that is imposed under another law, (such as HIPAA) so long as the electronic record accurately sets forth the information in the record and remains accessible to all persons who are entitled to access the record. As long as the accuracy and accessibility requirements are met, a law requiring that a record be retained in original form may be satisfied by retaining the electronic record.

Why does everything have a timestamp for when it occurred?

Recording the actual date and time for the actions as they take place, including signatures, is a best practice necessary to meet the HIPAA Security Rule Technology Safeguards generally and the audit requirements. Additionally, while there are no current audit standards for psychology out patient mental health practice that are not unnecessary complex elements such as prescription components, time stamps have been required for ONC HIT and CCHIT in other areas such as far back as 2007.

What about a signature pad like Topaz?

We do not current support the Topaz device. We currently perform electronic signatures using a signing pin and public/private key cryptographic methods.

We see value in allowing mental health workers to allow their patients to "sign" document using a signature pad or graphic because patients would not have a signing PIN. We continue to welcome feedback from our customers on what features they would like to see in development.

What cipher and key size do you use?

TherapyCharts holds data compliant with HIPAA and processed according to various best practices and standards issued by the National Institute of Standards and Technology of the United States (NIST). In terms of symmetric ciphers we use the Advance Encryption Standard (AES) as defined in FIPS 197. We use 256-bit keys. For public/private key ciphers we use RSA and DSA and 4096 or 2048 bit keys depending on the situation. Different software handles the encryption at different points but in all cases the encryption is handled by standard library implementations of the ciphers on the respective platforms. At the transport layer when the data is moving from your computers to our servers is handed by the web browser using the HTTPS standard. At the application layer encryption is handled by the TherapyChart application software using standard libraries. At the database layer encryption is handled by the Database Management System itself. And finally at the storage layer encryption is handled by the OS's encrypted filesystem implementation.

Is there a FAQ?

We are starting to index the questions individually listing only the most common here. See FAQ as the list expands. You can also see items in the Questions by Category

I'm coming from the TheraScribe desktop based edition...

We have designed the web based system from the ground up to be optimized for the web. It has a new web friendly workflow based on customer feedback. We will continue to update the web based version with enhancements based on our customers feedback.

Are all updates included?

Regular updates will be included at no cost to you.

Some special updates may have an additional fee only if you choose to opt-in. This is because those additional fees are required by 3rd parties to offer those services, for example, licensing fees or transaction fees for electronic claim submission.

Do I have to write out all my own goals/symptoms/objectives/etc?

With us you have options. You can write your own OR you can use the built in treatments planner, progress note planner, and homework planner to assist you in writing them from the 10,000+ clinically designed goals/symptoms/objectives available.

Which modules are included?

ALL of them. All the treatment planner, progress note planner, and homework planner modules are included in the monthly subscription. You no longer have to buy modules.

Can I import my existing data?

Yes for TheraScribe users, Please see Can_I_import_my_existing_data? for details.

Before Logging into TherapyCharts

Is your EHR system compatible with voice recognition software? Specifically Dragon NaturallySpeaking?

Yes. Our system is fully compatible with 3rd party voice dictation software. To use such software, click on the field into which you wish to dictate and then activate your software. Once you are done with that field, select then next field using your mouse or if your voice recognition software supports it you can move among the fields with voice commands.

Does it support pre-existing handwriting recognition? Does it have built-in handwriting recognition?

Our system does not have built-in handwriting recognition. However, most tablet computers provide a system-wide application for handwriting recognition. For information on using handwriting recognition for Windows XP, click here: http://support.microsoft.com/kb/306906 For information on using handwriting recognition for Windows Vista, click here: http://windowshelp.microsoft.com/Windows/en-US/help/e404c5ca-a5b5-416c-80c7-4900a30dc5601033.mspx For information on using handwriting recognition for Mac OSX, http://docs.info.apple.com/article.html?path=Mac/10.5/en/8138.html

Can I use my tablet PC?

Absolutely! Any PC that runs a modern web browser will do the trick. Our website has been tested on tablets running Chrome and Firefox. Clients have reported that they have been very satisfied with the experience of using a tablet with our site.

Can I use my iPad?

Sort of. Some existing customers use their iPad. However, we do not consider the iPad a supported device at this time. While TherapyCharts works under normal Safari, Apple did something to the iPad's version. While pages load and can view data, entering data can be challenging because of the small screen. And occasionally certain pages that work fine before just refuse to load on the iPad. We have investigated this odd behavior and believe it to be an issue with the iPad device itself.

Can I change my password?

Yes, as long as you know your current password you can change it to something new. Make sure your new password is solid. We suggest that it has at minimum: lowercase letters, uppercase letters, numbers, and is at least 8 characters long. Remember, it's the key to your patients' confidential records!

It is crucially important that you remember or write your username and password down on a piece of paper and put it somewhere safe like a vault, safe deposit box, or where you keep your passport and birth certificate. See the next two questions below.

I can't remember my password, can you help?

The short answer is no. For your protection and the protection of your clients, TherapyCharts employs a one-way-hash-function that prevents anyone, even us, from accessing your client records without entering the correct password. For similar security reasons, our system prevents us from creating a new password that could be used to access your patient records.

It is crucially important that you remember or write your username and password down on a piece of paper and put it somewhere safe like a vault, a safe deposit box, or where you keep your passport and birth certificate.

Can you reset my password?

Basically, no. This helps guarantee that you are the keeper of your patients' confidential and private information. Even TherapyCharts cannot read your notes.

Can TherapyCharts employees read my notes?

No. All of your notes (and other types of protected health information) are encrypted in the database using DSA public/private key and AES 256 cryptography. TherapyCharts employs a one-way-hash-function that prevents anyone, even us, from accessing your client notes without entering the correct password.

What about Popup Blockers, Virus Scanners, and Security & Privacy Settings - Do they effect using the site?

Sometimes. Some virus scanners, popup blowers, and web browser setups, in particular IE, causes problems. Please note we strongly recommend you use Chrome and not IE. The common symptom of this is when you try to login you find you get stuck on the animated loading screen.

• For web browsers, we recommend Google Chromium (or Mozilla Firefox)as the default install works with our site.
• For virus scanners and firewalls, you need to configure your particular scanner to allow full access to the TherapyCharts.com internet website.

If you are using IE and that's happening you need to double check you settings. We've confirmed that IE works with our system if it is setup correctly.

Here are the instruction for configuring this under IE7 (IE8/IE9 have similar settings and examines of instruction can be found online using a search engine):

• Open IE7
• Goto Tools
• Select Internet Options

In the Internet Options Dialog:

• Click Security Tab
• Click Trusted Sites Icon
• Click Sites button

In the trusted sites dialog:

• Add "https://secure.therapycharts.com"
• Click Add button
• Click Close button

Back on the Internet Options Dialog:

• Set the Security Level for the Trusted Sites to to Low
• Click the Privacy Tab

On the Privacy Tab:

• Click Site button
• Type "secure.therapycharts.com" and click Allow button
• Type "www.therapycharts.com" and click Allow button
• Type "therapycharts.com" and click Allow button
• Click ok

Under Pop-Up Blocker Area

• Click Settings
• Add "secure.therapycharts.com"

After Logging into TherapyCharts

The intake form timeouts on loading.

In order to preserve the privacy of your clients, we never store anything on your machine. This means that longer forms, like the intake, can take longer to download. This delay should not cause errors. If it does please let us know via the feedback button. We are working on solutions to gather all the assessment information without the long delays.

How do I add appointments?

On the bottom right of the screen select "new appointment." To select which patient the appointment is for, type the first few letters of the client's name (the rest will be completed for you) or select their name from the drop down. Once you have a patient selected, choose a desired start and stop time and a date from the pop out calender. The appointment will then appear on your schedule. Be sure you are looking at the right day. By default, the current day is displayed on the screen.

How do I add patients?

Click on the patient list tab on the top right of the screen. On the top left of the patient list there is a button that reads "Add Patient." If you click that, you will get a blank patient information tab to complete. Once you click "Submit and Save," the new patient will appear on the patient list.

Why are there required fields? I don't require Field X in my practice.

While TherapyCharts can be used by anyone, we originally designed the system for small or solo private pay practices. We've tried to keep the required fields to a minimum to satisfy legal, ethical, and procedural best practices. For example, some are obvious laws like HIPAA (http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html) while others are more subtle, like the FTC Red Flag rules (http://www.ftc.gov/bcp/edu/pubs/articles/art11.shtm). So the field is required by either a law, ethical requirements, or best practices. If you think your practice falls into some exception, you could just enter some random data. We hope you see this not as an inconvenience but as a strength of TherapyCharts -- helping mental health workers stay up-to-date with the legal, ethical, and other best practices.

I've done X and nothing happens.

Look at your entries for red markings. This indicates that the field either hasn't been filled out or that it has information in it that doesn't meet the formatting standards. Once you have filled out all required sections or have fixed the formatting on certain fields, try submitting again.

If there are no red markings, make sure that the active patient box is checked. Inactive patients are not shown on the patient list by default. To show inactive patients, uncheck the "only show active clients" button on the bottom left of the screen.

How do I write a progress note?

If this is a patient in your schedule, simply click the patient's name and enter the new information on the progress note that opens. If this patient is not on your schedule, go to the patient list and highlight their name by clicking on it. Then you may either click the progress note tab on the top left of your screen or the first pinwheel symbol on the far right of the client's name.

Can I write a SOAP note? Or other special format?

The TherapyCharts system has a generalized Progress Note form (shown on the progress note tab) to allow one to write any kind of progress note. Since the SOAP note format is just a more structured and formalized progress note, there are two approaches to writing SOAP notes in TherapyCharts. (When we're talking about SOAP notes we're talking about these http://www.coe.ufl.edu/Counselor/PracticumInternship/Files/SOAPNotes.pdf)

First, simply write the text of your SOAP note as you usually would in the free text "Progress Note" field on the Progress Note form -- done. This approach requires little change in your current process but doesn't take full advantage of the features of TherapyCharts.

Alternatively, TherapyCharts encapsulates parts of the SOAP note in other fields. Each Progress Note form (as shown on the progress note tab) contains fields that address those required in a SOAP note. We have a "Progress Note" free text field for subjective or objective data, we integrate the reported symptoms independently with an updateable field for objective data which allows for independent tracking, and we include the treatment plan objectives and medication management for treatment planning.

Flexibility and choice are yours. Use all, some, or none of the available fields and approaches.

I can't add symptoms or objectives.

These can only be monitored on a progress note if they are added on the treatment plan. Save a draft of the progress note, then click the treatment plan tab on the top left of your screen. If there is no treatment plan for this patient, fill out the fields to create a treatment plan then click sign and save when the plan is finished. If there is a treatment plan already in place, click the new button on the top left. All the previous data will fill in automatically, just delete or add the symptoms or objectives you need and then click sign and save when the plan is finished. Don't forget to indicate the reason for modifying the plan.

Are there any auto-generated treatment goals?

The system allows you to use the Wiley Treatment Planning tool to develop and choose appropriate treatment goals. However, you still have to choose them or write your own. The system will not automatically choose them for you based on the symptoms. It is set up without auto-generated therapeutic goals in response to the directions and requirements of CARF, JCHO, professional ethics, and other best practice guidelines that state that individualized planning, not pre-generated goals, is best for patient care.

How do I write a treatment plan?

If this patient is not on your schedule, go to the patient list and highlight their name by clicking on it. Then you may either click the treatment plan tab on the top left of your screen or the second pinwheel symbol on the far right of the client's name.

Do you support DSM-IV

Yes, the diagnosis can be coded according to DSM-IV.

Do you support DSM-V

Yes, the diagnosis can be coded according to DSM-V with ICD-9 codes.

Do you support ICD-9

Yes, the full codes are available.

Do you support ICD-10

We will by Fall 2014.

Do you support spell checking?

Yes, through the spell checking built in to modern web browers. For example, in Firefox, to enable it goto the Preferences -> Advanced Tab. Under "Browsing" check the "Check my spelling as I type" checkbox. Then, when you are in a text area in the web application, right-click and ensure that "check spelling" is checked in the pop up menu. Also verify the correct language under Languages expansion menu. You may also need to install additional dictionaries. For more information see Firefox Features at http://www.mozilla.com/en-US/firefox/features/ or their support page at http://support.mozilla.com/en-US/kb/Using%20the%20spell%20checker

I enter a lot of text so the text area is too small for the progress notes or other fields. Can you make it bigger?

We've selected the default text area size based on our customers' feedback. Please let us know if you think the default size is too small. While we don't officially support it, in the meantime you can control the text area size on your own. If you are using Google Chrome http://www.google.com/chrome you can resize the text area with the small triangle in the lower right corner. If you are using Firefox, you can add the Text Area Resizer & Mover add-on extenstion https://addons.mozilla.org/en-US/firefox/addon/8287 to make them resizeable.

Is there a limit to the amount of storage for EMRs allowed by TherapyCharts per provider over time? In the Document Manager?

There is no limit on the number of patients, progress notes, treatment plans, etc that can be created when you sign up for the Full Time plan. Other plans have various limits to make a plan affordable to all.

Within the document manager, which allows one to upload scanned documents, there are some limits to the amount of default storage you can use, but you can always buy more space to accommodate your needs if the defaults are not enough.

What size should I scan my document at to get the best benefit from the Document Manager?

We sent our computer geeks to study scanned documents for a week. They determined that the average size is 52kb per page when scanned at our recommend settings. Our recommended settings are based on 8.5"x11" paper at 200 DPI black and white compressed using TIFF Group IV -- these setting are great for text document storage, similar to the quality of a fax machine, and configurable on most scanners. Our studies have shown when documents are scanned to this level they are ideal for EHR storage because they are small and compact and retrieved quickly. The default limit for storage is 1024MB which gives room for about 20,000 pages of scanned text. There is the ability to purchase more space as the organization needs because you need more pages or choose to scanned pages at different size, bit depth, # of colors, and compress type then our recommendations.

My credit card was lost while on vacation, I've canceled it, how do I update your system with my new number?

To update your credit card information:

• Log into TherapyCharts
• Click on the Configuration Tab
• Click on the Payment Method Sub-Tab
• In the Credit Card list, Click the Add button
• On the new screen that appears, Enter the Credit Card information, then click the Add button in the lower right corner of the dialog
• After the Payment Method list refreshes, click the row for the new credit card
• Click the Use Selected Card for Billing

To Delete the old credit card:

• Click the row for the old credit card
• Click the Delete Card button

Leaving TherapyCharts

How do I stop using TherapyCharts?

Once a therapist has decided to use TherapyCharts for their practice we've rarely had anyone wish to stop. But we make it easy anyway.

You have to choose between two options: Cancel or transition to a Read-Only Retirement Account.

Canceling: If you don't want us to hold your records anymore, just submit a cancel request using the feedback function of your account to document the request. If you'd like, you can tell us why so we can try to get better. We would appreciate that since we'd have to update the answer to this question.

Most organizations also have the ability to Cancel an account via the Configuration -> User Manager section.

For complete details and the procedure see How_do_I_cancel?

Read-Only Retirement Account: Alternately, if you'd like us to continue holding your records you need to transition to a Read Only Retirement Account.

For complete details and the procedure see What happens when I retire?

What happens to my records if I stop using TherapyCharts?

It depends on how you stop.

If you cancel your account: Your account would be deactivated to prevent misuse. This leaves your records encrypted on our data store in case you change your mind later and come back in the first 30 days after canceling. Then all your records will be waiting for you. In the meantime, they can't be read by anyone because they are encrypted and only your username and password can decrypt them -- not even our staff can read them. So if you do leave DO NOT FORGET OR LOSE YOUR PASSWORD, because if you do you won't get your old records back later. During this time or before deactivation, you can print all the records for a given patient by going to Patient Info Tab and selecting Print All Clinical Records. Once an account is canceled for more then 30 days the records associated with it may be deleted at TherapyCharts sole discretion. See also How_do_I_cancel?

If you transition to a read-only retirement account: Your records will continue to be stored in TherapyCharts for a yearly fee. For more details see What_happens_when_I_retire?

Abandonment: If your account balance is unpaid for 3 months then your account will be suspended. If you account is suspended for 3 months then is will be administratively canceled.

How do I cancel?

Simply log into your TherapyCharts account and submit a feedback message requesting cancellation.

Most organizations also have the ability to Cancel an account via the Configuration -> User Manager section.

Remember: We do not take cancellations over the phone, email, or through the regular web forms. We must have an authenticated request tied back to the account to process it. This is also true for any other account modification that has the potential to change access to the records. We do this for security reasons to prevent anyone from impersonated our clinicians, canceling our clinicians accounts, and preventing access to the EHR records. Any cancel requests sent via phone, email, or web forms will be ignored by our staff.

Alternately, if you'd like us to continue holding your records you need to transition to a Read Only Retirement Account.

For details and the procedure see How_do_I_cancel?

What if I retire?

Two choices. First, same basic things as above except you could choose to have your account stay active so you can immediately access your records. Second, you could designate a new person who has a TherapyCharts account to receive your records. We will assist in transferring the records to that new account.

For details and the procedure see What_happens_when_I_retire?.

What if I die or become incapacitated?

In a group practice, if you have permissions set up broadly, the other members of your group will be able to take over management of your caseload automatically. If the permissions are narrow, then your group practice will have to present us with the correct documentation and we can change the permissions administratively to allow them access.

If you are in a solo practice, then before something happens you should designate a trusted third party, such as a local attorney, to be the keeper of your username and password. Give that attorney directions on what to do with your account in the event of your death or incapacitation.

Disclaimer: Summary Only

This pages gives a summary of common concerns. Whenever possible please see the detailed article in this KnowledgeBase as statements on this pages are just summaries.