Today on ChiroHub we will be reviewing one of the many electronic health record systems available. The system is call Charm EHR. Many chiropractic clinics have switched over from paper to electronic records in the last 5-10 years. In fact, insurance companies in some states have penalized clinics that can't bill electronically. So, it has become more necessary for chiropractic clinics to explore the world of electronic health records. We believe the jury is still out regarding how much the systems actually enhance patient care and communication between clinics and doctors, especially in a solo clinic setting. Most of the systems used by DC’s are chiropractic specific, but we have chosen to explore a system that is fully customizable and allows for a multidisciplinary clinic, as well as inventory management for supplements and medical supplies.

COST (9/10) - While this system is not free, no decent system worth your time is free. The only ones that are tend to buy and sell user information patient demographics to large corporations. That being said, we think the cost for Charm EHR is very reasonable. Charm EHR charges based on the number of encounters, so it is very cost-effective for new clinics, or solo practitioners. Last time we checked, the charge is about $.50 per patient encounter. We felt this was a reasonable and fair fee for the system, and it allows you to grow with the system.

User-Friendliness (6/10) - Charm EHR definitely requires a lot more navigation and clicking of the mouse than most systems. Even though you are able to completely customize your templates, we found that there is an enormous amount of mouse clicking required. Some simple steps require even two or three clicks, so there is definitely some redundancy. One of the disadvantages of Charm for a chiropractic clinic is that the flexibility requires time and effort, and there are no streamlined steps typical chiropractic therapies and procedures like subluxations and physiotherapy modalities.

Accessibility (7.5/10) - We love that Charm EHR is web-based. While there is not an Android or iOS app for the system, it does work fairly well on tablets and smart phones. We found that the website works fairly well on mobile devices, with the exception of the calendar.   Even when you zoom in on a calendar, clicking to make an appointment on a mobile device will almost always put the appointment in the wrong slot, so we really had to be careful about scheduling patients using mobile devices.

Support (6/10) - Support for Charm EHR is really hit and miss. The phone support is very limited, and there is no quality online chat. We did get some help via email, but even that was intermittent. As for new features and bug fixes, those are also rather slow to be implemented. We have been bugging them for 6+ mos to improve their reporting/billing section of the Practice Management portion (see complaints below), but we have seen only minor changes.

Features (7/10) - Charm does pretty well in terms of features, but it is lacking a few major ones. We really like the text messaging system for patients, and we found that we got really good feedback from patients about it – just make sure to always put their number in the “mobile” phone section in demographics. One of our complaints about features is that they don’t have different colors for various appointment types. That means if you have a massage, new patient, existing patient, x-ray appt, etc…, you can’t tell without clicking on the name of the patient. The nice thing about the calendar itself is that you can switch between day/week/month views, and you can drag the duration of an appointment. It would be nice to be able to drag the entire appointment without having to hit “reschedule”, but we understand the limits of web browsers in that case.

Reporting/Financials (4/10) – This section is where Charm really falls behind the pack. Our biggest frustrations come from the reports/financials/billing area of the Practice Management portion of the software. Your Office Manager or Biller will suffer multiple concussions from banging his/her head against the wall in frustration with the billing portion. To start, there is NO LEDGER in this system. That means you have to click line by line at the invoices, and scroll through various tabs to see insurance vs payments at time of service vs supplements, etc…  Click on these screenshots for a better view.

CHARM EHR Screenshots

Compare the cumbersome billing function of Charm (pictured above) with the ledger system in most EHR's, and you will see the potential frustration.  Here is a much cleaner version of a ledger from Future Health EHR:

Of all the EHR systems we’ve tried, this one had the most cumbersome billing/reporting section. For those really interested in customized and accurate reports, we recommend Kareo EHR.   We have made Charm aware of this problem, but have only seen minor improvements to the system in our year of use. For some small clinics this may be an inconsequential consideration, but those trying to optimize clinic performance and productivity might find this to be a deal breaker.

Qualifies for Federal EHR reimbursement: Yes.

ICD-10 Ready? TBD

FINAL ChiroHub SCORE: 6.5/10