If you've ever asked in a Facebook group which EHR to use, you already know what happens next. Twenty replies roll in, half of them contradict each other, and none of them ask the most important question: where is your practice right now?

There's no single best EHR. There's only the right fit for your stage, and the stage you're in today probably isn't the stage you'll be in two years from now. Choosing (or switching) without that context is how practices end up paying for enterprise features they don't need, or outgrowing a system six months after signing a contract.

The Real Question Isn't "Which EHR"

Every practice sits somewhere on a spectrum: from a solo caseload run out of Google Drive, to a multi-location clinic managing several disciplines. What you need from a system changes at each point along that spectrum. You have to consider the price, billing complexity, user permissions, reporting, and what it costs you to switch later.

Here's a four-tier way to think about it.

Just Starting Out

If you're solo and low-volume, you don't need a full EHR yet. You need something HIPAA-compliant and simple enough that setup doesn't eat a week of your time.

Google Workspace, on a paid plan with a signed Business Associate Agreement, can be enough at this stage: Gmail, Drive, and Calendar covered under HIPAA, at a fraction of the cost of dedicated software. The tradeoff: you're building your own system from scratch, with no billing automation and no clinical documentation structure built in. We cover this in section 5 of our Demystifying HIPAA course. You can also read our blog post on Demystifying HIPAA.

Solo or Small Group, Ready to Formalize

Once you're managing documentation, insurance billing, or a second provider, a dedicated platform starts to earn its cost. 

Ambiki is one option clinicians in our community have pointed to, built specifically for pediatric SLPs, OTs, and PTs, with documentation and billing designed around how therapy practices work, not retrofitted from a generic medical record system.

Multi-Clinician, Single Location

As you add providers, the questions change: Can everyone see what they need to, and nothing more? Can you run reports across the whole team, not just one chart at a time?

WebPT is a familiar name here. It was built originally for PT and now supporting PT/OT/SLP practices with multiple clinicians under one roof, with strong billing and outcomes tracking built in.

Multi-Location or Multi-Discipline

At enterprise scale, the priority shifts again: consistency across sites, role-based administration, and reporting that rolls up cleanly no matter how many locations or disciplines you're running.

Raintree is built for exactly this — supporting PT, OT, SLP, and ABA under one system across multiple locations. There’s a tradeoff though: a steeper learning curve, custom pricing, and an implementation timeline that can run several months. Worth it at this scale; overkill below it.

What to Ask Before You Choose (or Switch)

Regardless of which tier you're in, a few questions apply across the board:

• Practice size and complexity: Are you solo, or do you have multiple providers? Will this scale with you over the next 1–3 years, or just solve today's problem?

• Billing needs: Insurance, private pay, or both?

• Who built it: Was it designed by clinicians in your field, or adapted from another industry?

• Cost, fully accounted for: What's the actual price per provider, and what does switching cost beyond the subscription — data migration, setup, staff training time?

• Integrations: Does it connect with (or include) scheduling, telehealth, and payment tools, or does everything live separately?

There are more questions than this, as always. What matters most depends on where your practice is right now and where you want it to go.

Want to Go Deeper?

These four examples are a starting point. There are more named options at every tier, and the right fit depends on details specific to your practice.

We're covering the full landscape live, with a hands-on self-assessment worksheet, at the October Private Practice Collective: Finding Your EHR Fit. It's a working session where you'll leave with a sense of which EHR to consider for your practice needs and what to look for next.

Your Next Steps

• Register for the October Private Practice Collective

• Join the free Private Practice Discussion Group for ongoing conversation on topics like this one

• Not ready to register yet? Bookmark this post and revisit it when you're closer to deciding