Best EHR for Telehealth-First Practices

Telehealth-first practices — including therapists, psychologists, psychiatrists, dietitians, physical therapists, and primary care physicians — operate differently from traditional in-person practices. Their EHR infrastructure needs to match the distributed, digital nature of their care delivery. Based on the primary workflow needs of this persona, the following capabilities are operationally essential:

• Video conferencing is the core delivery mechanism for telehealth-first practices — and the right question is not just whether a platform has video, but whether the video experience is reliable enough to be the face of a clinical practice. Some platforms offer native video; others integrate with Zoom, which is purpose-built for video and maintains its own HIPAA BAA. What matters is that the video workflow is embedded in the clinical record so session notes, forms, and billing are linked to the same encounter, regardless of which video layer powers the call.
• Digital intake and consent forms allow providers to complete administrative requirements before a patient's first session, reducing no-shows and eliminating the paper workflows that have no place in a virtual-first setting.
• Secure patient messaging enables asynchronous clinical communication between sessions — essential for care coordination, between-visit check-ins, and reducing the volume of phone calls that fall through the cracks in high-volume telehealth practices.
• Automated reminders are critical for reducing no-show rates; without automated outreach, administrative staff must manually contact patients before every appointment.
• Insurance eligibility verification protects revenue by confirming patient coverage before a session occurs — a gap here directly results in claim denials and write-offs that accumulate quickly in multi-provider telehealth practices.
• E-prescribing is non-negotiable for psychiatrists, primary care physicians, and any prescribing provider operating virtually — the absence of native or integrated e-prescribing forces workarounds that slow clinical workflow and create documentation risk.
• E-labs allow providers to order and receive lab results within the clinical workflow — increasingly important for PCPs and psychiatrists managing medication and chronic care remotely.
• Multi-state provider coordination is a structural requirement for telehealth organizations operating across state lines, where providers may hold licenses in multiple jurisdictions and patients may cross state boundaries — the EHR must support multi-state scheduling and documentation without manual workarounds.

Telehealth-first practices evaluating EHR platforms should apply the following criteria. The criteria that matter most will shift based on practice size and billing model, but all of them should be assessed before committing to a platform.

1. Telehealth - Ask whether the platform supports both individual and group video sessions natively, or whether group telehealth requires an add-on or a third-party integration. Verify that video is built into the clinical record so session notes, forms, and billing are linked to the same encounter.
2. Mobile app - Confirm whether iOS and Android apps are available for both providers and clients. A browser-based mobile experience is not equivalent to a native app — evaluate whether the mobile experience will work for the providers and clients in your practice.
3. Intake and consent forms - Ask whether forms are fully configurable or templated only, and whether completed forms flow automatically into the patient record. Practices with multiple provider types may need different intake workflows for different specialties.
4. Client portal - Evaluate whether the portal supports self-scheduling, form completion, messaging, and record access without staff involvement. The stronger the portal, the lower the administrative burden per patient, which compounds quickly in growing practices.
5. E-prescribing - For any practice with prescribing providers, confirm whether e-prescribing is native, an add-on, or dependent on a third-party integration — and what the cost and setup timeline are. Practices with psychiatrists or PCPs cannot defer this assessment.
6. Insurance billing - Determine whether the platform supports CMS-1500 claims, ERA/EOB reconciliation, and real-time eligibility verification. Practices billing multiple payers or managing billing across multiple providers need to confirm that these workflows are handled in-platform, not exported to a separate tool.
7. Workflow automation - Ask what can be automated: intake form delivery, reminder sequences, follow-up messages, and care plan triggers. Automation matters more as practice volume grows — assess this based on where the practice will be in 18–24 months, not just today.
8. AI scribe tool - Evaluate whether the platform includes AI-assisted documentation, what the cost model is (included vs. per-session add-on), and whether it works in the telehealth session context.
9. BAA available - Confirm that the platform provides a signed Business Associate Agreement. This is non-negotiable for HIPAA compliance and disqualifies any platform that does not offer one.
10. Compliance certifications - Review which certifications the platform holds (HIPAA, SOC 2, HITRUST, GDPR). Multi-state and enterprise telehealth organizations may have procurement requirements that go beyond HIPAA — verify before committing.
11. Per-clinician pricing - Model the total cost at current team size and at 12- and 24-month projected headcount. Per-clinician pricing structures compound quickly in growing practices; understand what triggers the next pricing tier.
12. Support - Assess what support is available during implementation and on an ongoing basis — live chat, email, video, or dedicated onboarding. Support quality is one of the most reliable predictors of time-to-value when switching platforms.

Solo

Primary recommendation: Healthie or SimplePractice — depends on growth plans and workflow complexity.

Solo therapists, dietitians, and other telehealth providers evaluating EHRs typically find SimplePractice is the dominant platform in this segment — it offers the fastest onboarding, clean note templates, free credentialing support at sign-up, and a 30-day free trial. It is well-suited to solo providers with consistent, single-payer billing and no near-term plans to add providers or run group sessions.

Healthie is the right choice for solo providers who expect to add providers within 12–18 months, run group telehealth sessions, or need workflow automation, programs, and integrations built-in without layering additional tools. The upfront configuration investment is higher, but the platform is also competitively priced and does not require a re-migration when those needs emerge.

Practice Better is a strong option specifically for solo nutrition and health coaching practices that need program delivery and asynchronous content — its free Sprout plan (up to 3 clients) and fast setup make it accessible for new practitioners. Jane App is worth evaluating for solo providers who value multi-location flexibility, native outcome measures on all plans, and unlimited live support without a premium tier.

Small Group (2–5 providers)

Primary recommendation: Healthie, SimplePractice or Practice Better — depends on billing complexity and role needs.

Small telehealth groups evaluating platforms typically find that the right answer depends on billing complexity and role needs. Practices with two to three providers using the same billing model, the same documentation templates, and no group sessions can be managed in SimplePractice or Practice Better without significant friction.

Practices billing insurance across multiple providers, running group telehealth sessions, or needing differentiated staff access — separate permissions for billing staff, providers, and administrators — typically find that Healthie's multi-tier role permissions, native group charting, and multi-provider scheduling infrastructure are a better fit for these workflows.

Jane App is a credible option for small, multi-specialty groups that value multi-location scheduling and strong built-in support, but practices that need e-prescribing should note that Jane does not offer native Rx e-prescribing.

Scaling (6–10+ providers)

Primary recommendation: Healthie for telehealth organizations that need group charting, high configurability, third-party integrations, org-level reporting and white-label configuration.

Telehealth organizations scaling past five providers consistently encounter a set of infrastructure requirements that most EHR platforms in this category are not designed to meet: group charting that generates individual client records and claims from a single session, high configurability, third-party integrations, org-level reporting across providers and service lines, and white-label configuration for enterprise or franchise deployments.

Healthie's high configurability enables custom integrations that scaling digital health organizations typically require (the API is an add-on on the Group and Enterprise plans).

Jane App supports unlimited practitioners and unlimited locations, making it a viable alternative for multi-provider groups that do not need group charting or high configurability — but its limited workflow automation engine is a meaningful constraint for high-volume telehealth operations.

The telehealth-first persona operates across both insurance-based and cash-pay billing models, and the right platform depends partly on which model dominates the practice's revenue.

• Cash-pay practices have more flexibility in platform selection — all four platforms support cash-pay workflows including packages, memberships, and direct client invoicing. Practice Better and Jane App are particularly well-optimized for cash-pay wellness and coaching models, with clear package and program delivery workflows. SimplePractice also handles cash-pay efficiently for solo and small practices.
• Insurance-based practices need to assess billing depth carefully. Healthie supports CMS-1500, superbills, and ERA/EOB reconciliation via partner integrations, and is well-suited to practices billing multiple payers across multiple providers. SimplePractice supports standard insurance workflows adequately for smaller practices with consistent, single-payer models, but its reporting and multi-provider billing infrastructure is limited relative to Healthie. Practice Better integrates with Claim.MD for ERA/EOB tracking, making it a viable insurance billing option for smaller groups — though its reporting depth is basic. Jane App charges an additional $20/month for insurance billing (Practice and Thrive plans), which adds up in multi-provider settings; it is not available on the Balance (solo) plan.
• Hybrid models — billing both insurance and cash-pay across multiple providers and specialties — are best served by Healthie, which supports both billing models within the same multi-provider infrastructure without requiring separate tools or manual reconciliation workflows.

Healthie — Low/Moderate

Practices can go live quickly using Healthie's out-of-the-box configuration, or invest in a more tailored setup built around their specific workflows — establishing role-based permissions, configuring appointment types and specialty-specific templates, connecting billing integrations, and building out reporting structures. For practices with multiple provider types, complex billing workflows, or multi-specialty coordination needs, this configuration investment pays off — but practices should plan for a 2–4 week setup timeline and actively use Healthie's onboarding support, which is included on the Group plan. Assisted data migration from a prior EHR is available with onboarding support.

SimplePractice — Low

SimplePractice is the fastest to launch in this category. It is designed for individual providers and small teams, with templated workflows that require minimal configuration. Free credentialing support is included at sign-up, and data migration from a prior EHR is supported. The trade-off is limited configurability — practices with non-standard workflows will encounter constraints quickly.

Practice Better — Low

Practice Better is designed for setup in 30 minutes or less, and a Migration Concierge Service provides HIPAA-compliant assisted transfer from prior EHRs with one-on-one setup guidance. Its free Sprout plan (up to 3 clients) and 14-day trial on most paid plans (30 days on Team plan) lower the barrier to evaluation. Team plan configuration — custom roles, multi-provider management — adds some complexity at scale.

Jane App — Low

Jane includes free data import, a dedicated import team on all plans, with no additional cost. Setup is straightforward and the platform promotes a guided switch process.