How one small practice found big ROI from EHR-PM integration

Sterling Structural Therapy, a five-therapist concierge private practice in Carefree, Arizona, faced a significant challenge: It had no way to grow.


The therapists and the owner lacked a centralized system that would support them in being both efficient and scalable so they could serve as many patients as possible.

“We ran the business on paper for one year, and then used various software solutions for eight years,” said Dana Sterling, founder and owner at Sterling Structural Therapy. 

“I had four remote therapists and two full-time admins, one in the front who was client-facing for scheduling, payments and other administrative functions, and one in the back who was developing all our reports and managing the financials.”

There were pockets of information accessible only to specific staff members, which resulted in compartmentalization of staff responsibilities. Staff needed to centralize and integrate the various components of the practice, Sterling said. 

On a related note, staff had not been leveraging the positive feedback of clients in a meaningful way, which meant they were ignoring one of the most important means to grow business, she added.

“It was time to think about establishing an integrated approach to our clinical and practice management functions,” she said. “I am so grateful we had this insight before COVID-19 hit. By proactively addressing the problems we were experiencing, we were able to better respond to the pandemic.”


So Sterling Structural Therapy turned to electronic health record and practice management systems vendor AdvancedMD to help it address its challenges. The vendor also could help with reputation management, scheduling and data analysis needs.

“I was glad there was no need for multiple vendor engagements,” Sterling noted. “They offered a robust app that would centralize the key functions performed in our daily practice.”

“Using the EHR, I increased my volume of new client assessments by 40%.”

Dana Sterling, Sterling Structural Therapy

The vendor offered customization, including with EHR templates. Sterling Structural Therapy is a specialized practice founded on a unique model. It needed software that would enable staff to run how they wanted to run; they did not want to be made to fit into some rigid template designed for a specialty of another discipline, size or approach.

“We wanted to attach patient progress photos in the EHR, make notes about specific payment structures and track tasks relating to client care so we never missed a step,” Sterling explained. 

“AdvancedMD could provide us with all of that, and the foundation to run a really tight business on solid data and processes. I believed their technology could help take our practice to the next level, and I was correct.”


So Sterling Structural Therapy migrated all of its data over to AdvancedMD and trained on the software, including the EHR, reputation management, scheduling, and reporting and analytics with AdvancedInsight.

“The vendor’s platform enables cloud-based functionality that ties with all of our practice management processes, including billing and scheduling,” Sterling said. “It all works together seamlessly, which is a huge win for our remote-based therapists and scheduler. Our therapists use the AdvancedMD mobile app, which integrates the EHR and practice management systems, almost exclusively.”

Staff need to be hands-on even though they work remotely, so they use two iPads side by side to conduct the visits. Sterling said staff members “live and breathe on this app” and she’s seen a 40% uptick in the number of clients the practice can see because of the charting efficiencies of the app.

“On the administrative side, AdvancedInsight made my job much, much easier,” she said. “For example, a report that generates how much time each of my therapists is working is tremendously helpful for billing purposes. The technology made that process so simple, I can delegate it to someone else as I scale the practice.”

The analytics component also generates payment reports within custom time periods, which helps Sterling reconcile and update client packages and referrals.

“Many of our clients are pre-pay, which means I need software that can guarantee accuracy of the balances,” she said. “AdvancedMD allows me to integrate practice management functions with the analytics side, so auditing in this regard became simple.”

The reputation-management software has also proven useful. Clients frequently would tell the therapists or the scheduler about the good results they were experiencing, but staff had no way to capture or quantify that feedback.

“AdvancedMD provides a simple link that we can send to clients and prompt them to post a star rating to Facebook or Google, right when it’s top of mind,” Sterling explained. “Instead of automating it and inundating clients, we simply send them a link when they initiate feedback. We’ve seen very positive results.”


Using AdvancedInsight, Sterling Structural Therapy was able to cut administrative overhead in half. On top of the automated reporting, Sterling was able to see redundancies in the business, which helped her do more with less.

“Using the EHR, I increased my volume of new client assessments by 40%,” she reported. “Using virtual technology along with the EHR, I’ve been able to chart while I’m seeing the patient. Custom templates, memos and photo attachment options helped achieve this level of efficiency. While I used to block two hours of time for new clients, I can now do an assessment in 75 minutes or less, including charting.”

Further, Sterling Structural Therapy has achieved 5-star ratings on both Google and Facebook by using the online reputation-management tool. Previously, the practice collected little anecdotal feedback and was unable to translate it into reviews. Now reviews support the business, she added.

“Overall, I’m serving more people in need while running a solid and profitable business,” she said. “That allows us to be of service to our clients and truly be able to deliver the life-changing results that people seek when they come to see us.”


It’s important to invest in the right reporting and analytics tools for a practice so one can understand the big picture and eliminate redundancies, Sterling advised.

“Too often, we get caught up in daily operations and don’t make the effort to dig deeper into the data for real insight,” she said. “If you don’t have the time or commitment to do so, find a technology that does it for you. You may actually be able to do more with less manpower or use the manpower you have to increase your patient volume.

“No matter how busy you are, don’t neglect reputation management,” she continued. “I essentially did that for almost nine years. I didn’t realize there were simple solutions I could put into place to work for me. The key is keeping it simple: Make the process timely and direct – without too many options – so you are not asking too much of your clients or staff. We’ve found that small efforts in reputation management result in significant gains.”

Finally, it took Sterling a few years to come to terms with it, but unresolved business challenges simply were not going to be rectified without an automated, integrated approach to the EHR and practice management, she said.

“Consider the overhead for operating and integrating with different vendors to manage records, scheduling, billing and so on,” she concluded. “Scalable, customizable, integrated technology will enable you to practice your way and more efficiently.”

Twitter: @SiwickiHealthIT
Email the writer: [email protected]
Healthcare IT News is a HIMSS Media publication.

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