From Sticky Notes to Systems: Migrating Legacy Processes Into Your EHR

If you are a therapist who owns your own private practice, chances are your systems grew the same way your caseload did. One form here. A spreadsheet there. Sticky notes on your desk. Maybe a checklist in your head that only you know how to run. This works, until it doesn't.

We often hear from clinicians who are juggling insurance panels, documentation requirements, scheduling, and billing while also holding clinical work with care. The administrative load can quietly start to erode your energy and your confidence, especially if you are preparing for full licensure or trying to stabilize your income.

Migrating legacy processes into an EHR like Simple Practice is less about becoming tech savvy and more about building a system that supports your clinical work and your autonomy. The following outlines a practical, therapist-tested approach.

What Counts as a “Legacy Process”

Before opening your EHR and clicking around, it helps to name what you are actually migrating. Common legacy processes we see for therapists include:

• Paper or scanned intake forms
• Note templates saved as Word docs
• Manual insurance tracking spreadsheets
• Calendar reminders for authorizations or treatment plan updates
• Payment notes written on paper or in email drafts
• A mental checklist for what happens when a new client contacts you

None of these means you are doing it wrong. They usually mean your practice evolved faster than your systems did.

Step 1: Map Your Current Workflow First

Before setting anything up in Simple Practice or another EHR, pause and map how things actually work right now. Grab a piece of paper or a blank document and walk through:

• What happens from the first inquiry to the first session
• What you do after each session
• How you track insurance, claims, and follow-ups
• How and when you get paid

This step matters. If you skip it, you risk recreating clutter inside your EHR instead of reducing it.
Tip for therapists accepting insurance: Make a note of where you verify benefits, track authorizations, and follow up on unpaid claims. These steps often live outside the EHR at first and need intentional integration.

Step 2: Decide What Belongs in Your EHR and What Does Not

Your EHR should be the home for clinical and billing workflows, but it does not need to hold everything. In Simple Practice, most therapists benefit from keeping:

• Intakes, consents, and clinical documents
• Progress notes and treatment plans
• Scheduling and reminders
• Insurance information and claims data
• Client invoices and payments

You may still choose external tools for things like general accounting, personal task management, or team communication. At Coastline Counseling Association, we often help members decide what to migrate fully versus and what to link loosely so the system stays usable and not overwhelming.

Step 3: Standardize Before You Automate

This is where many therapists get stuck. If every note is structured differently, every intake asks different questions, or every insurance workflow lives in someone’s memory, then automation will only amplify the chaos. Before turning on features, take time to:

• Create one to two solid note templates that meet insurance and WA documentation standards
• Standardize your intake packet
• Define a consistent process for insurance claims and follow-ups
• Clarify who does what if you work with a biller or support team

This step makes insurance credentialing, audits, and transitions to independence much smoother.

Step 4: Migrate in Phases, not all at Once

You do not need a single “switch flip” day. A phased approach often looks like:

• New clients start fully in the EHR
• Active clients are migrated at their next session or treatment plan update
• Closed charts are scanned or summarized as needed for retention

Be mindful of record retention requirements and encourage clients to complete new digital forms rather than trying to recreate old paperwork perfectly. This is also a good moment to review compliance basics and confirm details with your licensure board and payers.

Step 5: Build Insurance Workflows That Reduce Mental Load

Insurance is often where sticky notes multiply. Inside an EHR, your goal is to externalize what you currently track in your head:

• Panel status and effective dates
• Authorization start and end dates
• Claim submission and payment status
• Follow-up timelines

Many therapists choose to pair Simple Practice with full billing services, so they are not spending evenings chasing claims. At CCA, members work with a dedicated biller while retaining full ownership of their practice and payer contracts.

Step 6: Expect Discomfort and Plan Support

System changes are stressful, even when they are helpful. It is normal to feel slower at first or to worry you are “doing it wrong.” This is where community and consultation matter. Consultation groups, peer support, and founder check-ins can help you check what is required versus what is optional. They also prevent overbuilding systems that do not actually support your clinical values.

 Bringing It All Together

Migrating from sticky notes to systems is not about perfection. It is about reclaiming mental space and building a practice that can grow without burning you out. Concrete next steps include:

• Map your current workflow this week
• Identify one legacy process to migrate first
• Standardize a single template before adding features
• Reach out for support instead of doing it alone

If you are starting a private practice in Washington or streamlining an existing one, you do not have to figure this out in isolation.
Ready to build a supported, independent practice in Washington? Apply to join Coastline Counseling Association or contact us with questions.