A college IT administrator tells you that your client files are using too much storage space. You are running a speech and hearing clinic inside a medical sciences university, serving dozens of families a semester, training two dozen students, and trying to keep every record private and every piece of student feedback flowing. Something has to give. For the in-house clinic at the University of Arkansas for Medical Sciences in Little Rock, that moment was the push to find a real system.
The Challenge
The clinic is small by design. A cohort of 24 students spends five to seven hours a week in the clinic, serving somewhere between 65 and 75 clients each semester. The caseload runs from pediatric groups and individual sessions to adult services like a stroke aphasia group. It is a non-billing clinic that charges a registration fee each semester, which makes it a little different from most practices.
It is also a teaching clinic, and that raised the stakes on documentation. Students needed to write notes and reports, and supervisors needed to give feedback fast.
For years, the answer was paper. "We were trying to get away from paper because paper is so portable," says Shana, the clinic's Clinical Education Director. Portable meant insecure, and insecure was a problem.
The clinic moved to Microsoft SharePoint next, building client files inside the system the college already had. That worked for a while, until it didn't. "It was when storage was an issue," Shana recalls. "Our administrators of our college were like, you're using up too much storage space."
Storage was only part of it. There were HIPAA and privacy obligations to meet, and a feedback process that still ran on paper even after the files went digital. "In the olden days, they would print it out," Shana says. "We'd sign it, give them feedback, put it in their box physically." For a clinic whose whole purpose is training students, a feedback loop that depended on printers and physical mailboxes was not going to scale.
Finding ClinicNote
The first exposure came at the CAPCSD conference in San Diego. Shana and the clinic director at the time attended, heard founder Lana Fox speak, and started asking around.
"We heard her speak, and she provided demos, and we talked to other universities who were using ClinicNote," Shana says. "And we were like, oh my gosh, this may be the answer to really help our students."
What followed was a round of remote demos, which in those days felt like new territory. "We were able to have some demos in these weird teleconference calls that we did over the computer, and it was a big deal," she says. "Where we could meet remotely and get a demo. Back then." The clinic selected ClinicNote in the late spring or early summer of 2019.
Implementation and Onboarding
The clinic started using ClinicNote in the fall of 2019, which turned out to be fortunate timing. COVID-19 was a few months away.
Training leaned heavily on ClinicNote's tutorial videos, and they did the job. "I feel like ClinicNote has always been really effective in their training videos," Shana says. "Those tutorials were always really helpful, and they're quick." Because the clinic brings in new students every year, quick and repeatable mattered. The main things the team had to reinforce were practical habits, like using Chrome as the browser and following secure internet practices.
The learning curve tracked with age more than anything else. "Maybe the older faculty had a harder time," Shana says. "But then they retire, and we get the younger faculty who are used to EMR systems maybe before they come into academia." She estimates it took a good semester for the team to feel fully comfortable.
Then COVID hit, and the timeline compressed. "We had to get really good at it during COVID," she says. "It really helped save us, because we transitioned to some online teletherapy services. We had to evolve and change faster because of that."
The Results
Printing and formatting that finally cooperate. The clinic prints a lot of material for clients and caregivers, and the system caught up to that need. "We've seen better functions as far as being able to print in a print preview and then make adjustments to allow for spacing," Shana says.
Documents that act like an EMR, not a word processor. Building charts inside reports used to be a struggle for students. A new snippets feature, rolling out by mid-July, is set to change that by turning the clinic's template bank into reusable, automated pieces. "It's gone from something that was more primitive of a word processing document to things that are able to automate and make it more like an EMR system that our students will see out in our community, with dropdowns," she says. "It's really come a long way."
A patient portal that fits real families. For caregivers with more than one child in the clinic, the portal reshaped the paperwork experience. The clinic can now share full reports, not just forms. "Being able to share reports in the portal" makes it easier for families to access their records electronically, Shana says, "and it's a more secure way, so the HIPAA risk is less on us, too."
Faster, more secure communication with clients. Transmitting information electronically replaced the slower, riskier paper handoffs. "It's improved that communication with our clients, just with being able to transmit some of that information electronically, and faster," she says.
Document recovery the team can trust. Early on, a blank document could mean lost work, and that cost the product some trust. The recovery process has since matured. "When a document goes blank, we can click a button, and it's like a last saved version of it," Shana says. "We aren't losing an entire document anymore. I can't remember the last time we've had to put in a ticket for that."
Looking Ahead
Seven years in, the relationship still feels personal to Shana, even as the company has grown. "Even though it's grown, it still feels like a small company, and people are always accessible," she says. "Anna's role has changed, but it still feels like we can reach out, and their response time to dealing with issues has always been great."
She is watching the next round of updates with anticipation rather than apprehension, which says something about how far the trust has come since 2019. "I'm excited about the new updates," she says. "I'll be excited to see how we evolve and use these new features."
For a clinic that started on paper, moved to a SharePoint workaround, and got told it was using too much storage, the destination is a system the students will recognize when they leave for the field, and one the faculty no longer have to fight.
About the University of Arkansas for Medical Sciences Speech and Hearing Clinic
Based in Little Rock, the in-house clinic at the University of Arkansas for Medical Sciences trains a cohort of 24 graduate students while serving 65 to 75 clients each semester. Its caseload spans pediatric groups, individual pediatric and adult sessions, and adult services including a stroke aphasia group. As a non-billing teaching clinic, it charges a per-semester registration fee rather than billing for services.
"This may be the answer to really help our students. It's really come a long way, and it still feels like a small company where people are always accessible."
— Shana, Clinical Education Director, University of Arkansas for Medical Sciences