Starting a Group Practice? Here's the Tech Stack You Actually Need
You've been solo for a while. You're full. You're ready to bring on another therapist — maybe two. Suddenly you need systems that work for more than one person.
The temptation is to sign up for the most expensive all-in-one platform and hope it covers everything. The better approach is to understand what you actually need and build a lean stack that does each job well.
Here's what a modern group practice tech stack looks like in practice.
Layer 1: EHR and billing (the non-negotiable)
You need a practice management system that handles scheduling, billing, insurance claims, and client records. This is the operational backbone of the practice and the one tool you genuinely can't run without.
SimplePractice is the most popular option for small to mid-size group practices. Solid scheduling, built-in telehealth, decent insurance claim management, and a client portal for intake and scheduling. The group practice plan runs per-clinician.
TherapyNotes is popular with practices that prioritize billing workflow. Stronger on the insurance and claim management side, less polished on the client-facing experience.
Jane App is gaining traction, particularly for practices that also do allied health work. Clean interface, good multi-provider scheduling, and an intake system that clients actually like using.
Any of these will serve a small group practice well. Pick the one that matches your billing workflow and don't overthink it.
Layer 2: Clinical outcome tracking
This is the layer most group practices skip — and the one that differentiates a practice that tracks outcomes from one that guesses at them.
Your EHR handles the business of therapy: who's scheduled, who's been billed, what notes have been written. But it almost certainly doesn't handle the clinical intelligence side: validated assessments with automatic scoring, longitudinal trend tracking, clinical alerts when scores change significantly, or outcome reporting across the practice.
For a solo practice, you can get away with informal outcome tracking. For a group practice, you need a system. Practice-level outcome data tells you how the practice is performing overall. Per-clinician data helps with supervision. Per-client data improves care.
Theracharts was built for this layer. Eighty-nine validated assessments, auto-scoring, client portal for between-session completion, trend charts with severity bands, clinical alerts, AI-assisted session notes, supervision tracking, and practice-wide outcome reporting. It's designed to sit alongside your EHR, not replace it.
Layer 3: Secure communication
You need a way for clinicians in the practice to communicate about clinical matters without using personal text messages or regular email, neither of which is HIPAA-compliant.
Spruce is a popular HIPAA-compliant messaging platform for healthcare teams. It handles internal team messaging, client messaging, and phone/fax in one system.
Google Workspace with a BAA works if you want email and shared drives with HIPAA compliance. Google will sign a BAA for Workspace customers, which covers Gmail, Drive, and Meet.
Microsoft 365 with a BAA is the equivalent option in the Microsoft ecosystem, with the added benefit of Teams for video meetings and chat.
The key requirement is a signed BAA with whatever communication platform you use. Slack, Discord, and consumer email are not HIPAA-compliant and should not be used for any communication involving PHI.
Layer 4: Practice operations
As soon as you have more than one clinician, you need basic operational tooling:
Shared calendar for knowing who's in the office and when. Your EHR's scheduling system handles client appointments, but you may want a shared team calendar for meetings, training days, and office hours.
Bookkeeping. QuickBooks or Wave for tracking practice finances. Once you're paying clinicians (whether employees or contractors), you need proper accounting.
HR and payroll. Gusto is the most common recommendation for small practices. Handles payroll, benefits, contractor payments, and tax filing.
A shared drive for practice policies, procedure manuals, templates, and non-clinical documents. Google Drive or SharePoint with a BAA.
What you don't need (yet)
A custom website with online booking. Your EHR's built-in booking link works fine for now. A polished practice website matters eventually, but it's not blocking you from starting.
A CRM. Until you have a dedicated intake coordinator handling a significant volume of new client inquiries, a CRM is overkill. Your email and EHR handle it.
Marketing automation. Focus on getting your first few clinicians full before investing in marketing infrastructure. Word of mouth, Psychology Today profiles, and your existing referral network are sufficient to start.
Custom analytics dashboards. Your outcome tracking tool and your EHR's built-in reports cover what you need. Custom BI tooling is for later.
The cost reality
Here's what a lean group practice tech stack costs for a 3-clinician practice:
EHR (SimplePractice Essential): ~$60-80/clinician/month. Outcome tracking (Theracharts Practice): $25/seat/month. Secure messaging (Spruce): ~$25-50/month. Bookkeeping (QuickBooks Simple Start): ~$30/month. Payroll (Gusto): ~$40 + $6/person/month.
Total for a 3-person practice: roughly $400-500/month in software costs. That's less than the revenue from two therapy sessions.
Building vs. buying
The temptation with technology is to build custom solutions or cobble together free tools to save money. Resist this when it comes to clinical and compliance-sensitive systems. HIPAA violations have real penalties, and the time you spend maintaining DIY systems is time you're not spending on clinical work or practice development.
Buy the tools that handle compliance-heavy workflows (EHR, clinical tracking, secure communication). Build or DIY the tools where compliance isn't a factor (internal scheduling, team social events, office supply ordering).