006 Transcript

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Hello everybody. This is Dr. Jeremy Sharp. This is The Testing Psychologist Podcast, episode 6.

Hello, again. Welcome to The Testing Psychologist Podcast. I’m Dr. Jeremy Sharp. I hope y’all are doing well. Things are looking good here in Fort Collins. We’ve had two days of really sunny weather. It’s actually been a little warmer than usual. The downside of that is in Colorado when it gets warm, it usually means that there is a pretty strong wind as well, especially in the winter. So, we were outside. Finally got our kids out yesterday to burn off some energy, but had to brave the wind while we were doing so. Either way, I will take it.

We’re going to be talking today about technology. Anybody who knows me can probably name, I don’t know, 2 or 3 things that I am pretty interested in. One is running. If I haven’t talked about running yet, I definitely will at many points in the future. The other is technology. I love technology. I’ve always loved technology and researching technology and figuring out how it can be useful and where to integrate it in my life and that kind of thing. So that definitely translates well over to testing.

When I was in grad school, I was the assistant director of our department clinic or community clinic. And back then even I was so interested in technology. Oh, gosh, like a lot of grad programs, we had to videotape our sessions and play them back for supervision. It was, I think my 3rd or 4th year in grad school, and I was like, what in the world are we doing? We were still using the VHS tapes.  So, I’m proud to say that my legacy from being in grad school here at CSU was transitioning our clinic from VHS to internet recording and live streaming video. So, I love technology for a long time.

Technology is important here in reports and testing because there are a lot of really cool tools out there that make testing a lot easier and a lot more convenient. And so, we’re going to be talking about a few different things.

I’m going to talk about EHR systems and how those can be helpful. I’m going to talk about report writing software. I’m going to talk about some individual tools to help you when you’re writing your reports and making your tables, dictation software, grammar, proofreading software, and things like that. And we’ll also talk a little bit about digital record storage, and how to go paperless. I will spend a little bit of time also on Q-interactive, which is a cool thing. If you haven’t seen it, Q-interactive is an iPad-based interface that has come out over the last few years that allows you to administer and score tests on the iPads. So we’ll talk a little bit about that as well.

Let’s dive into things. I’m going to start just by talking a little bit about EHR and how that can be helpful for you. EHR stands for Electronic Health Record. Now, there’s a lot we can get into in terms of how to evaluate an EHR. I think that’s beyond the scope of this podcast, but I will say there are some really cool resources for evaluating EHR systems over at Person Centered Tech. We will have a link to that in the show notes. But for our purposes here, I’m just going to talk generally about how an EHR can be really helpful for you, even for testing-based practices.

When I was first starting out, again, I love technology, so I was looking for an EHR pretty quickly. I ended up settling on TherapyNotes. TherapyNotes is one of the more popular EHR systems. We’ll definitely include a link to that in the show notes. The reason that I went with TherapyNotes is because they had some, what I consider pretty cool features specifically for testing folks right out of the gate.

One thing that I really liked is that their note template for psychological testing was really comprehensive. It breaks it down by domain of test and makes you enter the amount of time that you spent on that particular test, makes you enter the amount of time that you spent on your report writing, and it totals that all up for you. So, when you look at the interface, it has intelligence tests, academic tests, neuropsychological tests, other measures things like that.

So you can enter every test that you do and really account for the time that you spend, which is pretty important if you’re billing insurance. I’ve gotten requests from insurance companies to look at the records and in some cases that’s appropriate. They really benefit from having documentation of how much time you spent on each measure. So that’s why I like TherapyNotes. Back then, I was also doing a group and they had a really clear functionality for group therapy. So that drew me to them as well.

Now, Simple Practice is another EHR option. I think it’s really popular. You can do your research. And, of course, there are many others out there too. I don’t mean to say it’s just those two. You can do your research. A great site to research EHR systems for mental health is Capterra. Again, I’ll have a link there in the show notes where you can check it out and read all the reviews for all these different software options, and try to get a good idea of what would work best for you.

The general reasons I like an EHR: One, I think it helps a lot with billing insurance again, because it helps you document your time, and that can be really important. Also, it just streamlines the billing process in terms of sending statements, and scheduling your testing.

I use mine to do credit card processing as well. I think this is pretty important with testing. I think a lot of us have hopefully a pretty well-defined cancellation policy. And so, having the credit card stored right there in TherapyNotes lets me charge that credit card if there’s a no-show or a cancellation and it just happens smoothly like that. That makes things easier. You don’t have to chase people down and collect late fees or cancellation fees.

So those are some of the benefits. Just as you consider an EHR system, again, you can do your own research and figure out what works best for you. But I do know that there is a Promo code for TherapyNotes if you choose to go that route.

Now, when we get into the actual report writing, I think this is the place that a lot of us would love to have technology working for us. So there are a lot of options here. There are some options out there, certainly that I would call a full report writing software where often there is, I would just say a pretty thorough, comprehensive setup period where you communicate with the software designers and they tailor your report template to your practice. And once you get all the details input into the report writing software and into the program, then it serves as a master template where you then can go in and input the information that you collect during the testing process.

The ones that I’ve demoed, and I’ll be honest, I don’t use a full report writing software system at this point, but I’ve demoed a few, the ones that I see, they are pretty comprehensive, but they require quite a bit of work on the front. If any of you have experience with others, I would love to hear about that, but the ones that I’ve seen so far, one is called The Psych Writer. A lot of folks that I’ve run into use the Meyers system. There’s one called InsightFill, and one called Psych Screen.

So there are a lot of options out there. Again, I’ll have links to those in the show notes for you to check it out yourself. But the general idea is that you purchase software. Often there is a bulk purchasing option where you pay by the report, but have to buy in bulk. So you might buy like a batch of 20 or 50 reports. They work with you on the front end to set up all the variables, all the information that you like to have in your report, and then they custom build a master template for you.

So then, once you’re done with the testing or with your interview or with your feedback, whatever it might be, you go in and there is usually some variety of dropdown menus where all you have to do is click check boxes or choose options from drop-downs right there in the software, and then once you have done all that and input all the data that you have, there’s a master button at the end where you hit submit, and then it generates this beautifully written report that has all of your information in it. And it looks like a report that you wrote from scratch. 

So, if that appeals to you, like I said, definitely check those out and do some research and see if that would be an appropriate option for you.

Now, I did not go that route. I think ultimately when I really put in the energy to research some of these, which was let’s say two years ago, maybe a year ago, I just found that they weren’t quite flexible enough for me with the templated nature. Like I said, it just wasn’t quite flexible enough. I didn’t feel like I had quite enough control over it. And it’s in my experience, not one of those things that I could just go in and change on the fly because they had coded the software already. That may have changed.  But that’s why I stayed away originally.

Now, what I do at this point is I write my reports right now in Microsoft Word, and I use a combination of tools available, both within word and outside of word to really help me with that. I think like a lot of us, I have put together a report template that has all the main elements. I also have templates for recommendations and those can be just inserted into the report as needed.

One of the most helpful tools that I have used is basically an auto-correct option or a text expander option. What these do at the base level is let you type in a very short snippet of text and then that expands into a much longer detailed piece of text. For example, a phrase that I use a lot in my report is a summary of the type of evaluation. So a sentence that says something like, this full neuropsychological evaluation was aimed at providing appropriate diagnoses and treatment recommendations for so-and-so. So, instead of typing that sentence out every single time in every report, I created a little auto expander where if I type :fulleval, it automatically auto-corrects to that full sentence.

You can do this right in Microsoft. If you’re in the word window, you can go up to the tools option, and there should be an auto-correct choice on that menu. And if you click auto correct, then I think it’s pretty self-explanatory. There are two windows where it says, replace blank with blank and you just fill those in. That can really shorten the writing time, especially if you have like I said, sentences that you write over and over and over.

Now, I’d say the next step up from that is using software that allows you to do a hybrid between a full report writing software and just a simple auto-correct. So one piece of software that works really well for that is something called TextExpander. This has been around for a long time primarily for the Mac, but they’ve also expanded to windows. There are some other options too, but TextExpander is really, I think probably the most well-known version of this.

What that does is it basically allows you to create what they call snippets. Snippets are basically those short versions of text that act as shortcuts to create longer versions. Now, the cool thing about TextExpander is that it allows you to actually create your own templates. That’s why I said it’s a hybrid with the report writing software that I talked about earlier.

So with TextExpander, you can create longer snippets. You can also create bigger paragraphs. You can create dropdown menus and checkboxes. And if you want, there are two different ways that you can program it to output. The default output is that it just generates a text file which looks fine. It’s totally fine. You can do bold and formatting in italics and headings and that kind of thing, but if you’re willing to put in a fair amount of work on the front end, you can also have it generate a file that will open in Microsoft word. And that can be really helpful. Like I said, it takes a little bit more work on the front end, but definitely doable.

So, you have two options just for text. And those have been super helpful for me. That cuts out a lot of time, especially with those phrases and paragraphs that you just type over and over and over. 

I’ll be honest. I still haven’t been able to get comfortable with any sort of templated interpretation. It seems like my interpretations end up fairly personalized and fairly unique for each client. Even if I’m discussing the same presenting concerns or diagnostic impressions, I always end up writing them just slightly different based on the client. So that part is fairly immune to shortcuts, at least for me, but that might be different for you.

Now, some other pretty simple software options. A lot of people use Excel to make a table formatter where you can input the scores and write a little bit of, I guess you’d call it code in Excel where it transfers and converts the scores to standard scores and maybe percentiles and ranges. There are a lot of options out there. I think it’s fairly easy to do on your own as well, but if you are looking for one, I’ll have a link in the show notes to another psychologist out there, Joel Schneider. He has actually several self-made tools that can help with report writing. His a table formatter is just an option you can look at as an example of how to do that. So again, just another piece of software that can help eliminate a little time for you.

Now, a lot of folks also use dictation software. I imagine you probably heard of this. There are a few options for dictating. It’s actually gotten a lot easier over the years. It used to be that you had to use a pretty formal piece of software, like Dragon. Dragon has an option for medical terminology that could really help, especially if you’re in a hospital setting, or if you just happen to use a lot of medical terminology in your reports, there is a medical module that would probably help a lot with that.

Now, if you have a Mac and I’ll be honest, it’s just going to come up over and over and over. I’m highly biased toward Mac. I love Mac. That presents a little bit of trouble with scoring software. Sometimes it is only for windows. We do have a PC in the office, but I prefer Mac for pretty much everything I do personally.

With Mac, there is built-in dictation in your in your system settings. So if you go to system settings, you should just be able to search dictation or speech, it will come up and you can turn that on. It’s pretty good. Definitely helps if you have a microphone, but yeah, that’s an option. It’s a free option and it works fairly well. Some folks I know will use a smartphone to record and then dictate their interviews. There are quite a few options for dictation software as well.

Now, if you want to take it to the next level, there are two tools out there that can transcribe. Is that the right word? Convert your dictated speech into searchable text, or even convert your handwriting into searchable text. Smart Pens are an option there. So if you’re in your interview, if you still like to take handwritten notes like I do, you can take your handwritten notes with a Smart Pen.

This is paper and pen system that often will have a voice recorder in the pen, and then you use paper that has, I think has microchips in it. That sounds like magic as far as I’m concerned, but you take the notes with the pen, it goes onto the special paper, and then you can transfer that via the computer to software on your computer. And it will convert that to searchable notes. And it will also allow you to record what was being said in the interview and sync that with the notes you are taking right at that point in time. So you can go back and tap on the microchip paper and it will play back what was being said at that time when you were taking those notes, which is really cool.

Another app that is in the same ballpark is an app called Notability. And there are others too, but these are just the ones that I know of the most. And again, these are apps that just sync spoken information with written or typed notes. You can always upload those notes to the computer. And then they’re searchable. They turn into a word document or a text document. So lots of options for actually writing the report or getting your notes into a searchable format and putting all of that together. A lot of folks I know will just dictate the interview right after they do it. And that tends to save quite a bit of time rather than typing everything out themselves.

Now, once you get the report written, I think it’s fair to say that all of us hopefully are using a template of some sort, but when you use a template, of course, the risk that comes with that is that you’re going to make mistakes, that you may forget pronouns, forget to switch pronouns or maybe even leave a name in there, something like that.

One little thing that I did way back when was just in my master template, instead of copying and pasting from one client to another which some folks do, I just made a master template where I can substitute gender-specific pronouns and use the general terms, first name and last name. So I can just do a substitution right at the beginning of the report when I write those. Pretty simple, but it helps a lot.

So once you get your report put together and you think you’re ready to proofread it and send it out, I’ve gotten pretty interested in proofreading and grammar software. I think the spell check and the grammar check on word are decent at best. And so, there are some other tools that can really do a better job.

Grammarly, I think is probably the most popular one. It seems to have the widest application. There’s a Google Chrome browser extension. So, it tends to work in most text fields that you’re typing in on the internet. So email, blog posts, things like that. It also works on windows and works on Mac. Although, I don’t think it works on word on Mac, so that’s something to consider. Grammarly is really good. It, I think does a much better job at proofreading than just your standard word proofreader.

Another one that’s pretty similar is called StyleWriter. There’s another one called Ginger. So there are a few tools out there that I think are definitely worth looking into if you’re interested in grammar and proofreading, which you should be. I think a well-written, well-proof-read report is one of the most powerful marketing tools that you can have as a testing psychologist. And those tools can help quite a bit.

So let’s talk just a little bit about digital record storage. If you’ve been testing for any amount of time, you know that the files can be enormous. So each of those testing files, if you’re doing a pretty big battery, can end up being an inch or inch and a half thick and that adds up. I think I got to the point where I had, goodness 20, I don’t know, 25 banker boxes full of files. And I finally was like, we got to do something about this. This is terrible. I’m running out of space. My office looks terrible.

And so, I really looked into the option of digital record storage. A lot of folks have been doing this for a while. I was a little late to jump on the bandwagon with this, but it has made such a huge difference just in terms of being able to search through records, being able to find things easily, and of course, decluttering the office, which is awesome.

One thing that you got to keep in mind with any digital records storage is HIPAA. Make sure that whatever service you use, they are willing to sign a HIPAA business associate agreement. I should back up a little bit just to say that I am talking primarily about cloud-based services. Now, there are EHR services that have electronic record storage, of course. I prefer to go with Google drive only because we have all of our email accounts through Google drive and I just run everything through Google for the most part. And so, it made a lot of sense to integrate our records with Google drive as well because you can insert files and search and share and all of that pretty easily.

To have Google drive be HIPAA compliant, you do have to upgrade to their business version. It’s a pretty nominal fee each month and they will sign a business associate agreement. I believe Microsoft one drive will do as well. But that’s just something to consider if you’re thinking about digital records.

If you’re interested at all in guidelines around HIPAA and digital records and that sort of thing, there are a lot of really cool resources over at Person Centered Tech website that really specializes in technology for mental health professionals. I will have a link to that in the show notes so that you can check that out.

For us, the combination of Google Drive and a really good scanner has just made a huge difference. I’ll put in just a quick plug for the ScanSnap iX500- the scanner we use. It’s a super quick double-side very easy-to-use scanner. It goes really fast and the software integrates really well with both Mac and PC. It’s wireless so a lot of people in the office can use it. And I think it’s been vetted pretty well by a lot of psychologists and neuropsychologists out there. I’ve gotten a lot of pretty good feedback from others around it too.

So that’s our setup. We use Google drive with the business associate agreement and the ScanSnap iX500. There will be a link to that also in the show notes to get it on Amazon, if you’re interested. And that has helped a lot. Now we can search our records. Anybody can access them. I don’t have to pour through these paper files. And it is just so much more convenient.

Now, just a word about what records you would actually scan in with testing. I’ve heard people go both ways, but I take more of a comprehensive approach where I will scan in every testing record that we have. We cut the test booklets up the middle, we scan every page of the test booklets for the forms that have carbon like say the Brief or maybe a CAARS or something like that, where you have the two layers. We scan both the answer layer and the scoring layer. So that’s just a word on that if you were to ever need that raw data or those records. We just scan it all in just to be sure.

I would be totally remiss to not talk about Q-interactive. I think Q-interactive is arguably one of the more important technology advances for testing over the past few years. Like I said earlier, I’m a huge fan of technology. So I jumped on the Q-interactive bandwagon really early. I mean, as soon as I could be fairly certain that the test-retest or the reliability between paper tests and Q-interactive was solid, I started to use it. I think a big part of that was I just wanted to buy two iPads to be able to play with them, but the convenience was attractive.

The whole idea with Q-interactive is that you use 2 iPads that end up linked together. So you have to buy 2 iPads to run the system. They communicate with one another and they basically serve as the interface between you and the client. Again, we’ll have a link to Q-interactive in the show notes so that you can check out what it’s all about and read a little bit more and everything. But the general idea is that these iPads will be the interface between you and the client. And it’s amazing.

They have the option to do many tests on the iPad. The WISC, the WAIS, D-KEFS, NEPSY, WPPSI  the CVLT, the KTEA, the WIAT, and even some others. So there are a lot of options for fairly major tests. I think it’s worth a trial or I would certainly look around and talk with other folks who use it.

We eventually moved away from the iPads really for two things. There are some downsides to being an early adopter. The downside for me is that early on, the software was fairly buggy and we were just running into quite a few issues with just administration. It wasn’t as smooth. That has definitely gotten better over the years. One of the big things for us too, is that the scoring output from the iPads just was not the same as I was used to from say the WAIS or the WISC scoring program through PsychCorpCenter. But that has also changed. They’re definitely getting a lot better with that.

The other thing that turned us off was the cost. I think that using Q-interactive is good for folks who maybe do less volume in testing. Their cost structure is that you pay an annual license, which gets you a certain number of tests that ranges from $225 to $300, depending on how many tests you want access to. And then they charge per sub-test. So it’s about $1.50 each. They do do bulk discounts once you get above a certain number of subtests a year. For a WISC that has 10 subtests on it, it’s going to cost you about $15 plus the cost of a booklet.

So if you do the math, I think the idea is that it would be more cost-effective for someone who doesn’t want to buy the full test kit which can run $1,300 or so. Granted this could be off, but with the cost of the sub-test plus the test booklet, I think that balances out at about 50 or 60 administrations. So, if you would see yourself doing less than that over the course of 2 or 3 years, then it might be a good choice for you. But we just went ahead. We bought the full paper kits because we just do a lot of volume of testing and it was more cost-effective. I think Q interactive is a really good choice for folks who maybe aren’t doing quite as much testing.

So you can do some research and check that out. It definitely makes things easier. The advantages are that at scores on the fly. As quickly as you can enter the scores for the subtests, it will score it on the fly. So you can make pretty quick decisions about adding or modifying your battery if you need to. And it takes out the human error of scoring. So that’s kind of cool.

I will say that I found it to be super helpful in particular on the CVLT. Some of you out there would probably be familiar with just the tedium of administering that test and even using that scoring software where you have to type in the words. It’s really nice on the iPads. You just tap the words as the individual says them. And, of course, you have occasional times where you have to write in your own words, but it works really well. And that’s probably the one where I’ve found the biggest advantage so far.

So that’s just a little summary of Q-interactive. Like I said, you can check it out. My hope is that I will have some folks on from Q-interactive who can do a nice interview with us and really talk about the ins and outs of Q-interactive here sometime in the future.

So that’s my primer on technology in testing. Now, there are a lot of other options out there. I’m sure a lot of software that I didn’t even mention. I would love to hear from you if there are particular tools that you really enjoy or things that are worth checking out. Like I said, I love technology and I will continue to explore technology in the testing world.

All right. Thanks for listening today, everybody. I have two really cool interviews coming up in future episodes. I’m going to be talking with Jen Knopp, a local therapist, who’s going to talk with us about how assessment is valuable to a therapist and what therapists might be looking for in reports and assessments. I have an interview with Joe Sanok from Practice of the Practice. He’s going to talk with us about basic business and how to slow down and make the most of your time. And I’ll be talking with Dr. Amy Connery from Denver Children’s Hospital about validity testing and performance testing in kids, and how to make the transition from being a regular psychologist to a neuropsychologist.

As always, we have a few resources for you. Definitely check out the website and the blog. If you are more of a reader and like to get your info that way, the website is thetestingpsychologist.com. If you’re interested in taking some really concrete steps to build your testing practice. You can always sign up and download the four-week blueprint. That’s at thetestingpsychologist.com/fourweekblueprint. And by doing that, you’ll get a weekly email every week for the next four weeks with several action items that’ll really help you take some concrete, clear steps toward building your testing.

If you’re interested in connecting with other psychologists and people doing testing, you can always check out our Facebook community, that’s at The Testing Psychologist Community. You can search for that on Facebook and that top bar. It’s growing by the day. We’re having some good discussions about testing and resources and all sorts of good stuff. So check that out if you want to jump in.

As always, thanks for listening. Here in the beginning stages, it’s super important, you’d be a huge favor, if you enjoy it, subscribe, rate, and leave a review of the podcast and we will continue to grow. Thank you. I’ll talk to you next time.

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