Documenting a 45-minute therapy session is one of the most time-consuming tasks in psychiatric practice, and the way your EMR handles this documentation has a direct impact on both the quality of your notes and the time you spend writing them. Unlike medication management visits that can be efficiently captured through structured templates, therapy sessions require narrative documentation that conveys the therapeutic process, clinical observations, interventions used, and the patient's response in a way that is both clinically meaningful and legally defensible. We compared five EMR platforms by documenting the same clinical scenario: a 45-minute individual therapy session using cognitive behavioral therapy techniques with an adult patient being treated for major depressive disorder and generalized anxiety disorder. We evaluated each platform on documentation time, note quality, template flexibility, and the overall documentation experience.
Session Setup and Template Selection
Beginning the documentation process and selecting the appropriate note template
| EMR | Workflow Detail | Efficiency | Clicks |
|---|---|---|---|
| Hero EMR | The ambient AI scribe begins capturing the session automatically when you start the encounter. You can select a therapy session template if you prefer structured documentation, or let the AI generate the note from the session content. The system recognizes the visit type from the scheduling context and pre-configures accordingly. There is no template selection friction because the AI adapts to the session content rather than requiring you to fit the session into a pre-defined template structure. | Excellent | 1 |
| SimplePractice | Select from a library of therapy note templates, including DAP, SOAP, BIRP, and custom formats. The template library is extensive, and you can create custom templates using the form builder. Selecting the appropriate template is quick, with recently used templates appearing first. The interface is clean and the template options are well-organized. | Good | 2 |
| Luminello | Choose from available therapy note templates within the encounter documentation. The templates are designed for prescriber-oriented visits and may require customization for extensive therapy documentation. Template selection is straightforward once you have configured templates that match your therapy documentation preferences. | Good | 2 |
| TherapyNotes | Select the therapy note template from the available encounter types. TherapyNotes provides structured templates for therapy sessions that include standard sections. The template selection process is simple, and the platform's behavioral health focus means the templates are relevant to therapeutic encounters. | Good | 2 |
| ICANotes | Access the note creation system and select the therapy encounter type. The click-based content system loads the relevant behavioral health content library for therapy sessions. The initial setup directs you to the appropriate content categories for the session type. | Adequate | 3 |
Clinical Content Documentation
Capturing the substance of the therapy session including presenting concerns, interventions, and patient responses
| EMR | Workflow Detail | Efficiency | Clicks |
|---|---|---|---|
| Hero EMR | The ambient AI scribe captures the session in real time, identifying therapeutic interventions, patient responses, clinical observations, and key themes from the conversation. After the session, the AI generates a draft note that includes the presenting concerns discussed, CBT interventions applied (such as cognitive restructuring of negative automatic thoughts, behavioral activation planning, and homework review), the patient's engagement and response, relevant affect and behavioral observations, and the therapeutic formulation. You review and edit the draft, which typically requires 2 to 4 minutes of modification rather than 10 to 15 minutes of writing from scratch. The AI preserves clinical nuance and narrative flow rather than reducing the session to bullet points. | Excellent | 3 |
| SimplePractice | Write the note content within the selected template structure. SimplePractice provides spacious free-text fields that accommodate detailed narrative documentation. The writing experience is clean and uncluttered, with the template sections providing organizational structure while allowing flexibility in content. Autosave protects your work as you type. For a 45-minute CBT session, expect to spend 8 to 12 minutes writing the clinical content, depending on your typing speed and documentation detail level. | Good | 5 |
| Luminello | Document the session content within the template fields. Luminello provides structured sections for the encounter with some free-text areas for narrative content. The documentation experience is efficient for prescriber-focused visits, though extensive therapy narrative may feel constrained within the template structure. Documentation time for a 45-minute therapy session is typically 10 to 14 minutes. | Adequate | 6 |
| TherapyNotes | Complete the note sections with session content. TherapyNotes provides structured fields for therapeutic approach, interventions, patient response, and treatment plan updates. The fields accommodate narrative text, though the structure imposes a specific organizational framework on the documentation. Expect 10 to 15 minutes for comprehensive documentation of a 45-minute session. | Adequate | 6 |
| ICANotes | Build the note using the click-based content system, selecting pre-written phrases and statements that describe the session content. The system provides behavioral health content organized by clinical category, allowing you to assemble a note by clicking relevant content items. This approach is very fast for generating compliant documentation but can produce notes that feel generic rather than clinically individualized. Documentation time is approximately 5 to 8 minutes, though the resulting note may require free-text editing to capture session-specific nuances. | Good for speed, Limited for nuance | 15 |
Assessment and Treatment Plan
Documenting the clinical assessment and updating the treatment plan
| EMR | Workflow Detail | Efficiency | Clicks |
|---|---|---|---|
| Hero EMR | The AI scribe drafts the assessment section based on session content, including clinical impressions, diagnostic considerations, and risk assessment observations from the session. The treatment plan section pulls forward the existing plan and highlights changes discussed during the session, including homework assignments, medication considerations, and next session planning. Review and editing of the AI-generated assessment and plan typically takes 1 to 2 minutes. | Excellent | 2 |
| SimplePractice | Write the assessment and plan sections within the template. The platform allows detailed narrative assessment documentation and treatment plan updates. Previous session plans can be referenced but do not automatically pull forward, requiring manual reference to the prior note. Documentation time for assessment and plan is typically 3 to 5 minutes. | Good | 3 |
| Luminello | Complete the assessment and treatment plan sections. The template provides structured fields for diagnostic impressions and plan components. Previous treatment plan elements can be carried forward with modifications, which saves time for ongoing treatment documentation. | Good | 3 |
| TherapyNotes | Document the assessment and plan in the designated template sections. The structured format guides you through the essential plan components. Treatment goals from previous sessions can be referenced within the system. Documentation time is approximately 3 to 5 minutes. | Adequate | 4 |
| ICANotes | Use the click-based system to select assessment and plan content, supplemented by free-text entry for individualized treatment plan updates. The pre-written content helps ensure compliance-relevant elements are included. Assessment and plan documentation takes approximately 3 to 5 minutes. | Adequate | 8 |
Finalization and Signing
Reviewing the completed note, making final edits, and signing
| EMR | Workflow Detail | Efficiency | Clicks |
|---|---|---|---|
| Hero EMR | Review the complete AI-generated note, make any final adjustments, and sign with a single click. The note includes all required elements for compliance and billing, with the documentation quality reflecting the clinical richness of the actual session. Total post-session documentation time including review and editing is typically 3 to 5 minutes for a 45-minute therapy session, a dramatic reduction from traditional documentation approaches. | Excellent | 1 |
| SimplePractice | Review the completed note within the template view, make any corrections, and sign electronically. The final note reads well and maintains the narrative quality of your writing. Total documentation time for the complete note is typically 12 to 18 minutes. | Good | 2 |
| Luminello | Review the note, verify all sections are complete, and sign. The documentation is adequate for clinical and billing purposes. Total documentation time is typically 12 to 18 minutes for a comprehensive therapy session note. | Good | 2 |
| TherapyNotes | Review all note sections, ensure completeness, and apply your electronic signature. The structured format helps ensure nothing is missed. Total documentation time is typically 15 to 20 minutes. | Adequate | 2 |
| ICANotes | Review the assembled note, add any free-text customizations to the click-generated content, and sign. The note is compliant and comprehensive, though it may benefit from personalized editing to sound less templated. Total documentation time is typically 8 to 15 minutes, with the shorter times reflecting the click-based efficiency and longer times reflecting the editing needed for clinical individualization. | Adequate | 2 |
Conclusion
The therapy note documentation comparison highlights the transformative potential of AI-assisted documentation. Hero EMR's ambient AI scribe reduces post-session documentation time to 3 to 5 minutes while maintaining clinical narrative quality, which represents a fundamental shift in how psychiatrists can approach therapy documentation. For a psychiatrist seeing six to eight therapy patients per day, this efficiency gain recovers 60 to 90 minutes of documentation time daily, time that can be reinvested in patient care, continuing education, or personal wellbeing. SimplePractice provides the best traditional documentation experience with clean templates and a pleasant writing interface. ICANotes offers the fastest non-AI documentation through its click-based system, though with a tradeoff in narrative quality. Luminello and TherapyNotes provide solid middle-ground options that handle therapy documentation competently without standout features in either direction. For psychiatrists who provide substantial psychotherapy alongside medication management, documentation workflow should be a primary consideration in EMR selection, and the AI-assisted approach offered by Hero EMR represents the most significant available improvement in this dimension.
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