Automate the boring half of practice life
Turn the 50 small admin tasks a week into something the system handles, not you.
- Workflows are event-triggered; reminders are timed nudges off an anchor event. Different mental models, both live in Workflows.
- The opening stack: Send intake, Send Portal invite, an appointment reminder, and invoice reminders around the due date and 7 days overdue.
- Keep the default intake folder to three forms: main intake, one outcome measure, one consent. Every form in it goes to every new client.
- Smart chips personalise messages with live client and appointment data. Always hit Preview before saving.
- When something doesn't arrive, check in order: the workflow is Active, the reminder exists and your plan includes it, and the client's notification settings allow the channel.
What automating actually buys you
Automation saves a few minutes here and there, but the real win is consistency. The intake form goes out, the portal invite arrives and the reminder lands, every time, without anyone having to remember.
Done by hand, each of those depends on someone's memory on a busy day. Automated, they happen anyway. Your mental load shifts from 'did I send that?' to 'the system did, I can move on.'
The second-order effect is harder to feel until you've worked without it for a month. Clients who get a portal invite the same day you create their record start their relationship with you on a better footing than clients who chase you for one. Reminders before appointments help clients turn up, and intake forms that arrive automatically tend to get done before the first session.
A solo practice with good automation can look, to clients, like a practice with a full front desk. Much of that comes down to which workflows you turn on in your first week.
The automation event model
Before you turn anything on, understand the two different things in Workflows, because they behave differently and break differently.
Workflows are event-triggered. Something happens in your practice and a workflow runs in response. Built-in workflows cover the essentials: a new client gets intake forms (Send intake) and a portal invite (Send Portal invite); appointments that are created, requested, declined, cancelled or rescheduled send a notification; a secure message triggers Chat message received; and billing events send messages such as Invoice paid. On Plus and Advanced you can also copy a workflow from the Templates tab or build your own with New workflow, started by things like a status or tag change, a form that hasn't been submitted, or a client with no upcoming appointment.
Each workflow runs as a sequence of steps: send an email or SMS, add forms or a portal invite, wait, and so on.
Reminders are different. They're timed nudges attached to an anchor event, under Workflows → Reminders. Four anchors exist: appointment reminders go a set number of hours before the appointment, invoice reminders a set number of days before or after the due date, intake reminders a set number of days after the forms were sent (if they're not complete), and portal invite reminders a set number of days after an automated invite (if the client hasn't signed up). You can stack several per anchor, for example 48 hours and 24 hours before an appointment.
One rule worth knowing: portal invite reminders only follow invites that the Send Portal invite workflow sent. Invites you send by hand don't get them. Appointment, intake and invoice reminders don't depend on any workflow being switched on.
The Workflows page lives in the main sidebar. It used to be in Settings, but it isn't anymore.
The minimum viable automation stack
The opening stack for any practice, regardless of size or profession. Resist the temptation to add more.
Send intake. Auto-sends every form in your default intake folder the moment you add a new client. This is the single most valuable workflow in the entire product. It turns intake from a thing-you-have-to-remember into a thing-that-already-happened.
Send Portal invite. Sends the portal invite the moment a client is created. Clients with portal access engage with you between sessions; clients without it don't. Both start inactive, so activate them. Note that both workflows apply only to newly created clients. They won't backfill your existing roster, so if you want to invite existing clients you'll need to send those manually.
Appointment reminders. New workspaces start with an email 48 hours before and an SMS 24 hours before. Check the wording and timing suit you. SMS needs a paid plan; if your clients don't read SMS, delete that one. For some professions the bump in attendance is meaningful, for others it's noise.
Invoice reminders, around the due date and 7 days overdue. Two reminders, not five: the default email the day before it's due, and one 7 days overdue. The first is a polite nudge, the second is a real one. Anything past 7 days overdue needs a phone call, not another email. Automation won't recover that money on its own.
That's the entire opening stack: two workflows and a handful of reminders. Reminders need Plus or Advanced. You can run a whole practice on this.
Things to hold off on: building your own workflows before you know which gaps you have, adding every invoice reminder slot (clients learn to ignore them), and portal invite reminders before clients have a reason to log in. The built-in appointment notifications are already on, so read their wording once to make sure it sounds like you.
Default intake folder strategy
Every form in the default intake folder goes to every new client when the Send intake workflow is on. There's no hard limit on how many forms it holds, so the discipline is yours.
Three forms is the right number for most practices.
One main intake form. Demographics, history, presenting concern, emergency contact. Build it once, properly.
One outcome measure. PHQ-9 if you're in mental health, GAD-7 if anxiety-focused, pain VAS for physical therapy, whatever your profession actually uses. One measure at baseline tells you something. Five measures at baseline tells you less, because clients abandon halfway through.
One consent form. Your terms of service, telehealth consent if applicable, payment terms.
That's it. Practices that load eight forms into the default folder don't get more data; they get more half-finished intakes and clients who arrive at the first session apologising for not finishing.
The folder is the Intake folder marked Default on your Templates page. Move a form in by hovering it, clicking Move to folder, and selecting Intake.
If you want certain clients to get a longer intake (say, a comprehensive psych assessment battery for new therapy clients vs. a light intake for medication-management consults), keep those forms outside the default folder and send them manually from the client's record with More actions → Send intake when the case calls for it. The auto-send is for the universal subset everyone gets.
Smart-chip and reminder copy that doesn't sound robotic
Inside any reminder or workflow template, the editor lets you insert smart chips, pill-shaped tokens that pull live values like client name, appointment time, location, practitioner name. They're not curly-brace variables; you click the smart-chip control in the editor toolbar and the token drops into the message body. At send time, the system replaces each chip with the real value for that recipient.
The trap most practices fall into: writing reminders that sound like reminders. 'This is a reminder that you have an appointment on [date] at [time].' Clients tend to skim past those because they read as automated, which they are.
Write reminders that sound like you wrote them once and meant it. A few patterns that work:
*Appointment reminder, 24h before*: 'Hi [client name], just a quick note, we have our session tomorrow at [appointment time]. The link is in your portal. If anything has come up, message me through the portal and we'll find another time.'
*Invoice reminder, 1 day before*: 'Hi [client name], your invoice for [service] is due tomorrow. You can pay it directly from the portal, takes about 30 seconds. Let me know if anything looks off.'
*Intake nudge, 2 days after send*: 'Hi [client name], you'll have a couple of forms in your portal from us. They take about ten minutes and they help me show up prepared for our first session. No rush, but ideally before we meet on [first appointment].'
Three rules. Write like a person. Tell the client what to do, not just what's happening. Hit Preview before you save so you can see exactly how it renders with real data. Email and SMS reminders are separate, each with its own message, so keep the email fuller and the SMS short, and let smart chips do the personalisation work in both.
Communication mode rules
Go to Settings → Workspace Settings → Communications. Four options set who can start a secure message with you, and each one has a different operational consequence.
Reply-only (48hr window), the default: clients can reply to messages you've sent, within 48 hours, but they can't start a new conversation. Most solo practices want this. It gives clients a real channel to reach you without turning into 24/7 text support.
Can't initiate communication: clients can't send you direct messages at any time. Use this if you've decided messaging isn't a two-way channel for your practice. You'll still send appointment confirmations, invoices and so on.
Assigned clients only: only clients assigned to a team member can start a message with them. In a group practice, this keeps each practitioner's incoming messages to their own caseload. It limits who clients can message; it doesn't change what your staff can see.
All clients: any client can start a message with you at any time. Sensible for very small practices or specific concierge models. For most practices, this gets noisy quickly.
A few things worth knowing. Clients get an email when you send them a message, and you can change that email's wording in the Chat message received workflow (Plus or Advanced). You set a client's preferred notification method from their record via the gear icon. Clients can also switch email and SMS notifications on or off themselves in the portal, under Settings → Notifications.
Pick a mode in your first week and revisit only if it breaks. Switching modes mid-stream confuses long-tenured clients.
Why automations fail: the troubleshooting matrix
When a client reports they didn't get something, it's usually one of three things, roughly in order of likelihood.
- The workflow isn't active. Go to Workflows and check that the workflow that should have run (Send intake, New appointment) shows as Active. If it's inactive, nothing in it runs: not the email, not the SMS.
- The reminder doesn't exist, or your plan doesn't include it. Under Workflows → Reminders, each type (appointment, invoice, intake, portal invite) has its own list, and you add one with New reminder. Reminders need Plus or Advanced, and SMS doesn't send during the free trial. Portal invite reminders only follow invites sent by Send Portal invite.
- The client's notification settings don't allow the channel. Client record → gear icon → preferred notification method. Clients can also turn email or SMS notifications off in their portal, so ask them if a channel has gone quiet.
For workflows you've built yourself, open the workflow's Runs tab: it shows each run, including who was skipped and why.
The tier traps are the fourth thing. Free workspaces can switch built-in workflows on, and those send by email, but Free has no reminders or SMS and can't change a workflow's wording. Editing workflows also depends on the Workspace settings permission, which new team members don't have by default.
If all of that checks out and messages still aren't arriving, it's usually a client-side spam filter or a wrong email address. Verify the email on the client record and ask the client to check their junk folder. It's worth ruling out the basics in that order before chasing automation gremlins.
The next layer: AI prompts inside templates
Once your basic automation runs without you thinking about it, the next layer is AI prompts embedded inside note templates. This is where the time savings stop being marginal and start being substantial.
A template can include three kinds of content the AI uses to generate notes from a session transcript:
Placeholders in square brackets: [Patient Name], [Insert past medical history]. Markers for where information goes.
AI instructions in round brackets: (Describe in detail, only include relevant past medical history if explicitly mentioned in the transcript or contextual notes.). Tells the AI how to handle the placeholder or section.
Verbatim text in double quotes: signature blocks, disclaimers, anything that should appear exactly as written every time.
Combine them: [Insert past medical history](Describe in detail, only include relevant past medical history if explicitly mentioned in the transcript or contextual notes.) produces a populated history section, drawing only from what the session actually covered.
Inside the template editor, type / to open the quick-insert menu. It surfaces AI smart prompts, headings, lists, form fields, and images without leaving the keyboard.
The hard requirement: AI prompts only run when the note has a transcript. No transcript, no AI generation. So this layer compounds with AI Scribe, record the session, transcribe it, apply your prompt-equipped template, and a near-final note appears before you've typed a sentence. Edit, sign, done.
Useful prompt patterns to build into templates: 'Draft a discharge letter from this session's transcript.' 'Summarise the key takeaways for the patient in plain language.' 'List the homework or next steps agreed in this session.' Template prompts only see the current session.
For ad-hoc questions outside templates, including ones that compare sessions, use Ask in the note. It works from the open note, can draw on the client's recent notes, and reads files you upload (PDF, PNG, JPG or text, under 5MB each).
Start with one template per common workflow, your standard progress note, your standard intake review, your standard discharge summary. Run each through AI for a few sessions and refine the prompts based on what you keep editing. Once the prompts match how you write, your notes need less editing.