The question people type into a search box is usually “free electronic patient records”. The question underneath it is different and better: where should these notes live, given that I am legally responsible for them for years and I have no money to spend this month?
That question has a real answer, and it is not always “buy software”.
The five places notes actually live
- Paper. Still extremely common, still legally fine in most places, and the only option with no login. It fails on backup, on being in two places, and on being read six years later in someone else’s handwriting.
- A folder of documents. One file per patient in a cloud drive. Familiar, free, and the subject of most of this article.
- A notes app. Fast to write in, syncs everywhere, and almost never encrypted in a way you could defend, with no way to show who read what.
- A spreadsheet. Excellent for the diary and the money, poor for narrative notes. We wrote about the move off one here.
- A clinical system. Purpose-built, costs money above a certain size, and brings its own problem: your records are inside somebody else’s product.
None of these is disqualifying on its own. What matters is knowing which specific thing each one breaks, so that you choose the breakage you can live with.
Why a folder of documents is not a record
This is the distinction that catches people, because from the outside a well-organised drive looks exactly like a records system. One folder per patient, a document inside, dated headings. It is tidy. It is digital. It is not a record, and the difference shows up in four places:
- Nothing stops you overwriting. A document edited in March looks identical to one written in March. A record keeps the original and shows the amendment; a document quietly becomes whatever you last typed.
- There is no structure to query. “Which patients have not been seen in six weeks” is a question a folder cannot answer, which is why everyone keeping notes this way also keeps a list somewhere else.
- Attachments drift. The scan of the referral is in downloads, the photograph is in the phone gallery, the exercise sheet is in a different folder. The record is the union of four places and exists in nobody’s head completely.
- Sharing is all-or-nothing. Giving a colleague access to one patient usually means giving access to the drive.
For a caseload of five, none of that hurts. At forty patients across two years, every one of them hurts weekly.
The audit trail, and the day you need it
An audit trail is the record of who wrote what, when, and what it said before it was changed. On an ordinary working day it is invisible and pointless. It matters on exactly one kind of day: when somebody asks what happened at a session eighteen months ago, and the answer has consequences.
The uncomfortable part is that a note without a trail is not worthless — it is worse, because it looks like evidence and is not. A document with a date typed at the top proves nothing about when it was typed. If you were to add a sentence to that note today, nothing in the file would show it.
This is the single strongest argument for a purpose-built system over a document folder, and it is worth understanding before you need it rather than during. Notes written contemporaneously, with amendments visible as amendments, are the version that holds up.
Move three real patients in
Not test data. Three real histories, one written from scratch during a session, one exported back out. An hour answers this properly.
Create a free account → No credit card. The first 7 days have no limits at all.Searchable, or you will keep a second list
There is a reliable sign that your records are in the wrong place: you are maintaining a second list. A notebook of who owes money, a calendar with names, a note of who needs calling back. That second list exists because the first one cannot answer questions.
The questions a records system should answer in seconds, and a folder cannot answer at all:
- Who has not been seen in six weeks, but was not discharged.
- Who has sessions left on a package.
- Who owes money, and how much, today.
- Which patients did I see with this problem, when I want to remember what worked.
Every one of those is a question about the whole caseload rather than one patient, and per-patient files are structurally incapable of answering them. That is not a criticism of the files; it is what the shape of the data allows.
Who can open it, and who can prove they did
Two different obligations get confused here. The first is keeping people out — a password, a lock screen, encryption. Most setups handle that adequately. The second is knowing who came in, which almost no improvised setup handles at all.
The practical test, and it is uncomfortable: if a patient asked you tomorrow who has opened their record in the last year, could you answer? In a document folder shared with a receptionist, the honest answer is no, and in most jurisdictions that answer is a problem rather than an inconvenience. More on the wider duties in the data protection article.
Getting it back out again
Whatever you choose, assume you will leave it. Practices change software, products get discontinued, companies are bought. The records outlive all of that because your retention obligation does not care what happened to your supplier.
So ask, before the first patient goes in, and prefer a demonstration to an assurance:
- Can I export everything, including attachments, in a format that opens without this product?
- Can I do it myself, without asking support and without paying for it?
- What happens to the records if I stop paying? Read-only for a period is reasonable; immediate lock-out is not.
- What happens if the company closes? The answer is usually in the terms, and usually shorter than you would like.
Do the export on day two rather than year three. It takes ten minutes and it tells you what kind of supplier you are dealing with.
A workable minimum with no budget
If there is genuinely no money this month, this is a defensible arrangement, and it is better than a badly chosen product:
- One document per patient, append-only. New session at the top, with the date. Never edit a previous entry — add a dated correction underneath instead.
- An encrypted, backed-up drive with two-factor authentication on the account. Not the phone gallery, not messaging.
- One spreadsheet for the caseload-wide questions: who is active, who owes what, who needs a follow-up.
- A written retention date per patient, so files are not kept forever by accident.
- A backup you have restored from once, to prove it works. An untested backup is a belief.
That covers you for a small caseload. It stops being enough at the point where the spreadsheet and the folders disagree with each other — and they always eventually do.
Where Physioly fits, honestly
Physioly is the fifth option: a clinical system with the record, the diary and the money in one place, assessment forms by specialty, a progress note per session, attachments on the record itself, and a history that keeps what was written rather than only what it says now.
The honest limits, since this article is about choosing a place to keep records for years:
- The free plan holds 1 patient after the first week, with monthly usage limits. The first 7 days have no limits at all, which is the part that is genuinely useful for deciding. It is not a system for a full caseload at zero cost, and we would rather write that here.
- Export works on every plan, including the free one. The records are yours and you can take them out yourself.
- Nothing is sold. The business model is people upgrading, which is also why the free tier is small.
- It needs a connection. You can read what is on screen offline; saving does not work.
If you are choosing between a document folder and a clinical system, the questions in this article are the ones that decide it — not the feature grid. And if the answer today is the document folder, do it append-only, back it up, and test the restore.
Questions we get asked
Can I keep physiotherapy records in a document folder or a notes app?
For a very small caseload, yes, provided it is encrypted, backed up and append-only. What a folder cannot do is show that a note was not edited afterwards, answer questions about the whole caseload, or record who opened a patient file. Those three gaps are what eventually make it the wrong place, and they matter more as the number of patients and the age of the records grow.
Is there a genuinely free electronic patient record for physiotherapists?
Free tiers exist, including ours, and they are usually limited by number of patients rather than by features. The questions that decide whether one is trustworthy are not about the price: can you export everything yourself, what happens to the records if you stop paying, and is anything done with the data. Ask all three before the first patient goes in.
What is an audit trail and does a small practice need one?
It is the record of who wrote what, when, and what it said before it changed. It is invisible on a normal day and decisive on the day somebody asks what happened at a session eighteen months ago. A note in a document with a typed date proves nothing about when it was typed, which makes it look like evidence without being it.
What should I ask a software vendor before putting patient records in?
Four things, and prefer a demonstration to an assurance: can I export everything including attachments in a format that opens elsewhere, can I do it myself without asking support, what happens to the records if I stop paying, and what happens if the company closes. Run the export on day two rather than year three.
How many patients can I keep on the Physioly free plan?
One, after the first week, with monthly limits on sessions, notes, financial entries and PDF reports. The first 7 days have no limits at all and no card is needed, which is enough to run a real week and decide. Export works on the free plan, so the records are yours either way.