For the first three years I ran this practice, my entire marketing strategy was existing. I had a website that a friend built, a Google Business Profile I claimed once and never touched again, and eleven reviews, four of which were from patients I inherited when I bought the panel. I told myself this was fine because I was full anyway, and it was fine, right up until two families moved out of state in the same month and I found myself doing the arithmetic on what an empty Tuesday afternoon actually costs a solo practice.
So I did what everyone does and took a sales call with a reputation management company. The quote was $329 a month for review requests, listings sync across a couple dozen directories I have never heard a patient mention, a review widget for the website, and a dashboard. For a solo internist with one location and one Google profile, that is $3,948 a year to solve a problem that has exactly one moving part, which is getting more of my patients to write something after a good visit. I said no, felt good about saying no for approximately a week, and then went looking to see whether the thing I was already paying for could do it.
It could. Hero EMR has a full reputation module sitting under the admin menu, and I had walked past it for over a year without opening it. I have now had it running for a few months, so here is what it actually does, the one switch I deliberately left alone, and where it falls short of the thing I refused to buy.
The loop, in plain terms
A visit gets marked complete. If the patient is eligible, the system schedules a feedback invitation for whenever you told it to send, on email or text or both. The patient gets a short branded message with one link, the link opens a mobile survey with no login and no portal account, and they answer it in under a minute. Then the response gets scored, and the score decides which screen they land on. Positive gets a thank-you page with your review links, one tap from posting to Google. Negative gets a short acknowledgment that you take it seriously, no review links anywhere in sight, and your team gets an internal alert so somebody can call. Everything in the middle is neutral and gets a plain thank-you.
That is the whole product. Three outcomes, two thresholds, and a set of rules about who is eligible. Everything else is configuration.
The setup order the documentation recommends is survey first, then delivery rules, then review destinations, then send yourself a demo, then flip the master switch. I followed it in that order and I would tell anyone else to as well, mostly because of the demo step, which is the single best thing in the feature and the part I did not expect to care about.
The demo card is the reason I trust the rest of it
There is a card on the delivery tab that sends you the real invitation. Not a mockup, not a preview pane, the actual email or text a patient would receive, built from whatever settings you currently have saved, with the provider name placeholders filled in. You open it on your phone, you get the genuine survey with a small preview banner on it, and you answer it as a patient would to see each of the three outcome screens. Nothing you do in there is recorded, nothing counts toward your statistics, and a one-star demo answer does not page anyone. You can replay the same link for a week and copy it to send to somebody else for a second opinion.
Critically, the demo works while the whole feature is switched off. That is the part that matters. I spent an evening building the survey, sent myself four versions of it, decided the wording on my second question sounded like it was written by a bank, rewrote it, sent myself two more, and never came close to touching a real patient. Every piece of software that sends messages on my behalf should work this way and almost none of them do.
The switch I left alone
On the routing tab there is a setting called the prompt mode, and it decides which patients get shown your review links after they finish the survey. Two options. All patients means everybody who completes sees them regardless of score. Positive only means the links appear exclusively for people who scored above your positive threshold, and everyone else gets routed away from your Google profile without ever knowing the links existed.
Positive only is the setting every reputation vendor in the world has been selling since roughly 2014, usually under a nicer name, and it is the entire reason those dashboards produce the numbers they produce. It is also the setting I am not going to use, and I want to be specific about why rather than vague and principled about it.
The FTC's rule on consumer reviews and testimonials took effect in October 2024, and it is aimed squarely at review suppression. The agency's position, stated repeatedly, is that a collection of reviews assembled by asking only the customers you already expect to be happy can mislead the people reading it. I am not a lawyer and neither is my accountant, and whether one particular configuration crosses a line is a question for someone who is, but the direction here is not subtle and I am not interested in being an early test case over a handful of reviews.
What I did not expect is that the EMR warns you about this itself. When you select positive only, Hero throws a compliance notice at you explaining that selectively soliciting only your happiest patients while steering everyone else away can run afoul of the FTC rules, and it recommends prompting all completing patients instead. That is an odd thing for a vendor to do about its own feature, and it moved my opinion of the whole module more than any of the actual functionality did. A company optimizing for demo appeal does not put a warning label on the setting that makes the demo look good.
There is also a boring practical argument, which is that for a practice my size the gate buys almost nothing. I complete something like sixty eligible visits a week. The delta between prompting everybody and prompting only the happy ones is maybe two or three reviews a quarter, and I would be trading a real regulatory exposure for a rounding error. Set it to all patients, accept that the lukewarm ones will look at the Google link and decline, and move on.
The guardrails I did not expect
This is the part that surprised me, because messaging features in EMRs are usually where vendors get sloppy. The eligibility rules here are tighter than the ones in the standalone platform I almost bought, and several of them are the kind of thing you only think to build after somebody has been burned.
Only patients eighteen and over are ever surveyed, and the age check fails closed, so a missing or uncertain date of birth means no invitation rather than an invitation sent hopefully. Each patient can have exactly one live survey at a time, so a patient who comes in twice in a week does not get two. There is a per-patient cooldown you set in days, which is how you stop surveying the same frequent-flyer every visit. Links are single-use and expire on a schedule you pick anywhere from three to sixty days, and an expired or already-used link shows a polite page rather than a broken screen. If a visit gets reopened or cancelled after the invitation went out, the link is deactivated automatically, so you never collect feedback on an encounter that did not actually happen.
Invitations only go out inside a daily window you set in your own timezone, and that window has to sit inside platform-wide safe contact hours running from eight in the morning to eight thirty at night, with each patient's own quiet hours honored on top of that. Channel preferences and opt-outs always override your settings, so a patient who opted out of texts does not get texted no matter what you have turned on, and every text carries the STOP language. You can exclude entire visit types or specific providers. And the text preview shows you the SMS segment count before you commit, which is a small thing that tells you somebody who has actually paid an SMS bill worked on this.
One more that I appreciated as a solo doc with one part-time MA: access to the whole workspace runs on its own dedicated permission rather than on general admin status. Being an administrator is explicitly not enough. Owners have it automatically, and an owner can grant it to one specific person without giving them anything else in the system. That is the difference between being able to hand this to my MA and having to run it myself forever.
What actually earned its keep, and it is not the reviews
My review count went from eleven to thirty-four over about four months, which is a real improvement and also not the thing I would point at if you asked me whether this was worth the afternoon.
The thing I would point at is the alerts. Four negative outcomes came through in that same window. One was a billing statement that went out with a balance the patient had already paid, one was a forty-minute wait on a day I was running behind and nobody at the front had told her why, one was a genuine complaint about how I had explained a medication change that I did not handle well, and one was a patient who was upset about something a specialist I referred to had said. I called all four. Three are still patients. The fourth was not going to stay regardless, but she told me on the phone what she was going to have written online, and she did not write it.
That is the actual math on this feature for a solo practice. One retained patient is worth several thousand dollars a year to me. One bad review sitting at the top of my Google profile for the next five years is worth considerably more than that in patients who never call in the first place. The review generation is nice. The early warning is the product.
The alert mechanics are straightforward: an in-app alert fires by default, you can optionally have it email specific staff, there is an unacknowledged badge on both the workspace and the admin menu so you notice without going looking, the alert emails deep-link to the specific response instead of dumping you on a dashboard, and you acknowledge it once you have followed up. The recipient list only offers people who already hold the reputation permission, so you cannot accidentally route a patient complaint to somebody who should not be reading it.
Where it falls short of the thing I did not buy
I want to be straight about this, because a solo doc reading a favorable writeup of a bundled feature deserves to know what the bundle does not include.
It requests reviews. It does not manage them. There is no listings sync, no pulling your existing Google and Healthgrades reviews back into one place to triage and respond to, no competitor benchmarking, no review widget you can drop on your website, and nothing resembling a marketing dashboard. If you run three locations and employ somebody whose job includes the phrase online presence, the standalone platform is a genuinely better tool and this will feel thin next to it. Birdeye and Podium are not selling nothing.
Second, it fires on completed visits, which means it inherits your encounter-closing habits. If you are the kind of doctor who leaves eight charts open until Sunday night, your invitations go out in a Sunday-night clump nine days after the visit, and the survey asks people to remember a Tuesday they have stopped thinking about. Fix that first or the feature will underperform for reasons that have nothing to do with the feature.
Third, exclusions are set by visit type and by provider, not by patient. There is always one patient in a panel of any size for whom an automated message inviting them to rate their doctor is a bad idea, and there is no clean way to flag that individual. You can work around it at the visit-type level, which is clumsy.
Fourth, and this is more of an operational note than a complaint: survey responses tie a named patient to their score and their comments, and the documentation is explicit that this should be treated like the rest of the chart. That is correct, and it means the reputation workspace is not a marketing tool you hand to a contractor. Keep the permission list short.
What I would tell another solo doc
My rule for practice software has always been that a tool should do one job and I should be able to explain in one sentence why I pay for it. This one does not violate the rule so much as sidestep it, because it is not a tool. It is a feature of something I already pay for, and the correct comparison is not whether it beats a dedicated reputation platform on capability, which it does not, but whether the gap between them is worth $3,948 a year to a practice with one doctor and one Google profile.
For me it was not close. I got the request loop, the routing, the guardrails, and the early warning system for zero additional dollars, and the money I did not spend went toward a scribe day. If you are already on an EMR that includes something like this, go open the admin menu and find out before you take the sales call. If your EMR does not have it, that is a legitimate thing to weigh at renewal, because a bolt-on reputation service is one more vendor holding a list of your patients by name, one more business associate agreement, and one more monthly line item on a burn report that is already longer than it should be.
And whatever you end up using, leave the gate alone.