Sunday, May 23, 2010

Is Practice Fusion’s “Free” EHR for Real?

As I was writing three recent blogs, I kept pondering these questions: Is Practice Fusion, Inc, a San Francisco-based company offering a “free” EHR to physicians an example of “disruptive innovation”? After all, its EHR appears to be simpler, more convenient, more affordable, and intuitively easier to use than other EHRs– the criteria usually applied to disruptive innovations. Does it signal a “breakthrough” towards a decentralized technology deployable at the site of care? How can Practice Fusion offer its EHR for “free”? What triggered this “breakthrough”?

When all is said and done, I believe this “breakthrough,” if it is that, is not attributable to new EHR software or hardware, but to a new revenue model. Or you might say, it is a “fusion” of all three of these elements.

Here is how Ryan Howard, CEO of Practice Fusion, explains this model,

‘Our revenue model works in a few different ways. We monetize transactions from our partners. We do some lead generation. So if the doctors are looking for a billing service, for example, we have a billing service that they can use. We do some advertising to the physicians: different health care services, insurance companies, device manufactures and pharmaceuticals as well.”

If you think about it, Practice Fusion has adopted and modified the revenue model that has made Google so successful, namely gathering revenues from online advertising and lead generation tied to “free” access by users. It does not require physicians to install new hardware and software, but to off-load what they need in an EHR to the Internet using their existing office computers.

The beauty of it is, of course, is that you can use your own computer and somebody else – people and businesses who want access to physicians to sell them products – pays the freight for the EHR.

In other words, someone else, not physicians, is paying the bill. According to Howard,

“The product is provided to physicians fully subsidized. It’s not a “take now, pay later” or get half of the product now and then pays for the rest of it. Every feature that’s included with the product in any capacity is offered at no cost, so it’s truly free. It’s offered with support, training, and hosting. It’s the only totally free model on the market.”


Back to my recent posts for context.

• On May 22, in “Will Innovation Save America’s Health Care?” I wondered out load whether innovations from largely web-based technologies and systems would save us from Europe’s fate- the crushing cost and ensuing debt of unsustainable social welfare programs.

• On May 21, in “EHR ‘Inevitability’ and the Physician ‘Waiting Game,’“ I questioned whether EHR systems were ready for prime time, and I implied physicians were right in waiting for useful, affordable, and intuitively and clinical compatible systems.

• On May 20, in “EHRs – Size of Physician Market, Numbers Sold, By Whom, Comprehensiveness of Systems,” I reprinted an article by Chris Thorman of Software Advice, on the scope, players, and nature of the EHR market.

In the May 20 blog, I shared a chart showing EHR vendors and number of physician users.

Vendor Physician Users Practices Served

Epic 45,000
AllScripts 40,000
eClinicalWorks 40,000
GE Centricity 35,000
NextGen 35,000
SOAPWare 30,000
Practice Fusion 18,500
Eclipsys 11,000
Sage Health 10,000 .
Greenway Medical 6,000

On May 21, I received the following email from Emily Peters, Director of Communications for Practice Fusion,

“Hi Dr. Reece,

“I’ve been closely following your blog coverage this week about market share, innovation and Practice Fusion.”

“We do see some element of the “waiting game” that you described with physicians, but much less than even just six months ago. Practice Fusion now serves about 40,000 users and 2 million patients across the country – making us, not only the fastest growing EMR community, but also one of the largest.


Before that on May 13, I had read a podcast interview with Ryan Howard, CEO of Practice Fusion, in which he said, “We just broke 15,000 users.”

I have no reason to question or challenge these physician user figures, which bespeak of explosive growth. But I can ask: how could one EHR company grow so fast?

Maybe it’s simply a matter of timing, namely, the physician market is primed and ready to get into the EHR game. Maybe it’s the marketing magic of the word “free.” Maybe it’s because Practice Fusion has the only “free” EHR on the market. Maybe it’s word getting around among physician users that this EHR really works. Maybe it’s because the Practice Fusion model profits physician users because it qualifies them as “meaningful users” and therefore qualifies them for federal reimbursement. Maybe it’s because most physicians now have broad band Internet access in their offices and can put this EHR to work in a short time frame without elaborate training and installation preparation.

Or maybe Practice Fusion is not what it’s cracked up to be and is too good to be true. There are no perfect systems in the EHR world, all are evolving, and there is always room for skepticism, or as one pessimistic wag with a weakness for puns observed, there is always gloom for improvement.

Perhaps readers of this blog will give me insight into what they think of Practice Fusion? Is it for real, or does it have blemishes that I do not see? Please feel free to comment one way or another.

112 comments:

Emily said...
This comment has been removed by the author.
EHReditor said...

Hi Dr. Reece,

I'd be glad to put you in touch with a Practice Fusion user who can share their personal experiences with our free, web-based EMR. Or visit the community online at practicefusion.com/facebook

As for the growth figures: I'd estimate that podcast with our CEO was recorded back in September 2009. We ended last year with 25,000 users. Since then, we've been adding around 170 users each day - more as word-of-mouth continues to spread in the medical community. About half of our 40,000 users are physicians - hence, the 18,500 figure used in the market share report.

Feel free to reach out anytime if you'd like more information about Practice Fusion.

Emily
Practice Fusion EMR
emily@practicefusion.com

Elayne Gordon said...

So Dr. Reece are you for or against Practice Fusion. As a 'no free lunch' skeptic I'd like to hear what you think. Of course physicians will still have to pay for practice management/billing systems so it is not a completely free solution but it may go a long way toward eliminating some substantial cost if it is not too good to be true.

Dr. Himley said...

I have recently been offered by a billing service that they will install me a free web based EHR and help me learn the program
for free! and they will handle my billing for just 3.5% of my cllections, in the beginning it seemed to me to good to be true,
but later when they helped me with the all free EHR process and handled my billing where in a short time frame i recognized a increase in paid claims, i got learned that to good things are sometimes true!

Greg said...

Practice Fusion is working out to be a great tool for the practices that I support. The shortcoming is that the software really doesn't support tablet PC's, as of this posting.

Several of my clients have the Panasonic CF-C1 Tablet PC, which is the premier bedside tablet PC. Practice Fusion's charting screen will not display the whole chart in tablet mode, regardless of the screen resolution, and there isn't a horizontal scroll bar.

This one drawback is almost a show stopper for provider that want to chart from the bedside from a tablet PC.

As an Electrical Engineer providing recommendations to medical providers, it's hard to give Practice Fusion Five Stars with this limitation.

Dr. Abdelrahman said...

As a physician I tried using practice fusion and it seems user friendly with excellent features. The limitation comes when I tried to use iPAD or small notebook, the screen view is limited, and you can not restore/move or scroll down the screen. I agree they have more steps to do to get 5/5 rating.

Anonymous said...

There are a few free options out, Practice Fusion is one of them.

Another alternative mobile focused EHR is drchrono, they seem to me one of the best out in the market at the moment in terms of free, http://drchrono.com

There is also Mitochon Systems.

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Anonymous said...

After exploring several EMRs and demoing them, I wasn't happy with any, and was leery of expending all the effort and money in conversion only to be disappointed later. Practice-fusion turned out to be a blessing, I was able to implement it into our three physician practice with no cost to us, and 7 months later I can say that it meets most of our needs. I certainly would like to see improvements in the interface and usability with IPAD etc, but can't complain since it is free. Saad Khan MD

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If use the billing service then its FREE

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Pravin Reddy said...

After attempting to implement a web based EMR for a year, our practice finally gave up. The barrier to implementation was the lack of customer support. Despite our numerous complaints and attempts to work with their IT division, they merrily charged us the monthly subscription fee. We finally cancelled and had to pay a cancellation fee.

Following this experience, I switched to Practice Fusion. The user interface was intuitive and we were up and running in a day. E prescribing was easy and we were enrolled in a matter of weeks. The customer support is arguably the best in the business. I have recently been using the beta version of the I-Pad app and it allows me to document during the clinical encounter.

For a free service PF is outstanding and even if I were paying for it, I would rate it as excellent. It provides all the functionality our practice requires and we use the Kareo billing interface. We have developed a host of templates that has increased our charting efficiency. PF continues to add features which make our practice more efficient.

It's not hard to see why it is the fastest growing EHR in the country. Without doubt or reservation -- an outstanding product and service to physicians. And yes -- it really is free!

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My name is paul zerek.I do not know how to thank GREAT Agumagu for bringing happiness back to my family. i do really wanna tell the whole world that there is a spell caster called Dr.Agumagu that is so real and genuine. I never believed in any of these things but when i lose my wife for 4 years, i required help until i found a great spell caster, and he cast a love spell for me, and he assured me that I will get my wife back in just 48hours but i was in doubt, and after the spell has been cast, 48hours later, just as the spell caster said, my phone rang, and surprisingly it was my wife who has not called me for the past 4 years, and she made an apology for the pain she has caused me and she told me that she is ready to come back home for me. Dr.Agumagu really made her to know how much i loved and needed her. And he also opened her eyes to picture how much love we have to share together. With this testimony right now i am the happiest man on earth and our love is now stronger than how it was even before. I will keep sharing this testimony all over the world. All thanks goes to Dr.Agumagu for the good work that he has done for me. Here is his email address if you are having the same or similar problem contact him now because he is very powerful and he will always help you. Believe him and do all he ask you to do and never doubt him in any way.contact him for help,he is ever ready to help you. agumaguspelltemple@gmail.com

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My Name is Johnson from London UK. I will love to share my testimony to all the people in the forum because i never thought i will have my girlfriend back and she means so much to me..The girl i want to get marry to left me 2 months to our wedding for another man..,When i called her she never picked my calls,She deleted me on her Facebook and she changed her Facebook status from engage to Single…when i went to her place of work she told her boss she never want to see me..I lost my job as a result of this because i can't get myself anymore,my life was upside down and everything did not go smooth with my life…I tried all i could do to have her back to all did not work out until i met a Man when i Travel to Africa to execute some business have been developing some years back..I told him my problem and all have passed through in getting her back and how i lost my job…he told me he gonna help me…i don’t believe that in the first place.but he swore he will help me out and he told me the reason why my girlfriend left me and also told me some hidden secrets.i was amazed when i heard that from him..he said he will cast a spell for me and i will see the results in the next couple of days..then i travel back to UK the following day and i called him when i got home and he said he’s busy casting those spells and he has bought all the materials needed for the spells,he said am gonna see positive results in the next 3 days that is .My girlfriend called me at exactly 12:35pm on Thursday and apologies for all she had done ..she said,she never knew what she’s doing and her sudden behavior was not intentional and she promised not to do that again.it was like am dreaming when i heard that from her and when we ended the call,i called the man and told him my my girl friend called and he said i haven’t seen anything yet… he said i will also get my job back in 3 days time..and when its Sunday,they called me at my place of work that i should resume work on Monday and they gonna compensate me for the time limit i have spent at home without working..My life is back into shape,i have my girlfriend back and we are happily married now with a baby boy and i have my job back too.This man is really powerful..if we have up to 20 people like him in the world,the world would have been a better place..he has also helped many of my friends to solve many problems and they are all happy now..Am posting this to the forum for anybody that is interested in meeting the man for help.you can email him, I cant give out his number because he told me he don’t want to be disturbed by many people across the world..he said his email is okay. You can email him lordagumamagicspellcaster@gmail.com

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Am giving this testimony cos am happy

My name is Midred Jackson from Michigan I never believed in love spells or magic until i met this spell caster once. when i went to Africa in November 28th 2015 last year on a business summit. i ment a man called DR OTIS DARKO. He is powerful he could help you cast a spells to bring back my love’s gone,misbehaving lover looking for some one to love you, bring back lost money and magic money spell or spell for a good job.i’m now happy & a living testimony cos the man i had wanted to marry left me 3 weeks before our wedding and my life was upside down cos our relationship has been on for 2 years… i really loved him, but his mother was against me and he had no good paying job. so when i met this spell caster, i told him what happened and explained the situation of things to him..at first i was undecided,skeptical and doubtful, but i just gave it a try. and in 6 days when i returned to taxes, my boyfriend (is now my husband ) he called me by himself and came to me apologizing that everything had been settled with his mom and family and he got a new job interview so we should get married..i didn’t believe it cos the spell caster only asked for my name and my boyfriends name and all i wanted him to do… well we are happily married now and we are expecting our little kid,and my husband also got a new job and our lives became much better. in case anyone needs the spell caster for some help, email address: otisdarko60@yahoo.com

GREAT OTIS DARKO I thank you very much thank you in 1000000 times.. if not you I would have been losted and wasted thank you. Email Him Through his email address... otisdarko60@yahoo.com

please make sure you contact him for any financial difficulties okay..

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