Practice Fusion

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Practice Fusion is a free, web-based EHR system of health data management available to many practitioners and organizations across the nation. The system is operated and owned by Practice Fusion Inc. based in San Franscico, CA. [1] The software, also called as Practice Fusion is the largest cloud based EMR company in the U.S. It is a free web based EMR System that is available in a software -as-a-service (SaaS) model. The SaaS startup provides private physicians and medical professionals with free, advertising-supported medical practice management technology. [2] The mission of Patient Fusion is “to connect doctors, patients, and data to drive better health and save lives. The mission drives company culture and passion is the biggest requirement.” [1] The company claims to be the fastest growing electronic health record community in US. As of 2011, Patient Fusion was recorded to have 112000 users from all 50 states, with at least 81 million records stored in its cloud. [3] [4]

Practice Fusion is a privately owned company and their private investors include but are not limited to Kleiner Perkins Caufield & Byers, Founders Fund, Artis Ventures, and Qualcomm.[1]

History

Practice Fusion Inc was co-founded by Ryan Howard and Alan Wong in 2005. With the background in technology and business, Ryan howard saw a need for affordable, easy-to-use technology to meet the needs of small medical practices. [5] In 2007, the first version of the web based Practice Fusion was launched with a small charge for support. Practice Fusion registered about 100 new users in four months of its initial release. [6] The company began to grow in 2009 when the EHR and customer support were made free. [7] [8]

Practice Fusion was created as a solution to problems users had with their current EHR system. First, the cost of using Practice Fusion is free for all users, due to online accessibility and being ad-supported. “Live-In-Five” was coined by the Practice Fusion team to emphasize the EHR’s implementation: within five minutes of opening a new account, users will be ready to document patient data [4]. This EHR system is also certified under the Medicare and Medicaid EHR Incentive Program, allowing users who choose to adopt this system early to earn up to $44,000 in stimulus compensation [4]. Lastly, Patient Fusion abides by the guidelines of the Health Insurance Portability and Accountability Act (HIPAA) for information security. [9] In 2013, Patient Fusion earned $70 million dollars from investments, increasing their start-up value to $700 million dollars. [10]

Band of Angels and Felicis Ventures invested in the company in May 2009, followed by Salesforce.com in June and Morgenthaler Ventures in December 2010. [8] [11] The company closed a $70 million Series D round of financing led by Kleiner Perkins Caufield & Byers in September 2013, followed by a $15 million Series D extension in December 2013 led by Qualcomm Ventures, bringing total funding to date to $149 million. [12]

According to Businessweek, the company makes money by charging more than 70,000 pharmacies, 350 diagnostics labs, and 50 imaging centers for access to its captive community of medical pros. For example, labs pay for the convenience of transmitting test results rather than faxing them, while drugmakers pay to deliver targeted ads to doctors. [13]

Practice Fusion achieved ONC-ATCB Meaningful Use Certification in June 2011. [14] It has been named the No. 1 EMR for customer satisfaction among primary care providers from 2011 to 2013 in addition to being named No. 1 for e-prescribing client satisfaction and helping doctors achieve Meaningful Use by Brown-Wilson’s Black Book Rankings. [15] In addition, Practice Fusion was named a Technology pioneer in consecutive years 2013 and 2014 by the world economic forum.[1] [15]

On August 14, 2015, Practice Fusion announced changes to its management. The founder of Practice Fusion, Ryan Howard, stepped down from his CEO position and became the Chairman of the Board of Directors; Tom Langan, chief commercial officer of Practice Fusion before the change in management, assumed the position of Interim CEO following the leave of Ryan Howard. [16] The change in management, according to a Fortune article published on August 19, 2015, was due to a board decision. [17] In the published article, Fortune reports that “Langan confirmed that the CEO swap was a board decision predicated on a desire for a more commercially-focused leader.” [17]

On August 24, 2015, Practice Fusion announced its 600th partnership deal, partnering with Theranos, a consumer health care technology company, and RadNet, an outpatient imaging service. [18] The new deal with RadNet will allow users of Practice Fusion to access “over 50 RadNet imaging centers located in California and New York.” [18] With the partnership with Theranos, there is now new access for Practice Fusion users to “Theranos' innovative approach to lab testing.” [18] However, no further details were given about the exact nature of the partnership of Theranos and Practice Fusion. [19]

Products

  • Practice Fusion: Free, web-based electronic health record (EHR) software for physicians and medical professionals. Its lab, imaging, and billing modules integrate with a network of third-party laboratories, medical imaging centers and medical billing services. Free support is available for EHR setup and usage; Meaningful Use, PQRS, and ICD-10 incentives; and technical issues. All offerings are HIPAA-compliant.
  • Patient Fusion: Personal health record (PHR) system that gives patients access to their prescriptions, diagnoses and test results. Records update as physicians adds information to their patients’ charts. Consumers can search physicians by location and specialty, and request an appointment online. [20]
  • Insight by Practice Fusion: An analytic product based on the Practice Fusion dataset of 81 million patient records. Real-time data provides perspective on clinical trend [21] and helps with population health management and clinical decision support. [22]

Present & Future

On August 2014, Practice Fusion announced an acquisition of Ringadoc which is considered to be an innovator in bridging the gap between provider and patient communication. In addition, it is expected that Practice Fusion will enter the telemedicine space and leverage some of the intellectual property / tools developed by Ringadoc to scale their business and seek new market opportunities. [23]

The 2013 State of the Small Practice survey conducted by Practice Fusion indicated that 36 percent of providers were using three to six year old computers. In response, the company launched a "Free EHR + Free Laptop" campaign in 2014. The campaign supplied a complimentary Google Chromebook to new physician users of Practice Fusion's EHR platform to increase incentive. [24]

In the coming years, Practice Fusion hopes to improve its system by tackling the following four goals [4]:

  1. Effectiveness Research- Practice Fusion researchers aim to find de-identified ways to project the best therapies for specific diseases based of its EHRs.
  2. Clinical Trial Recruitment- Researchers and providers will have the capability to link patients with clinical trials that may benefit the patient, as well as increase participation for studies.
  3. Adverse Event Tracking- In the event of a sudden health adversity (such as a drug recall), Practice Fusion will become automated so physicians can follow protocol for patient safety.
  4. Public Health- Public health organizations will be able to create prevention and surveillance programs for specific demographic areas. John Schrom, data scientist of Minnesota, won the Practice Fusion data competition in 2013 by overlapping Practice Fusion health data with obesity rates and farmer’s market availability.

On June 18, 2015, Practice Fusion launched its latest EHR product specifically designed for iOS and Android based tablets. [25]

EHR Features

Practice Fusion's EHR was developed from the real workflows of office-based physicians. Practice Fusion consists of the following features [26]:

  • e-Prescribing (eRx)
  • Medical Charting
  • Scheduling
  • Referral Letters
  • Lab Integrations
  • Patient Management
  • Clinical Collaboration
  • Medical Documents
  • Reporting
  • Secure Messaging
  • Medical Billing
  • Patient Health Record
  • EMR Integration & API
  • Mobile EMR
  • Patient Portal
  • Unlimited Support
  • Mobile Access

Criticisms

  • Practice Fusion launched a "Doctor's Review Website" on April 2013 which caused a serious patient privacy debate in the industry. The company designed an online scheduling system that allowed patients to make an appointment with a specialist or physician. However, according to Forbes, they started to send email to patients who used appointment system and ask them to write reviews about their experience with their physicians or specialists over their visits. [27] The critics stress on a beliefe that "patients weren’t properly informed about the public nature of their feedback and didn’t provide informed consent." [28] Company answered the complaints and noted that all physicians and specialists received and notice a year before starting the new application and introduced to the patient feedback system with the right to decline the program. [29] As with other products that are free to acquire, other factors may influence cost of ownership. Potential customers should be aware that the user-community hosted by the company is a major source of product support.[30]. Potential users performing diligent product evaluations will include consideration of the sufficiency of this support model. In addition, pre-implementation testing for tolerance with other applications required to run concurrently in the production environment is of particular interest as of January, 2015.

References

  1. 1.0 1.1 1.2 1.3 About Practice Fusion http://www.practicefusion.com/pages/about_practice_fusion.html
  2. Psst. Want a free Electronic Medical Records system? Blanckenhon D. ZDNET. 2008 http://www.zdnet.com/blog/healthcare/psst-want-a-free-electronic-medical-records-system/1207
  3. More Than 50 Million Patients Use Medical Startup Practice Fusion, And It's Saved At Least One Life. Lynley M. 2012. http://www.businessinsider.com/practice-fusion-medical-records-ryan-howard-interview-2012-8
  4. 4.0 4.1 4.2 4.3 The Health Data Initiative Forum. Institute of Medicine of the National Academies. 2011 Jun 09. www.iom.edu/Activities/PublicHealth/HealthData/2011-JUN-09/Apps%20Demonstrations/Balcony-A/Practice-Fusion.aspx
  5. Employee Turned Entrepreneur – Ryan Howard, CEO Practice Fusion. Dwivedi D. http://www.breakingthe9to5jail.com/employee-turned-entrepreneur-ryan-howard-ceo-practicefusion
  6. Timeline of Practice Fusion http://www.practicefusion.com/pages/timeline-history-milestones.html
  7. Practice Fusion, Wikipedia http://en.wikipedia.org/wiki/Practice_Fusion
  8. 8.0 8.1 Roush W. Practice Fusion Bids for Dominance in the Doctor’s Office with a Free, Ad-Supported Electronic Health Record System Xconomy. 2011. http://www.xconomy.com/san-francisco/2011/11/10/practice-fusion-bids-for-dominance-in-the-doctors-office-with-a-free-ad-supported-electronic-health-record-system/3/
  9. ehr incentiveEHR Incentive Programs http://www.healthit.gov/providers-professionals/ehr-incentive-programs
  10. Moukheiber, Zina. Free Electronic Health Record Provider Practice Fusion Raises $70 Million In Oversubscribed Series D Funding. 2013 Aug 9. http://www.forbes.com/sites/zinamoukheiber/2013/09/24/free-electronic-health-record-provider-practice-fusion-raises-70-million-in-oversubscribed-series-d-funding/
  11. Start-Ups Chase Cash as Funds Trickle Back. Dougherty C. & Tam PW. The Wall Street Journal. 2010. http://online.wsj.com/article/SB10001424052702303410404575151871554316884.html
  12. Practice Fusion Adds Another $15M From Qualcomm To Help Fuel Growth, Acquisitions & Mobile Push http://techcrunch.com/2013/12/09/practice-fusion-adds-another-15m-from-qualcomm-to-help-fuel-growth-acquisitions-mobile-push/
  13. Practice Fusion Wants to Be Free http://www.businessweek.com/articles/2014-02-06/practice-fusions-medical-records-technology-is-free-for-doctors
  14. Practice Fusion’s Electronic Health Record System Achieves Complete ONC-ATCB Meaningful Use Certification. Campbell S. EMR Daily News. 2011. http://emrdailynews.com/2011/06/07/practice-fusions-electronic-health-record-system-achieves-complete-onc-atcb-meaningful-use-certification
  15. 15.0 15.1 2012 Black Book Ratings Top EHR and EMR Vendors http://www.blackbookrankings.com/healthcare/rankings-ambulatory-physician-emr.php
  16. Leadership Update at Practice Fusion: A Letter From Interim CEO Tom Langan http://www.practicefusion.com/blog/leadership-update-practice-fusion/
  17. 17.0 17.1 Behind the Practice Fusion CEO switch http://fortune.com/2015/08/19/behind-the-practice-fusion-ceo-switch/
  18. 18.0 18.1 18.2 Practice Fusion Surpasses 600th Partnership Deal Becoming the Most Integrated Cloud-Based EHR Platform http://www.dotmed.com/news/story/26830
  19. Practice Fusion inks deal with Theranos http://www.healthcareitnews.com/news/practice-fusion-inks-deal-theranos
  20. Practice Fusion Continues To Reach Beyond Digital Health Records, Adds Free Expense Tracking To New Booking Engine http://techcrunch.com/2013/05/22/practice-fusion-continues-to-reach-beyond-digital-health-records-adds-free-expense-tracking-to-new-booking-engine/
  21. Practice Fusion pulls back the curtain on its electronic health data – for a fee http://gigaom.com/2013/06/04/practice-fusion-pulls-back-the-curtain-on-its-electronic-health-data-for-a-fee/
  22. Rock Health Panel: The Power of the Practice Fusion Dataset. Practice Fusion Blog. 2013 Aug 29. www.practicefusion.com/blog/rockhealth-panel-the-power-of-the-practice-fusion-dataset/
  23. Practice Fusion Acquires Ringadoc http://www.practicefusion.com/pages/pr/pf-acquires-ringadoc.html
  24. Practice Fusion Gives Chromebooks to New EHR Users. TechnologyAdvice. 2014-06-23. http://technologyadvice.com/news/blog/practice-fusion-gives-chromebooks-new-ehr-users/
  25. Why Practice Fusion Is The Dominant Player In Cloud-Based Electronic Health Records http://www.forbes.com/sites/robertglatter/2015/06/29/why-practice-fusion-is-the-dominant-player-in-cloud-based-electronic-health-records/
  26. Practice Fusion EHR Features http://www.practicefusion.com/pages/ehr_features.html
  27. Hill, K. Medical Start-up Invited Millions Of Patients To Write Reviews They May Not Realize Are Public. Some Are Explicit. http://www.forbes.com/sites/kashmirhill/2013/10/21/practice-fusion-patient-privacy-explicit-reviews/
  28. Murphy, K. Has Practice Fusion’s review site violated patient privacy? https://ehrintelligence.com/2013/10/23/has-practice-fusions-review-site-violated-patient-privacy/
  29. Levingston S. A. Practice Fusion Wants to Be Free. http://www.businessweek.com/articles/2014-02-06/practice-fusions-medical-records-technology-is-free-for-doctors
  30. Practice Fusion Support https://forum.practicefusion.com/practicefusion