No More Medical Record Hell – Startup Looks to Bring Doctors And Patients Into The Digital Age

Rows and rows of file folders? WTF!!

If Practice Fusion has their way, your doctor’s office is about to get an upgrade – big time. Like other electronic health records (EHR) systems, Practice Fusion empowers doctors with brand spanking new superpowers for the digital age. What’s makes it different than its 300+ competitors? For starters, it’s web-based, 100% ad-supported, and absolutely free. It’s the fastest growing EHR community by a long shot, reaching 80,000 offices and 10 million 11 million patients (yeah, that fast). For doctors, it has been a financial godsend, saving their practices around $60 million so far. What could it mean for you, the patient? Expect fewer medical errors, more personalized care, and the utmost privacy regarding your medical information. Bureaucrats and policymakers have been urging docs to switch to digital for over a decade, but they have little to show for it. However, after considering what Practice Fusion offers and pondering a few insights its CEO shared with Singularity Hub, I believe we have a real turnkey solution for America’s health IT woes on our hands. Au revoir to the towering mounds of hard copies that sway over antiquated clinics. With the help of Practice Fusion, the U.S. health sector is poised to join the 21st Century with the rest of us.

So what does your doctor actually get when they sign up for Practice Fusion? A fully functional EHR system with all the bells, whistles, and then some. Medical records software typically requires months to get rolling, but physicians can get Practice Fusion’s show on the road in five minutes. For docs who are tech-novices, Practice Fusion also boasts extensive customer support and training, all free and unlimited, so even the most computer illiterate in the healthcare workforce shouldn’t have trouble making the digital switch.

You log-in to check on your friends. Soon, you could log-in to check on your health history.

The coolest feature, hands-down, is Patient Fusion, where you, the patient, can access your personal health record (PHR) as easily as your Facebook page. We forget doctor’s appointments all too often, and obtaining your immunization records can feel like pulling teeth sometimes. For those that use Patient Fusion, those days are over. Just log-in to your account, and everything you want to know about your medical history is right there. Medicine just got a little more personal.

Concerned about privacy? Who wouldn’t be? Practice Fusion may assuage some fears with its bank-level, HIPAA-compliant encryption. However, on a long enough timescale, a hacker will get one step ahead and compromise patient privacy. In contrast to the recent security breach of the PlayStation Network, health data hacks could be more unsettling than credit card info breaches. But keep in mind that we’re already living in an era in which we give up a little security to make our lives better. Besides, paper records are prone to breaches, too. People trust their life savings with online banking, which has revolutionized personal finance. Why not trust your health info with online EHRs? In my eyes, it’s an acceptable risk.

So what do we get with that risk? Healthcare like you’ve never seen it before. For example, remember the good ol’ days of house calls for even the mildest of ailments? Me neither (I’ll ask my grand-dad). Well, it’s getting a makeover, because Practice Fusion is helping revive this relic of the past with modern technology. Raymond Zakhari, a nurse practitioner and founder of Metro Medical Direct, brings his entire patient database with him as he roams the streets of Manhattan. Also, NYC is home to many pharmacies offering home delivery, so his patients don’t even need to leave their residence to get treatment. Now that’s service!

Okay, Practice Fusion is an awesome tool for any practice that wants to streamline their record keeping, and it’s a great way for patients to reclaim their own health information. However, it’s bursting on the scene at a time when policymakers and and physicians are quibbling over EHR adoption rates. If EHRs were universally adopted, research indicates that the U.S. heathcare sector could save $81 billion annually and eliminate up to 200,000 drug errors. For policymakers, the switch is a no-brainer, so healthcare providers will face penalties if they haven’t adopted a certified electronic records system by 2015. But they’re also offering a pretty big carrot. Those who jump on the bandwagon could earn a $44,000+ grant to offset the cost of implementation.

Does Practice Fusion thrive in the wild? Raymond Zakhari, a nurse practitioner who makes house calls, loves it. If this EHR system can make it on the mean streets of New York, then it can make it anywhere.

Despite the incentives, doctors aren’t taking  those policies lying down. The American Medical Association has been lobbying heavily, and penny-wise physicians argue that EHRs will be a productivity killer as their staff adjust to digital record keeping.  Moreover, with some systems approaching the $90,000 range, the initial installation is out of reach for small practices. It’s not surprising that, according to a CDC study, only 6% of practices have comprehensive EHRs. In its core, this push-back reflects the “don’t tread on me” mentality that has entered our national politics. In my opinion, when the government and doctors fight, patients lose.

As a service with virtually zero capital costs, Practice Fusion is definitely a game changer, but how will it fit into the broader debate? In my brief interview with Ryan Howard, the CEO of Practice Fusion, we discussed the undue financial strain placed upon practices by early EHR vendors.

There is a perception, which was at one time accurate, that EHRs are egregiously expensive, require onerous training and costly support, come with a huge maintenance burden, and are quickly outdated. The average primary care doctor makes about $120,000 a year, but the total cost of a traditional EHR system for a small practice is $50,000. The numbers just don’t add up for most doctors and they simply stick to paper.

In other words, the widespread EHR ambivalence is understandable. Keep in mind that most doctors really have two jobs. While treating patients is #1, private practice doctors are also running small businesses. Like any business owner, if the balance sheets don’t leave room for a major investment like a new records system, then pursuing one is decidedly unwise. But that position is no longer tenable. Practice Fusion’s new model of service delivery is pulling out the barriers to EHR adoption at the root.

In Ryan Howard’s eyes, the gates are wide open, but the damage done by legacy EHR vendors has left a lingering stigma. Therefore, a mission of Practice Fusion is to undo those old misconceptions. In his words, “. . . this is an education campaign. Health providers simply don’t know that new delivery models, new technologies can make EHR adoption free, painless and fast.”

After de-stigmatizing, is the sky the limit for Practice Fusion? It seems that way to me, and it’s clear Mr. Howard and Practice Fusion have some big plans to back it up.

Long-term, we want to become the ubiquitous EHR system for family doctors and touch every patient in America.

Think that’s too bold of a statement?  Well, Peter Thiel, co-founder of PayPal and managing partner of Founders Fund, doesn’t think so. In fact, Founders Fund and a handful of other firms have just placed a big stack of venture capitalist chips on the table, $23 million of series B funding to be exact. He also had some pretty nice things to say about the EHR system:

Practice Fusion revolutionizes our interactions with the medical community, just as Facebook did for social networking. . . [It] represents the future of medicine: healthcare married to the efficiency of information technology.

Mr. Thiel foretold the dot-com bust, the housing market crash, and the rise of Facebook (he was an early investor), so when he makes a move, people take notice. Given his impressive track record and the financial backing he’s offered Practice Fusion, I wouldn’t be surprised if this revolutionary EHR arrives at your doctor’s office within the next year or two.

In a world of telerobotic surgeons (left), and smartphones that can diagnose cancer (right), why do medical offices still look like this (bottom)?

The Internet Age has changed our lives for the better, and we can barely fathom a world without e-mail, social networking, and Internet media. Honestly, I feel like a caveman chiseling stone every time I send snail mail. Also, doctors who have adopted EHR echo that sentiment, saying, “. . . there is no way I would go back to using paper.’’ Why, then, are so many doctors bound to the shortcomings of a fragile medium that is not easily shared with interested parties? Cost? That’s not an excuse anymore. As patients and consumers of healthcare services, we need to start urging our doctors to make the switch so that our care can become safer and more personal. Therefore, I’d like to close with an open letter to all the physicians who have yet to adopt an EHR system:

Dear Docs,

I know, change is a scary thing. Your entire career in private practice is chronicled in those massive piles of paper. Plus, who has the time to implement an entirely new system? However, given that startup is now free, technical support is ample, and you get to keep the $44,000+ grant from the government, you must learn to let go of that fear. If nationally adopted, EHRs could provide our faltering health sector some much needed breathing room, and most importantly, save lives through reduced medical errors. Inaction is no longer an option, and the time has never been better to jump on the EHR bandwagon.

Digitally Yours,


To see some software demos of Practice Fusion, click here. Also, check out Singularity Hub’s Q&A with Practice Fusion CEO Ryan Howard below.

Singularity Hub: Do you think we’ll be able to meet Obama’s 2014 goal for EHR adoption? What do you think is a reasonable deadline?

Ryan Howard: Opinions differ wildly about whether or not the 2014 goal is achievable. If you talk to one of our users – an early adopter – they’ll tell you the goal can be met and is critical to revolutionizing primary care. If you ask a non-adopter, they’ll insist the 2014 target is too aggressive and puts undue pressure on health providers to comply. As a company, we’re optimistic about the 2014 target and we’re doing everything we can to educate health workers about the incentive dollars available to them for making the switch, as well as the potential penalties they face if they delay their practice’s EHR adoption. From our perspective, this is an education campaign. Health providers simply don’t know that new delivery models, new technologies can make EHR adoption free, painless and fast. Ultimately, technology will decide if 2014 can be met.

SH: Could Practice Fusion be a catalyst for reaching that goal?

RH: Absolutely. If every small practice in the US decided to adopt Practice Fusion tomorrow, this challenge would be solved. Because our technology is delivered through an ad-supported Software as a Service model, there is no financial barrier to adoption and users can be up and running within 5 minutes. The challenge is in educating health providers about solutions like ours and breaking down the fears and negativity around EHR systems, which big legacy vendors are largely responsible for.

SH: What are the primary barriers of EHR adoption, in Practice Fusion’s experience?

RH: For those hesitant to digitize medical records, the main barrier for adoption of an EHR system is cost, although physicians tend to be misinformed about the actual costs and resources required to purchase and implement EHR systems. There is a perception, which was at one time accurate, that EHRs are egregiously expensive, require onerous training and costly support, come with a huge maintenance burden, and are quickly outdated. The average primary care doctor makes about $120,000 a year, but the total cost of a traditional EHR system for a small practice is $50,000. The numbers just don’t add up for most doctors and they simply stick to paper.

SH: What are the near and long-term goals of Practice Fusion?

RH: Our primary goal, of course, is empowering health professionals to deliver the highest standard of care to their patients with the least disruption to their workflow through the greatest ease of use within the product. Long-term, we want to become the ubiquitous EHR system for family doctors and touch every patient in America with both our EHR for doctors and our personal health record (PHR) for patients. We want to work closely with the wider medical community, helping researchers, policy-makers and other healthcare stakeholders to better understand America’s health in aggregate through our de-identified patient data, which comprises 10 million patients, and a community of 80,000 health workers. Near-term, our focus is squarely on product development, user-acquisition and support. We’re constantly adding new features to the product, driven by user requests and compliance requirements. We’re also seriously growing our team to meet the demands of our booming user base.

[Image 1:]

[Image 2: Facebook, Practice Fusion]

[Image 3:  Practice Fusion]

[Image 4: Simulated Surgical Systems, Center for Systems Biology, Flickr – sindesign]

[Sources: Practice FusionEMR and HIPAA, Health Affairs, InMedCDC,  Boston Globe]

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