Practice Fusion Blog

A New Term and Movement for the Industry: EMR 2.0

Ryan Howard — 2008-10-03T19:56:08-07:00

This past week we have been preparing for the 2.0 release of the Practice Fusion EMR. During this time I spoke with various press outlets, including Matt at MarketlIntelNow. Matt, who is one of the individuals who truly understands what Practice Fusion is trying to accomplish in the market and how our approach is different, posted a blog about our product release here.

In the posting, Matt makes (what I feel to be) a very profound statement and coins a new industry term, EMR II… “Many docs were burned by EMR I, where turnkey software systems were found to be very expensive, overly complex and painfully difficult to integrate into their traditional workflows. Now EMR II is all about SaaS, and radically lower price points-- even free-- are being mapped by a new set of bold vendors like Practice Fusion.”

His statement nails the problems with the current big vendor approach and their failure in the market on the head. He is also right-on about how we are changing the healthcare IT landscape.

We spent a tremendous amount of time on our mantra of ‘Free, Web-based, No-risk,’ and we have delivered on it. All of the hurdles and horror stories of traditional EMR I are eliminated with Practice Fusion: 1) There are no costs – it’s free for life. 2) Its totally web-based with no installation - no servers or consultants needed – it runs on almost any computer allowing you to leverage your existing IT investments. 3) The risks are low – you can sign-up and assimilate the product into your workflow at your own pace. For example, upload your patient data (we do this for you for free) and start scheduling. Once you are comfortable with this, start using secure messaging to streamline communication in your practice. When you have mastered this, start charting with the EMR and paper charts in tandem, until you r ready to make to full leap. The transition doesn’t have to be painful – just see what our doctors have to say here.

On a side note – we have many doctors that go through our live training (provided at no cost) who are so comfortable that they literally start charting with the next patient on their schedule. You can go as fast or as slow as you want. This is because we have a constant emphasis on simplicity. From the sign up process to the user interface – everything has been assembled and delivered to be as simple and easy as possible and to eliminate all of the pain experienced with other vendors.

Hats off to Matt and MarketlIntelNow, who coined the term EMR 2.0. It fits the bill perfectly, and we are excited to be one of the innovators in this new movement.

-Ryan Howard
CEO, Practice Fusion

Practice Fusion 2.0 Is Now Availalble

Ryan Howard — 2008-10-03T19:54:29-07:00

Today we launched our latest incarnation of our EMR product suite, Practice Fusion 2.0. There are some key attributes of this product that make it very unique and powerful in the market place.

For starters, it’s an RIA. What’s an RIA you ask? RIA stands for ‘Rich Internet Application’. Rich Internet applications are web applications that have the features and functionality of traditional desktop applications. (More can be read about RIAs here.)

Take a look at the product screenshots here, or register for a demo or even sign-up (Why not? There are no hassles, no obligations and no one will call and bother you!) and you will see that the user interface is extremely elegant, intuitive and simple – more so than any other application on the market.

Next to cost and implementation, usability is a major key factor in the overall adoption of an EMR by a physician practice. A poor interface will kill productivity and as well as cause anxiety and hostility when attempting to get your staff to start using a new system - just ask anyone who works for Kaiser about the adoption turmoil experienced during the EPIC implementation (which from my understanding is still persisting).

As I mentioned in my last posting, Practice Fusion 2.0 runs on a Mac, Windows or even a Linux. We are the first EMR company to have a product that runs on Google Chrome, Apple/Mac Safari 3, Mozilla Firefox 3 and Internet Explorer 8 Browsers.

There are also some very innovative features, including the ability to search across all of your templates and our extensive template library, view and copy past charts, see frequent diagnoses for the patient that you are working with, associate emails to the patient chart and more.

Beyond just being more intuitive and he new features, there are significant benefits from our new product. I will detail these, along with other benefits from a Software-as-a-Service model in another posting next week.

-Ryan Howard
CEO, Practice Fusion

Looking forward to October…

Ryan Howard — 2008-09-21T18:11:04-07:00

Some of you have been wondering why we have been dormant over the past few months. The Practice Fusion team has been hard at work on the next evolution of our product suite. In early October we will be releasing the latest version of our electronic medical system.

What is unique about this incarnation is that it is completely ubiquitous. It runs on every major operating system and browser combination on the market, including Google Chrome, Apple/Mac Safari 3, Mozilla Firefox 3 and Internet Explorer 8 Browsers. Practice Fusion continues to innovate by being the first vendor to deploy on these browser platforms.

More importantly, this shows how we are continuing to tear down the barriers to EMR in the healthcare market. No longer do you have to install and maintain software and databases in your office, or even run clunky Citrix sessions. Whether you are a Mac, Windows or even a Linux user – you will be able to use Practice Fusion on any internet connected computer, so long as you’re running a major browser.

There are some significant reasons that we have taken this new technology approach, specifically to support some groundbreaking new features we have coming out in November. I can’t mention them quite yet, but stay tuned.

The product also boasts one of the best looking, and more importantly, most intuitive interfaces in the market place. We have spend countless hours with our UI team and physician experts to greatly simplify the entire concept of EMR. A new user can literally start charting within a few minutes of acquiring Practice Fusion.

Also, we have some additional interesting news brewing for October and I will be sure to share them.

-Ryan Howard
CEO, Practice Fusion

Live in Five

Ryan Howard — 2008-06-23T00:00:38-07:00

One of Practice Fusion's primary goals is to eliminate the barriers to entry for practices to start using Electronic Medical Records and Practice Management applications. We accomplish this in a variety ways - our free model eliminates all costs associated with licensing software and our web-based model does away with the need to purchase and maintain servers in your practice.

Another way Practice Fusion is innovating and eliminating barriers for your practice is our 'Live in Five' program. 'Live in Five' allows you to be up and running on Practice Fusion's applications in minutes. If you like what you see at www.practicefusion.com, we invite you to click the 'Sign up now' button you will see on any of our product pages - once you register, your practice will be up and running in minutes - no charges, no waiting, no hitches and no sales people pressuring you...

And it's all free, forever - the applications, hosting, and live support (in plain English!)

We invite you to take a tour Practice Fusion and look forward to having you join the fastest growing physician practice community.

-Ryan Howard
CEO, Practice Fusion

Red Herring

Ryan Howard — 2008-04-09T20:00:02-07:00

I am excited to announce that today Red Herring selected Practice Fusion as one of the finalists for the 'Red Herring 100'. I feel this is a direct testament to the Practice Fusion team's hard work, and our continued growth and innovation in the HealthcareIT space. To read more click here.

About the 'Red Herring 100':
For more than ten years, Red Herring has been the known leader in finding and advocating the most promising tech startups. Red Herring North America continues this tradition by once again recognizing the top 100 privately held companies in North America. Formerly named Red Herring Spring, this is where we will reveal the Red Herring 100 North America Award winners. At the conference visionaries, corporate leaders, and investors will converge for two days of interaction that will shape the future of the tech industry.

Google Health Comments

Ryan Howard — 2008-03-08T15:55:14-08:00

One of our advisory board members, Graham Walker, made some interesting comments on Eric Schmidt' s recent speech at HIMMS that I wanted to share - the original post can be found here.

Several comments and critiques as I watched Eric Schmidt, Google’s CEO, talk about Google Health:

Please stop calling patients consumers. Patients are people with illnesses or injuries who need medical care; consumers are people who purchase goods or services and are informed about what they’re purchasing. (Most patients are not actively dictating what health care resources they’re consuming.) Note: there are certainly consumers of health information, but a person who comes to me seeking medical attention is not a consumer. He or she is a patient.
The medical record is not the patient’s property. I believe the model we need to use for the medical record is “shared control,” that is, the patient controls who sees the information in their medical record, but the patient’s physician controls the actual information. A patient with HIV or a history of anaphylactic shock to penicillin should not be able to delete this from their medical record.
Wow, it would be amazingly cool to have all XRays and CT scans from everyone in the country online. I would love that.
Dr. Schmidt talks about young people, and how we already see the future of what will happen with society, what changes will occur and how quickly and says that the older people like him need to be ready to change and adapt. But I’d guess no one on their Health Advisory Board, with the exception of Matthew Zachary, is under 40 or 50; few if any likely have a Youtube account or Facebook profile. If young people are so in the know, get our opinions!

-Ryan Howard, CEO Practice Fusion

Advisory Board

Ryan Howard — 2007-07-02T01:23:46-07:00

I would like to take this opportunity to annouce Practice Fusion's Advisory Board. Over the last year, these industry leaders have each played a key role in assisting us in establishing our business model and bringing Practice Fusion to market:

Cora Tellez
CEO, Sterling HSA; Ex President/CEO Healthnet, Blue Shield CA, Prudential Healthcare
Marty Diamond
Founder, Diamond Group; President & CAO, John Muir Medical Center; Director, UCSF/ Mount Zion Hospital
James Hickman
VP Comm, Institute for OneWorld Health; Ex CEO, St. Luke’s Hospital Foundation
Jonathan Gerber
CEO and Founder, Physician Services, Inc.
Stan Stead, M.D.
President, The Stead Group; Ex Sr. Associate Director at UC Davis Health System
Flash Gordon, M.D.
President/CEO, Ross Valley Medical Corp; Former Director, Haight Ashbusy Free Clinic
Manly Hyde, M.D.
Cardiac Surgeon, Kaiser Permanente; Founder, Click411.com
Alan Rosenstein
Vice President & Medical Director, VHA West Coast
Gwen Watanabe
Vice President of Business Development, Nelix; General Partner, Saratoga Ventures
Scott Munro
Managing Director, PageMill Partners, Ex President/CEO Savior Technology Group

-Ryan Howard, CEO, Practice Fusion

Who pays for the Benefit?

Ryan Howard — 2007-06-18T17:42:39-07:00

Sometimes the world of the blog gets wrapped up in itself. We all know how it goes. A quick sanity check usually comes in the form of an article in a national newspaper. We had such a sanity check last week.

After weeks of one-off articles on healthcare and its problems, on June 11, the New York Times devoted an entire section, The Business of Health, to our small corner of the blogsphere. Its lead article "Who Pays for Efficiency?" chronicled several doctor’s journeys in streamlining and automating their office workflows.

Not only did it validate our assumptions in the challenges these doctors face, but it brought to light the inequity in the cost-benefit ratio. One would think that if the doctors, spending tens of thousands of dollars of their practices’ earnings, install the technology, they would realize the lion’s share of the benefits. But they don’t. One guess in who does .. tick tock, tick tock … the public and private insurers.

If the gains are not aligned with the spend, the old software license model has to change.

-Gail Romano

VP Marketing, Practice Fusion

Hill medical group invests in IT, hurting net income

Ryan Howard — 2007-05-24T00:34:20-07:00

The San Francisco Business Times is running a great article about how Hill Physicians Medical Group's NextGen implementation is impacting the organization's revenues. Here's the entire story:

Hill Physicians Medical Group, one of the few medical groups or IPAs to publicly divulge its financial results, generated $428 million in revenue and $5.3 million in net income last year, according to preliminary figures from the San Ramon-based group. Its formal annual report is expected by early June.

Dan Robinson, vice president of corporate services for 2,600-doctor Hill and its PriMed Management Consulting Services management group, said 2006 revenue increased 3.4 percent over the prior year. Net income fell 31 percent, from $7.7 million in 2005, due to a steep increase in funds invested in implementing its electronic medical record system and increased performance-based pay for its doctors.
Hill spent $5.89 million on its EMR implementation last year, 78 percent more than 2005's $3.3 million, Robinson said; meanwhile, performance-based pay jumped 23 percent, from $26 million two years ago to $32 million in 2006.

PriMed's administrative costs remained low, he said, at 10.8 percent, "whereas other similar groups generally run in the 13 percent to 14 percent range."

Hill, run by longtime CEO Steve McDermott, is considered one of the best-run IPAs in California, if not the nation, and is one of the very few to provide any public accounting of its financial results. "Bottom line, financial performance remained strong again," Robinson said of the preliminary results. "We're continuing to invest aggressively but judiciously in clinical and technical support services that support our physicians' practices."

-Ryan Howard
CEO, Practice Fusion

Thinking Like A Doctor

Ryan Howard — 2007-04-09T22:00:17-07:00

Doctors, for the most part, aren't software engineers.

And software engineers, for the most part, aren't doctors.

This would be just one of many reasons electronic medical record
(EMR) software has been incredibly slow to be adopted by the medical field. Medicine is a highly complicated field--add the complexity of the human body to the complexity of all the human bodies in the health care field and you're bound to struggle to keep things simple.
No matter *what* type of system you try to use to keep track of patients and their health.

And because of this, you end up with incredibly complex computer software. This database has to talk to that one, this system has to integrate with that one, Network A has to merge with Network B. This is not the work for a doctor--it's the work for a software engineer.

The problem, I often find, is that so much work is necessarily spent on the "backend" -- that is, making the software work and record and recall information accurately and securely without crashing -- that very little time seems to be spent on the "frontend" -- what the user of the system actually sees. Since doctors are usually the ones that have to take the data from a patient (his or her symptoms, physical findings, lab values, and past medical history) and turn it into a diagnosis, shouldn't these systems be setup to think like a doctor would?

(The answer is yes.)

Unfortunately this is often not the case. Information is put into categories and presented in ways that may make sense, or be easiest to program, for a software engineer, but when it comes time to turn the software over to the doctor, it seems downright clunky, inefficient, and frustrating to use.

We need systems that take physicians' thought processes and workflows into consideration. Systems that understand how a doctor makes it through the day in a clinic, and helps facilitate that process, not hinder it.

The Practice Fusion goal is to create a software package that provides physicians with such a system. *And* something that doesn't require an entire IT department to support. Software that helps physicians to be more efficient--and therefore have more face time with patients. Software that has thought through how doctors work and process information, and software smart enough to show doctors pertinent information right in front of them. Software that also provides an extra layer of safety, without mind-numbing clicking of errors and alerts that end up getting ignored anyway.

Graham Walker
Medical Student, Stanford University School of Medicine
Practice Fusion Advisory Board Member