17 Leading EHR Vendors

Fast-growing ambulatory electronic medical records (EMR) vendor Practice Fusion has become the latest company to create mobile apps for its medical records software. At last week's Health 2.0 Conference in the company's hometown of San Francisco, Practice Fusion said that both Apple and Android apps are in private beta testing.

According to CEO Ryan Howard, the mobile apps will allow users to see patient charts, review test results, refill prescriptions, and conduct secure messaging sessions with patients. The native Android and iPhone/iPad apps will be free, like the company's core EMR product.

Howard said to expect a "mobile light" version with limited functionality within a month and a full public release early next year. "The expectation is really to redefine EMR," Howard told InformationWeek Healthcare, giving physicians the freedom to keep up with their practice and patients from anywhere.

Despite some controversy over its business model, Practice Fusion has been successful targeting an underserved market segment, namely small and midsize physician practices. Howard said that practices composed of fewer than 10 doctors account for 80% of the ambulatory EMR market, or about 2.5 million potential users, counting clinicians and office staff.

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Practice Fusion claims 130,000 users now and has built an anonymized database of 21 million patient records. Howard said that the user base handles 1 million patient encounters per week and that the company is adding 600 new users a day.

The core product is free to medical practices, supported by advertising. Howard said he thought advertising would be a problem for many physicians, until he realized that doctors are used to getting things for free from pharmaceutical companies, device manufacturers, and medical supply companies, though there has been a crackdown on pharma perks in recent years. "There is a slight sense of entitlement," he said.

At first, Practice Fusion charged $300 a month, then dropped the EMR price to free with a $50-per-month support fee. The product became totally free in 2007, though there is an option to purchase a version without ads. Few do, Howard said.

When Practice Fusion first announced the free product, the San Francisco Chronicle reported that the company had cut a "deal" with Google and was "partnering" with Google's AdSense advertising network for the Internet search giant to provide the commercial messages.

Despite the headline-grabbing nature of the Google tie reported in both the Chronicle and in the Wall Street Journal, Google said that the arrangement was nothing special, just a standard AdSense arrangement available to any blogger or Web developer. That led some to question whether an EMR vendor could make a go of it based solely on AdSense revenue.

Last year, Practice Fusion announced a partnership with Dell to sell computers, scanners, printers, and networking hardware optimized for EMR usage to physician practices. Practice Fusion continues to deny accusations from some in the privacy community that the company makes a lot of its money by selling access to its rapidly expanding database.

"We have not sold any data yet," Howard says. Even so, he says that the aggregated records are "being used in a strictly de-identified way," in accordance with Health Insurance Portability and Accountability Act (HIPAA) privacy regulations. To date, Practice Fusion has mined its database for quality reporting and public-health purposes, such as to identify patients affected by a drug recall or hot spots for outbreaks of the H1N1 virus.

Howard did leave open the possibility of monetizing the database in the future, but said that Practice Fusion would abide by all applicable regulations.

Not every application is ready for the cloud, but two case studies featured in the new, all-digital issue of InformationWeek Healthcare offer some insights into what does work. Also in this issue: Keeping patient data secure isn't all that hard. But proposed new regulations could make it a lot harder. Download it now. (Free with registration.)