A free Ad-based EMR

I wanted to call your attention to Dr. Scott Shreve’s posting about Practice Fusion and ad-driven revenue. Having built out half dozen EMRs in my career, it’s good to see a company like Practice Fusion giving adware a try — I don’t think they have anything to lose.

I hope they can succeed where other EMRs have failed (or at least not done so well). The technology behind EMRs is embarrassingly easy to create nowadays — most EMRs are just simple databases that act like electronic typewriters and simple filing cabinets. In fact, kids in high school doing game programming are doing more difficult things with computer science concepts than EMRs. What’s really hard about EMRs are dealing with the integration and usability headaches — which are no easy tasks. However, if you create a single-site solution where all the users connect together in one place and not have to worry about cross-site integration and the mismatch between concepts across EMR packages then it could be a winning solution.

Apparently hundreds of docs have already signed up for the free Practice Fusion site. If they can get the adware EMR concept accepted perhaps this will open up other healthcare IT service solutions in the same category. Lots to look forward to!

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12 thoughts on “A free Ad-based EMR

  1. Shahid,

    Intriguing concept. If the privacy issues can be worked out it may stand a chance. However, if I’m a provider and my patients sensitive information as well as my own exposure is handed over to an organization partnered with the worlds largest search engine & parsing tool – YIKES. Free or not, that’s scary.

    Additionally – when it comes to EMR, there’s no such thing as free, period. 15% productivity losses on average for the first year alone! How far above average do you have to be just to break even, even at free?

  2. Shahid,

    Thank you for taking the time to mention us. We have received a tremendous amount of excitement about the model from practices and health plans, alike. Around the privacy side, we have worked extensively with out attorney, Davis Wright Tremaine and are completely secure and HIPAA compliant.

    Best Regards,

    Jonathan Seb
    Practice Fusion, Inc

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  4. I agree with your assertion that most EMR’s are databases that act like electronic typewriters and filing cabinets. These software need more intelligence and decision support which is very easy to implement given that vendors are ok to work with people like SNOMED and Elsevier.

  5. Also, as a reply to Shahid’s concern about privacy, I would say that Practice Fusion only has to give Google access to parts of patients’ records. They can block access to all personal information displayed on a given form/page, so Google only reads medication, diagnosis etc. related information without knowing which patient it belongs to; taking care of privacy.

  6. I think this is a particularly interesting approach. At the end of the day most physicians are simply risk adverse, and a no-cost, on-demand approach may lower that initial hurdle. I have been tracking these guys for some time and they have some interesting things brewing:

    Practice Fusion, Top Health IT innovator 2007

    Abobe Showcases Practice Fusion

    Practice Fusion offers free EMRs to docs, paid for by ads

    Wall Street Journal Features Practice Fusion

    Practice Fusion brings free, on demand service to physicians

  7. EMRs have “failed” in the marketplace for many reasons, but perhaps the most important one is that doctors are afraid that EMRs will slow them down in the exam room. Doctors are correct to fear that – as most EMRs are in fact slower than paper. Paper is inefficient for many reason in the overall enterprise – but not in the exam room, where doctors have developed a highly efficient iconography for recording their exams. At least in some specialties – we’re in the ophthalmology EMR business – specialty specific EMRs make all the difference. We can really help our doctors get through the exam room experience faster. It took us 7 years and a lot of work. What we charge – which is on the high side – is less important to our customers than what we can accomplish. I think there may well be a place for PracticeFusion, but at least in our specialty, price and delivery method (on-line) and secondary to performance and knowledge of the specific challenges faced by specific practices.

  8. Okay on a second thought, what happens to your records (that you MUST keep for 5 years) all of a sudden disapears when this “free” service disapears after they figure out the business model is not a success? At least if the software is on your server you can run the program at its current state until you transition. If you have no data, you are *!#^@%#!

  9. Good article here. Eric's comment below about possibly losing data when a free system goes belly up does have some merit. But since we covering Practice Fusion, take a look at another free EMR from Mitochon Systems (http://www.mitochonsystems.com). It's web based and even though they don't have the traction the PF does at this time it looks like it will contend.

  10. I've started using the service. You can ask for a copy of your data to be exported in an excel file once every couple of months. I think that will give you some semblance of comfort. I can tell you that paid emrs have gone belly up and cost me a whole lotta money. The best thing is to use the free emr, print all pt files to pdf and ask them to send you your entire practice file once every 6 months. You feel safe, data is secure, and you don't spend any money.

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