While in Texas recently I took the opportunity to spend time with Practice Fusion, an Electronic Medical Record (EMR) vendor that I’ve covered previously. Practice Fusion is an interesting vendor, providing a free EMR service to physicians. It boasts that its solution is used to manage the records of over 31 million patients across the US through primarily small and mid-sized primary care practices. Practice Fusion must be on to something as they’ve managed to attract $38M worth of venture funding from some big names.
Anyway, I was invited to attended a Practice Fusion event where I met with a number of practitioners using Practice Fusion to run their operations. it was interesting talking with these folks about the benefits that a move to a cloud practice management solution is driving efficiencies in the healthcare industry. I wanted to dig into this a little further and took the opportunity to communicate with an internist based in San Francisco, Allan Treadwell. Treadwell is affiliated with UCSF as a volunteer clinical instructor and also has a solo primary care practice near the UCSF hospital.
I let Treadwell tell his own story about how he came to be using electronic health records;
I took over this practice almost 5 years ago, and during that time converted the practice from a traditional insurance based practice to a retainer practice. The practice has become much smaller in terms of numbers of patients, but I have been able to improve the level of care significantly.
When I assumed this practice 5 years ago the records and appointment system was entirely on paper. Scheduling appointments was difficult and time consuming, since any changes had to be made by rifling through a paper appointment book to make the requested changes. Any patient who would call asking about the date of an upcoming appointment would have to wait for my office manager to find it, after flipping pages in the appointment book. At that time I was already interested in exploring electronic medical records, but had held off on fully researching it due to a couple of constraints. One was cost. As a solo practitioner I don’t have a lot of cash to spend on an expensive system. I had worked at offices previously that had problems implementing EMR systems, and the cash outlay was substantial. I couldn’t afford to get the wrong system. Secondly, my need at the time was primarily for scheduling which I felt would be far easier to implement initially than a complete EMR system.
It was about then that I heard about Practice Fusion, which at the time was offering only an electronic scheduling service. It seemed perfect for my needs, and I decided to try it out at least on a trial basis. My entire office became dependent on it for my scheduling needs. Then, as Practice Fusion grew and offered more services, I continued to expand my usage accordingly. I now use it for all of my medical records, scheduling, internal messaging, electronic prescribing, drug interaction, lab results – in essence it has fundamentally changed almost every aspect of my practice. I continue to keep a shadow paper chart for the days when my internet connection is down, but that has only happened once in the past five years. Not only does my office run more efficiently and safely, I can also access the information from any computer. If, for example, a patient calls while I am at home or away from the office, I can quickly pull up all of their medical information in an instant.
Treadwell isn’t an evangelist at all costs, he rightly points out some areas for improvement, citing the need for a mobile application in his particular situation. More broadly than specific functionality however, the example of Treadwell shows the efficiencies that can be gained in particular by small practices moving from primarily paper-based solutions to electronic ones.
Practice Fusion’s approach of providing a free solution that is monetized by targeted advertising to practitioners will certainly turn some potential customers off. In particular targeted advertising in the health sector has a degree of “yuck factor” that many will be wary of. personally I am relaxed about anonymised data being used for contextual advertising, even in this most personal of areas, health.
While there is a downside to the advertising approach, it does have the significant benefit of putting cutting edge EMR solutions into the hands of even the smallest practice and this is a disruptive and enabling trend. Clearly the investment that the US Government has made into EMR is playing in Practice Fusion’s favor but I believe that even without this extra attention, the benefits and efficiencies driven by EMR would have gained the attention of practitioners. If we imagine a few years in the future when EMR have replaced the majority of manual systems, and the core functionality within these sorts of systems has been built out further, we can imagine how much more efficiency medical practitioners will be – that’s a positive change, and one which validates the value that cloud computing can bring.