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Practice Fusion CEO talks market share in solo practices and relationship with bigger vendors

Ryan Howard, the 40-year-old founder and CEO of cloud EHR vendor Practice Fusion Inc., certainly doesn’t lack for confidence.

In some ways, Howard’s brash charisma resembles that of  a market nemesis, Jonathan Bush, president and CEO of athenahealth Inc.

Practice Fusion, athenahealth and eClinicalWorks LLC, are probably the highest-profile vendors of EHRs for physician practices, though you could also include NextGen Healthcare and Amazing Charts, LLC as well.

In a media blitz this week, Howard has worked to promote the idea that Practice Fusion has distinguished itself from competitors by being number one in a rarefied space: the market segment of solo physician practices and practices with three or fewer physicians.

As evidence, Howard cites the American EHR web site’s recent survey of 1,366 physicians and clinicians, which found that Practice Fusion leads in that small space, with 15% market share.

Sure, athenahealth and eClinicalWorks have a longer reach in that they generally target bigger practices, and in athenahealth’s case, even small hospitals after a couple of recent deals.

But Howard told SearchHealthIT he is confident that Practice Fusion will stay strong in the solo practice area even as small doc practices are being snapped up practically every day by big healthcare systems, whose EHR suppliers are generally among the top five in that arena: Epic Systems Corp., Cerner Corp., McKesson Corp., Medical Information Technology, Inc. (Meditech), and Allscripts Healthcare Solutions Inc.

At least three of those – Epic, Cerner and Allscripts – are also strong in the ambulatory sandbox that Practice Fusion plays in.

Howard maintains that even when a larger healthcare system gobbles up a small practice, the system usually lets Practice Fusion customers stick with their smaller cloud EHR, which Practice Fusion provides for free in exchange for letting pharmaceutical companies market to his customers.

“Rarely do they rip and replace us,” Howard said in a telephone conversation.  “Because we’re in the cloud, they want that data injected into their system.”

He says it’s a lot easier to stay with a practice’s existing systems, and argues this hypothetical case to explain his view:

Let’s say an Epic hospital system acquires 100 solo practices and tries to replace each doctor’s existing EHR. Doing so would cost about $25,000 per customer, Howard said. And it would take Epic a lot of time and effort to install its system.

“That’s expensive and slow,” he said, which is enough reason to keep a small practice’s current EHR intact.

Like athenahealth, which has intimated it will someday seek to bring a cloud EHR to big hospitals – a development health IT hasn’t yet seen – Practice Fusion also dreams of bigger things and much bigger customers.

But achieving that would be a Herculean technological feat.

“It’s easier said than done,” Howard said.