Practice Fusion Inc. is a San Francisco-based company that developed a free electronic health record (EHR) system available to physicians as software as a service (SaaS). The software, also called Practice Fusion, includes modules for patient management, e-prescribing, scheduling and billing. The company claims to support more than 30,000 medical practices and over 100,000 providers in all 50 states.
Patient management features of Practice Fusion include a library of shared charts for physicians within a practice or network, a live feed of patients' medical and diagnostic history, records of lab tests, immunization records and Centers for Disease Control and Prevention (CDC) growth charts. The e-prescribing feature maintains a patient prescription history, includes a medication library from which physicians can add custom medications and has an email feature for sending drug information and dosage instructions.
Since Practice Fusion offered its EHR software to healthcare providers for free, it made money by showing relevant pharmaceutical ads to users. Google provided the targeted ads, based on patients' conditions, and collected more than half the ad revenue. Physicians who did not want to participate in the ad-supported model could choose a $250 per seat per month option.
As of this writing in March 2018, it is not clear whether Practice Fusion will continue to offer free EHRs; the company did not return requests for comment to verify its future pricing. CNBC reported the company would end free pricing in summer 2018.
Practice Fusion was founded in 2005, and the first version of its cloud-based EHR launched in 2007. In 2009, the company made its service free since it was primarily targeting doctors in small medical practices.
The Health Information Technology for Economic and Clinical Health (HITECH) Act, which incentivized healthcare providers to adopt EHRs and related technology, was passed that same year, but most of the EHR vendors that emerged around that time charged subscription and upgrade fees.
Acquisition by Allscripts
Chicago-based EHR vendor Allscripts announced that it had acquired Practice Fusion for $100 million in January 2018. Less than a year earlier, Practice Fusion was considering possible bids for $225 million to $250 million and in 2015 had sought a market valuation of $1.5 billion ahead of potentially becoming a public company, according to CNBC and The New York Times.
The situation changed by the time Allscripts acquired Practice Fusion. The reasons are not fully clear. However, in a March 2018 filing with the U.S. Securities and Exchange Commission (SEC), Allscripts stated that, "in March 2017, Practice Fusion received a request for documents and information from the U.S. Attorney's Office for the District of Vermont pursuant to a civil investigative demand."
The government's inquiry was related to the certification of Practice Fusion's software under the U.S. Office of the National Coordinator for Health IT's (ONC) EHR certification program and associated business practices, according to the SEC filing.
The Allscripts acquisition was also controversial because top executives stood to gain millions of dollars from the deal, while midlevel employees and company shareholders would not receive anything. Stakeholders claimed Practice Fusion's leadership allegedly misled them about the company's growth potential during the acquisition process, according to a report by CNBC.
Major products and features
The company offers several products and features for physicians, as well as patients.
- Practice Fusion: Practice Fusion is the company's free EHR software. The software includes features such as:
- e-prescribing: allows providers to send e-prescriptions directly from a patient's chart;
- medical billing: allows providers to electronically check insurance eligibility and create International Classification of Diseases, 10th Revision (ICD-10) compliant "superbills," which are itemized forms that detail patient information, services rendered and insurance information;
- medical charting: provides customizable medical charting templates; allows patients to fill out intake forms electronically; and allows providers to send a patient's chart to any U.S. provider electronically;
- labs and imaging: allows providers to submit lab and imaging orders from a patient's chart and receive results in the chart; and
- meaningful use: allows providers to track meaningful use progress and attest to meeting meaningful use requirements to qualify for incentives.
- Patient Fusion: Patient Fusion is a free, web-based personal health record and appointment booking service. Patients can complete their intake forms and check in online, as well as book appointments online.
Market share and major competitors
Practice Fusion is the second-largest cloud-based EHR vendor, with more than 112,000 monthly active healthcare providers using its services, according to the company's website.
According to a 2017 report by healthcare data and digital marketing company SK&A, Practice Fusion came in fourth in the overall EHR vendor market after Epic, eClinicalWorks -- which is also cloud-based and has more than 130,000 users, according to its website -- and Allscripts with an overall market share of 6.34%.