Practice Fusion is a cloud-based electronic health record (EHR), offered as a free Web application and used primarily by sole practitioners and small practices. The company makes money from advertising and providing market research data to pharmaceutical companies and other healthcare industry businesses.
The lack of a price tag, combined with Practice Fusion's ability to offer doctors a chance to cash in on Meaningful Use incentive payments, has allowed the company to sign up medical practices at a rate of about 400 a week. Practice Fusion says 100,000 medical professionals are active users, accessing the software at least monthly.
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Federal incentives for adopting electronic health records were introduced as both an Obama administration stimulus measure, as well as a component of healthcare reform intended to introduce efficiencies and reduce medical errors. The government has paid out more than $16 billion to both hospitals and individual providers, but to qualify for continued payments and avoid Medicare cuts providers must meet a set of more demanding Stage 2 requirements in the 2014 fiscal year. Modern Healthcare recently reported that less than 10% of the EHRs certified for Stage 1 have completed certification and testing for Stage 2, putting providers in a bind.
Practice Fusion doesn't have Stage 2 certification in hand yet, either, but is guaranteeing that it will by the end of 2013. "It will pass all the tests -- we're well ahead of that," CEO Ryan Howard said in an interview. The guarantee is backed with an offer to pay up to $5,000 in EHR costs for any new customer who switches to a different EHR if Practice Fusion's certification timing is not met.
Practice Fusion is benefiting from the advantages of offering a cloud solution, while many competitors are busy upgrading enterprise software, Howard said. He sees no reason for deadlines to be pushed back. "The vendors can complain about it, but they all took their checks. They got the upside, so they've got to be willing to participate on the downside, and the downside is risk."
For a provider, using a Stage 2-certified EHR is a requirement for continued incentives, but the provider must also meet goals for active and effective use of the software and for patient engagement. For example, to meet Stage 2 objectives, more than 50% of patients seen by the provider are supposed to be provided with timely access to their online health information, and more than 5% of patients are supposed to access that data in some way -- by viewing it, downloading it, or transmitting it to a third party. Providers don't have to meet every goal on the list, but they do have to meet the majority of them.
The patient-engagement objectives might be the real challenge because patients tend not to take an active interest in their data unless they are very ill, Howard said. Is it achievable? "No one knows because no one has done it well yet," he said. "It's not going to work for everyone." The solution is not simply for the online system to say, "here's your data -- it's a matter of how do you market to the patient?"
In other words, for the use to be truly meaningful, the patient will have to see it as meaningfully useful.