A conversation with Practice Fusion CEO Ryan Howard

In May I interviewed Ryan Howard, CEO of Practice Fusion, a free web-based electronic health record (EHR). A lot has happened in the EHR world since then so I thought I'd check back in. (This interview was conducted via email.)David Williams: How are things progressing at Practice Fusion since our last discussion six months ago?Ryan Howard: Practice Fusion has grown significantly in the past six months. We brought on Salesforce.com as an investor, partnered with BioReference and Quest Diagnostics, passed the 22,000 user milestone and are in the process of launching our Patient Health Record (PHR). We’re now the fastest growing EHR community in the country with 400 new sign ups each week. It’s been a great period for us and we’ve more than doubled the team here in San Francisco.Williams: With the definition of "meaningful use" coming into view, how is that shaping the way physicians are looking at EHR?Howard: The Meaningful Use criteria as they stand in draft format are pretty extensive – the focus on interoperability, connecting with patients, eprescribing and reporting to CMS – well beyond just an electronic version of a patient chart.  These connection requirements exceed what a lot of the legacy vendors can provide. If you have a locally-installed EHR in your practice, you’re looking at a brutal year ahead trying to get that system to be interoperable. It would be like trying to turn a car into an airplane.So I think physicians are shifting their focus to web-based EHR systems that already have his data exchange structure in place. We’ve seen a surprising increase in the number of customers who already had an EHR installed making the switch to Practice Fusion.Williams: When we spoke you mentioned that Practice Fusion is not CCHIT certified. Why not?Howard: The HITECH Act’s Meaningful Use and HHS certification plan has canceled out any other EHR certification process.   CCHIT is not going to be the only HHS-approved means for Meaningful Use certification. Practice Fusion is looking at independent organizations like the Drummond Group who have announced their intention to certify EHR’s and have an extensive history of outcomes-oriented evaluation.  Whatever emerges as the best way to be HHS-certified, we will pursue.Williams: Will Practice Fusion users be able to meet the "meaningful use" test?Howard: Absolutely yes. We’re confident that Practice Fusion will be HHS-certified before the HITECH stimulus incentives begin and we have a published road map based on the drafted criteria. Practice Fusion issued a certification guarantee in September.Williams: With incentive payments coming, is the fact that Practice Fusion is free as much of a draw as it was originally, in the pre-ARRA days?Howard: Why would a physician choose a system that will cost them tens of thousands of dollars up front and several thousands of dollars continuing each year when they could go with a free EHR that has the same or better features and pocket the $44,000 to spend however they wish? Our free model continues to be a huge advantage.Williams: How does Practice Fusion compare with other Internet-based clinical systems such as Doctations and American Well?Howard: I think they’re both viable technology solutions in the marketplace, each is pretty advanced on the technology side.  But they’re lacking the adoption rate and community size. In this “land-grab” environment, a lot comes down to usage.