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These 5 Innovative Companies Are Cause for Health IT Hope

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When the topic is health IT, it’s easy to get caught up in discussing the major EMR players.

And because of Meaningful Use, there’s a tendency for everyone to do the same things — even if they go about it in different ways. Whether you’re a giant like Epic, an upstart like Kareo or a specialty firm like the gastroenterology-focused gMed, you’re likely making sure, for example, that your customers will be able to exchange structured care summaries with other providers and with patients.

But there’s still plenty of innovation in health IT, much of it with little or no connection to MU2 or other federal requirements. Startups all over the country are trying to improve lives through more efficient collection and use of data.

Here’s a sampling of startups and specific innovations:

  • HealthLandscape. This Cincinnati-based firm markets a mapping application that lets you input data from a variety of sources. The idea is to better understand health information by visualizing it. The company is a subsidiary of the nonprofit Health Foundation of Greater Cincinnati, which worked with the American Association of Family Physicians and the Robert Graham Center to develop the platform.
  • SwiftPayMD. This iPhone and iPad app from Atlanta-based Iconic Data allows physicians to note diagnostic and billing codes by voice right after seeing a patient. I have to admit, when I stopped to think about it, I was surprised that doctors couldn’t already do this. The major selling point: It helps practices to get paid as much as two weeks sooner.
  • Vivify Health. Based in Plano, Texas, this startup has created a cloud-based platform for monitoring and testing patients remotely. Its system works with just about any consumer mobile device to provide customized care plans, coaching, educational videos and interactive video conferencing. In a press release, Vivify Health said it’s helping hospitals, home health agencies, payers and others to reduce readmissions, manage chronic diseases and improve care transitions. It received funding this year from Ascension Health Ventures and Heritage Group.
  • Drchrono. This Mountain View, Calif.-based company bills its flagship product as “the original mobile EHR built for the iPad.” It was part of the Y Combinator, a Mountain View-based seed accelerator, in 2011. Drchrono in 2012 raised $2.8 million in funding led by venture capitalist Yuri Milner.
  • Doc Halo. This firm, based in Cincinnati, makes possible HIPAA-secure texting. (If this list seems slightly Cincinnati-centric, it’s because I worked in the city for eight years and know the market better than I know others.) Many doctors use regular text messaging to discuss patient information, but they shouldn’t. Doc Halo’s mobile app system uses several levels of encryption.

These are just a few projects that I thought were cool. Based on what they’re doing, there’s plenty to be hopeful about in health IT. There are, of course, many other firms equally worthy of mention. And there are now accelerator programs all over the country specifically for health IT startups.

I often get the feeling that the federal government’s involvement is taking the joy out of health IT. That’s not the case, but amid the push to meet MU2 requirements, you might have to look a little harder to find it.

And with these startups, here it is.

Disclosure: gMed and DrChrono are both advertisers on this site.

October 1, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

EMR Market Share

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Editor’s Note: This is the first post on EMR and HIPAA by James Ritchie. James is a longtime journalist including the past eight years as a staff writer with the Cincinnati Business Courier.

Practice Fusion announced in June that it led the EMR industry in market-share gains.

Citing SK&A reports, the San Francisco-based firm boasted that it controlled 5.8 percent of the market as of May, up from 3.8 percent in July 2012. Beyond Practice Fusion, only Epic, AthenaHealth and Cerner showed gains.

In this data, which represents physician offices only, Allscripts was the market leader, with a 10.6 percent share. Not far behind were eClinicalWorks, with a 10.5 percent share, and Epic, with 10.3 percent. (The report that Practice Fusion links to is actually dated January 2013.)

But there’s more than one way to look at the EMR share picture.

Epic was the clear winner in a report by the Austin, Texas-based consultancy Software Advice on meaningful use attestations. Epic, based in Verona, Wis., accounted for 20.3 percent of attestations for a complete EHR in an ambulatory setting.

The firm’s competitors were nowhere close as of the March 2013 report. Allscripts was the system of choice for 11.6 percent of attestations by eligible professionals, and eClinicalWorks accounted for 8 percent. Next on the list were NextGen Healthcare, GE Healthcare and, with 2.7 percent share, Practice Fusion.

Software Advice claimed that the figures, based on Centers for Medicare and Medicaid Services data, might be the best around. They at least provide a standard in a market where vendors “use varied criteria to calculate their customer base,” according to the company.

Companies “might count number of users (which could include everyone from physicians to administrative staff), number of medical providers (which could include everyone from physicians to midwives) or number of practices,” Software Advice noted on its website.

Practice Fusion, founded in 2005, claimed in its press release to have doubled both its monthly active user base of medical professionals and its patient population between 2012 and 2013. The company claims to reach “a community of 150,000 medical professionals serving 65 million patients.”

The prospects for the free model that Practice Fusion uses are still up in the air. Doctors might question whether they want ads, unobtrusive as they are at the bottom of the screen, to compete for their attention when they’re entering patient data. Data, by the way, might prove to be the real revenue generator for Practice Fusion. In June the firm launched Insight, an analytics product offering a population-level view of diagnoses, prescribing patterns and other information. It’s a model worth watching. If Facebook and google can build businesses on data, maybe Practice Fusion can, too.

The SK&A figures show just how fragmented the outpatient EMR/EHR market is. The top 10 vendors accounted for only 64.8 percent of attestations, leaving about 35 percent of the market to the “other” category. By Software Advice’s count, 560 firms logged at least one meaningful use attestation.

Eager to steal share are firms like Irvine, Calif.-based Kareo Inc. It launched its own free, cloud-based EHR in February based on technology acquired from San Mateo, Calif.-based Epocrates Inc. The firm reported in June that 4,000 providers had signed on, with a third of them moving from another EHR.

Of course, ambulatory adoption is only part of the EMR story.

Epic is No. 1 among the nearly 3,000 hospitals that have received federal incentives for using complete electronic records systems, according to Modern Healthcare. The company holds a 19.6 percent share, followed by Computer Programs and Systems Inc. with 15.5 percent, Meditech with 14.1 percent and Cerner with 11 percent. The late-May report was based on numbers from CMS and the Office of the National Coordinator for Health Information Technology.

The inpatient market is far less fragmented than the outpatient space. The top 10 companies control 92 percent of share, according to the report.

No matter how you count share, the EMR space will continue to be hypercompetitive because of the dollars at stake. The market amounted to $20.7 billion in 2012, up 15 percent from 2011, according to the research firm Kalorama Information.

July 18, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

Practice Fusion EMR Brings Patients Into The Picture

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Practice Fusion was one of the first free, advertising supported, cloud-based EMR to enter the market and has likely been the loudest proponent of free EMR software. Although, they have some interesting Free EMR competitors like Mitochon and Kareo. Since 2007, Practice Fusion has focused on offering unfettered access to its product in exchange for physicians being willing to accept advertisements relevant to the health records they’re using and the aggregate use of the EHR data.

The company, which has raked in venture capital in buckets since its founding, now says it has 150,000 healthcare providers using its EMR and records on 60 million patients, according to a piece in The New York Times.

Now, the company has taken another step in its free-for-all model with a new service it calls Patient Fusion. Patient Fusion is a new service which allows patients using the system to schedule appointments with any participating doctor who uses the EMR. It also allows patients to rate the doctors in question and to access their records with permission. So far, 27,000 of Practice Fusion’s EMR users have signed up for the service, the Times reports.

The Times columnist covering this announcement speculates that Practice Fusion has launched its new product as a means of building up patient traffic, but I don’t see how that would work. Patients may see more of their records, but this won’t necessarily do anything to increase the number of doctor-based views the network can sell to lab companies and pharmas.

On the other hand, Patient Fusion could prove to be a powerful way of attracting and keeping doctors who want to offer easy-to-administer appointment scheduling to patients. Also, getting patients engaged with their medical records is very much in the spirit of Meaningful Use and the ONC’s priorities generally, so this new patient feature could be a beacon for doctors going through MU-motivated EMR switching this year.

Bottom line, this seems like a nifty idea. I predict that most of Practice Fusion’s EMR customers will sign up over the next year or so.

April 22, 2013 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Some Inside Baseball for the EHR World

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I thought I’d take this moment to take a quick look at what many might consider inside baseball when it comes to the EHR world. Although, I’ve been intrigued by a couple announcements that were made recently.

The first announcement is Kareo buying the Epocrates EHR which came just in time for HIMSS. You might remember that I covered the Epocrates EHR on a number of occasions. I first saw the Epocrates EHR at HIMSS in 2010, and subsequently wrote about Epocrates “killing” their EHR immediately after launch. When that happened, I think we all wondered what would happen with the Epocrates EHR code base. You don’t just throw a meaningful use certified EHR to the curb do you?

We now know the answer to that question is no. Kareo saw fit to acquire the Epocrates EHR software and Dr. Tom Giannulli, formerly of Epocrates, is now the Kareo CMIO. I can imagine that Dr. Giannulli wanted to stay with his baby (the Epocrates EHR). I’m also quite intrigued that Kareo is offering the EHR for free (at least for now?). The funny thing is that I had written that the Epocrates EHR should be free. I guess I was sort of right, but I definitely didn’t think that the Epocrates EHR would become free since Kareo makes their money from the Practice Management and billing side of the house. We’ll see how that strategy works for Kareo. In some ways it’s taking a page out of the AthenaHealth playbook.

What might be simply an odd coincidence of timing (or not), Practice Fusion just sent out a letter (shown below) to its users from Practice Fusion Founder and CEO, Ryan Howard. In it he acknowledges Practice Fusion’s past challenges with billing, and he outlines their strategy on making the Practice Fusion billing situation better.

Does this relate to Kareo? Maybe, maybe not. What I do know is that many Practice Fusion users are on Kareo as well since it was Practice Fusion’s only major Practice Management software partner when Practice Fusion started. It seemed like a great match since Practice Fusion only had EHR, and Kareo only had Practice Management. Kareo now has an EHR, and Practice Fusion is working on billing and practice management. I guess we should have seen this coming.

Here’s the full email I got from Practice Fusion (Full Disclosure: They said Dr. Lynn, but I’m not a doctor.):

Hi Dr. Lynn,

The Practice Fusion team takes pride and appreciates your role in making us the fastest growing EHR community in the US.

We also recognize that billing has not been our strongest suit. Improved superbills and an updated payer list have been highly requested by our user community.

That’s why, by the end of March, we’re going to deliver you major new enhancements to your billing experience:

• A comprehensive, streamlined superbill, directly integrated with your workflow
• Flexible reports for billing users
• The ability to export billing data to most major billing systems
• New billing software and service partners with more economical pricing

This means you can stick with the exact billing workflow and system you use today in your practice. We’re building the ability to integrate directly by allowing you to export data to your billing system via HL7. If you prefer superbills, you’ll soon have a drastically improved superbill to work with. And if you’re looking for a new billing system altogether, we’ll also have new, low-cost partners coming soon.

We’re excited to be making your EHR faster, more flexible and easier-to-use. Lastly, our commitment to you has not changed since the day you signed on—Practice Fusion will deliver all this for free. Stay tuned for our billing revamp at the end of March!

Best,
Ryan Howard
Founder and CEO
Practice Fusion
ceo@practicefusion.com

February 22, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.