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EMR : Free or Not Free

Free ambulatory EMR platforms have become  popular with physician practices — particularly independent practitioners. However, for this demographic, a free EMR can mean more than a sense of euphoria.

There are several free EMR systems available, including Practice Fusion, Hello Health and Kareo, but their revenue-generating models all differ.

Practice Fusion is the poster child when it comes to free EHR platforms. The company has received several rounds of funding from private investors and has been referred to in the media as “The Facebook of EMRs.” Practice Fusion targets small to midsize medical practices throughout its evolution, has remained completely free for physicians to use. It has been careful to ensure the marketing messages don’t disrupt physician workflows; a single, almost understated, ad appears on the user interface, and this ad changes whenever the clinician navigates to a different EMR screen. Click that a patient has allergies, see an ad for Zyrtec. That in itself has brought up data mining/patient privacy concerns, as well as possible HIPAA rule violations. Many question whether this approach alone is viable for an application as critical to business operations and patient care as an EMR, considering advertising is a fickle business that can be greatly influenced by ebbs and flows in the economy.

Hello Health relies on patient contributions to make its EMR free. Physicians who use Hello Health ask patients to pay for the system. This model is actually billed as potentially revenue-building for offices, as doctors get about one-third of the patient’s total investment directly. In return, however, the patient gets access to things other patients who don’t pay for Hello Health don’t get. For instance, online appointment scheduling with blocked out periods of time strictly for Hello Health patients, virtual visits and emailing their doctor directly. It’s more of the concierge model for patients who want to pay for it.

The common drawback to these free EMR systems however is the data and security concerns. This has many users and practices asking, who owns the patient data in a free EMR, and what is being done with it?

For instance, a recent article focused on Practice Fusion emailing product reviews directly to the patient with the doctors’ name on the email – making it seem the email came directly from the doctor, when many had no idea this was happening.  Hello Health’s privacy policy also says that the data they collect can be used to send customers product news, send surveys or collected for research purposes; they do however say the data is “anonymized” prior to being sent.  Many have suggested that the real revenue stream for these free EMRs will be the selling of patient data to drug companies, researchers and others.

The major issue here with these free EMR systems is data privacy and security. A few EMR service providers have been known to sell sensitive user data to various drug manufactures and medical representatives. The question that always stays with these free EMR systems is that of doubt and knowing that your entire medical history is out in the open for anyone to see. For people who don’t consider this to be such a huge threat, a free EMR system is the way to go for them!

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cloudchowk is a healthcare software company based out of Delhi. Its software help medical labs, clinics and patients share information and collaborate seamlessly.

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