There’s no doubt that Practice Fusion has been making a big splash in the world of EMR. They were the first EMR company that I’d seen that was pioneering the “free” ad based EMR on the web. You can read more about my first impressions of their free EMR offering on EMR and HIPAA. This interview with the CEO of Practice Fusion is pretty interesting as well.

Now Practice Fusion has made the next logical step and added a PHR front end for patients to be able to access their clinical record. From the look of the screenshots (see below), I’m not seeing anything particularly special about the PHR. In fact, I’d likely say that this isn’t much more than an initial PHR offering. Since it is their initial offering, I guess that makes sense. Certainly they’ll be building it out over time.

What I find more interesting about this new PHR is that Practice Fusion built the PHR on top of Sales Force. SaleseForce.com recently made an investment in Practice Fusion and so this seems to be an extension of that partnership. I see this as a really interesting move for Practice Fusion to build a healthcare application on top of the Force.com cloud. It also will be interesting for SalesForce.com to enter the healthcare space.

Check out the following screenshots of the PHR application:

So many people have propped up the VA’s EMR system (Vista) as the model for how EMR should be done.  This story about the GAO finding the EMR implementation over budget is really interesting.  Here’s just one short section about the budget that they have for the VA EMR:

VA officials cited resource availability and interdependencies among projects as key drivers of cost and schedule variances. The GAO has estimated that the program will overrun its current budget – worth approximately $1.897 billion – by $350.2 million.

WOW! That’s a lot of money. I would hope that if you’re spending close to $2 billion you’d have something good to show for it. Too bad it’s just not reasonable for most doctors offices to spend that kind of money.

Here’s another interesting quote from the article (emphasis added):

VistA-FM is designed to provide a framework as well as additional standardization and common services components. It’s also intended to eliminate redundancies in coding and support interoperability among applications. However, VA officials have told the GAO that VistA-FM is costly and difficult to maintain and doesn’t integrate well with newer software packages.

I’m sure the MUMPS fans will come out of the wood work and tell us how great it is. I’m sure it does some things very well. However, I agree with the quote from this article is that it doesn’t integrate well with newer software packages. This is a major problem if we’re talking about inter operable EMR software.

Vista is free for doctors offices. I think it’s the “difficult to maintain” issue that kills most people even with the free price tag. Of course, my focus is on ambulatory EMR. The hospital environment is a mess regardless of which EMR you choose.