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Patient Advocate, Multiple Screens, EHR Consolidation, and EMR Happening

Posted on August 12, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re in the middle of the dog days of summer. I can see the Fall Conference slam around the corner as I plan my various itineraries. Plus, my children just found out who their teachers will be this Fall. So, Fall is just around the corner. In the 110 degree heat of Las Vegas, that’s a very good thing. It’s always hot in the summer in Las Vegas, but this is really hot.

Enough with the digressions. Time to take a quick look at some of the interesting EMR and health IT tweets.

Ariana Markle ‏@GoldAtlantis
Dying for Data: Comprehensive #EMR systems promise to save lives and cut #healthcare costs –but how do you build it? http://spectrum.ieee.org/biomedical/diagnostics/dying-for-data

The article linked in this tweet is really interesting. It starts with a really compelling story. Something that the patient advocates will love if they haven’t seen it already. The problem is that EMR implementation on its own still doesn’t solve the problem that’s described in the story. The real solution is some sort of HIE or portability of patient data. EHR is one step towards that, but is still far away from that state of healthcare portability nirvana.


Nice to see a doctor who loves his EMR. Even better than a 27″ screen in most cases is dual monitors. I can’t imagine life without dual monitors. I’m not sure why doctors do without it as well.


I just don’t agree with all the people talking about widespread EHR consolidation. Here’s a great quote from the article that actually supports the lack of EHR consolidation as well:

Ironically, according to Mercom Capital Group roughly $150m in venture capital has been poured into the EMR/EHR market in the last 18 months, pointing to continued confidence (or overconfidence!) in this space.

It’s not ironic. We’re in the golden age of EHR. We won’t see many folding up shop for quite a while.


The core thing for me in this tweet is that EMR is happening. Doctors can continue to resist, but EMR is going to happen. It was temporarily delayed while doctors waited for meaningful use. Now, many are going after the EHR incentive money. Eventually doctors won’t know life without an EMR.

$34 Million Series C Funding for Practice Fusion

Posted on June 28, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Artis Ventures led the Series C funding round for Practice Fusion. They raised $34 million in this round with them now having raised over $64 million total. The full list of investors joining the Series C round includes long-time investors Felicis Ventures and Band of Angels, plus Glynn Capital, Ali and Hadi Partovi, Founders Fund, Morgenthaler Ventures, Scott Banister, SV Angel, Ghost Angel, and several other institutional and individual investors.

Some other good stats from the Techcrunch article on the EHR investment:
*Currently 170 employees, and expect to reach 250 employees by year’s end
*Added 4x a many users as Allscripts last quarter (Who Ryan Howard considers their largest competitor)
*2012 Q1 Revenue was “comfortably in the seven figure range”
*Hosts 40 million patient records
*150,000 doctors signed up (This is their signed up user number, not their active user number)
*7 months ago they were at 25 million records and 130,000 signups

I also found this Techcrunch quote fascinating: “Howard was careful choosing Artis Ventures to lead the round, telling me “it’s a wedding. You’re married to that investor. Artis is a hedge fund with a venture fund. It’s preparing us. It’s who would be buyers in a public market” indicating the company has its sights on an IPO.”

It’s worth noting that the founding doctor/CMO (Chief Medical Officer), Robert Rowley, MD, also recently left Practice Fusion. He’s still actively blogging about healthcare IT on Robert Rowley, MD and he tells me it was an amicable departure. I think it’s noteworthy though since Dr. Rowley was the physician face of Practice Fusion since the start of the company.

There’s no doubt that Practice Fusion is now a major player in the EHR world. Although, I’m still interested to see if they can live up to a $64 million financing at around a half a billion dollar valuation. I wonder how quickly things like having their software built using Flash will catch up with them. Plus, Practice Fusion was designed with the small doctor office in mind. Will it be able to evolve its platform to be able to support larger group practices?

I do think they have the right culture when it comes to opening up their data to other outside developers that will be required for them to have a widely adopted healthcare platform. We’ll see how the healthcare ecosystem responds to that type of open platform. They now have plenty of money in the bank to be able to find out.

Full Disclosure: Practice Fusion is an advertiser on a couple Healthcare Scene websites.

EHR Company Funding Risks – Large Company Backed EHR

Posted on June 1, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This is the fifth and final post in my EHR Company Funding Risks series that was started in response to my original post about the The Current Health IT & EHR Bubble. In this series, we’re looking at the following EHR company categories: Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR. Next up is Large Company Backed EHR.

Large Company Backed EHR
The companies in this category are quite interesting, because they can often exhibit the characteristics of EHR software in every other category of EHR company. It’s all about the story of the company. For example, I’ve come across some really large companies who have developed their own EHR and only have 1 practice using their EHR. This is very much like a seed company. There are some larger companies who have acquired essentially the EHR software of another company and now they’re trying to grow the user base similar to a well funded EHR company.

I can think of a few EHR acquisitions where the large EHR company acquired a cash flow positive EHR company and they’re continuing to grow that EHR company in a cash flow positive way. Then, of course there are a few large companies that have large EHR install bases as well. There’s also everything in between in this category, so it’s hard to generalize about this group.

With that said, since it has the backing of a large company (in healthcare or not in healthcare) the biggest risk is that they’ll shift their priorities from the EHR software and on to something else in their company. Most large companies trying to get into the EHR software business come quick out of the gate. If they do well, they’ll continue growing it like they did. If they don’t do well, they’ll often throw in the towel by cutting resources to that venture and then eventually a sale of the EHR assets to another company.

Read all the posts in the EHR Company Funding Risks series.

EHR Company Funding Risks – Large EHR Companies

Posted on May 29, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This is the fourth post in my EHR Company Funding Risks series that was started in response to my original post about the The Current Health IT & EHR Bubble. In this series, we’re looking at the following EHR company categories: Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR. Next up is Large EHR companies.

Large EHR Companies
Most of the EHR companies that fit into this category are publicly traded EHR companies (with a few notable exceptions). Each of these EHR companies has their own story, but the majority include some mix of EHR acquisition or EHR merger to get into or expand their EHR market reach. Often this means that the EHR company has more than one EHR software under their purview.

Many of the larger EHR group practices and particularly the multi specialty clinics look to the larger EHR companies because these large EHR companies have usually worked to try and cover every EHR specialty in their EHR. In most cases the EHR software has been around for a very long time. This is good because then the software is often mature, but it’s also bad because it’s often built on old technology.

The large complaint against these large EHR companies is that they’re large and impersonal. That they are out of touch with the customer. Of course, this is kind of the nature of being a large company and having a large user base. Plus, you can imagine the challenge listening across a half dozen different EHR software products.

The risks associated with these large EHR companies software usually has much less to do with cash flow and much more to do with the decisions of the EHR company executives. With multiple EHR software under their umbrella, will they choose to close the one you use down and focus on their other EHR products? Will your EHR product get lost in the corporate shuffle of priorities? Sure, they’ll still support your EHR product if there’s an issue, but have they dedicated the company resources to your EHR or to another product in the company’s portfolio?

One argument that larger EHR vendors have made is that they’re the only companies that have the resources available to create the EHR software of the future. Some argue that many of the smaller EHR companies won’t be able to meet meaningful use stage 3, because they don’t have the resources available to do that. Not to mention when we eventually have to do Watson like Smart EHR software integrations across large data sets. I think the first part about doing MU is overstated. I think the jury is still out on how smart EHR software will become over time and how smart physicians require their EHR to be.

Next up, we’ll look at Large Company Backed EHR. Read all the posts in the EHR Company Funding Risks series.

EHR Company Funding Risks – Positive Cash Flow EHR Companies

Posted on May 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This is the third post in my EHR Company Funding Risks series that was started in response to my original post about the The Current Health IT & EHR Bubble. In this series, we’re looking at the following EHR company categories: Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR. Next up is Cash Flow Positive EHR companies.

Positive Cash Flow EHR Companies
This type of EHR company is usually a conservatively funded EHR company (often through non traditional funding mechanisms, or through a private buy out) that have grown large enough that their current user base provides enough cash flow to cover the EHR company’s ongoing expenses. The majority of these EHR companies have been around for a long time. In most cases they started out as EHR only companies (since everyone already had a PM system) and over time were able to grow a large EHR user base.

Instead of going after a large funding round, these EHR companies stayed small and chose to grow slow and steady over time. At this point, most of these companies have a large enough user base and enough cash flow that they’re in it for the long haul. While a sale could happen, most are content to continue growing the way they’ve done for a long time.

The users of these systems are usually happy with the software. Plus, they’ve often been using it so long that the idea of switching is something they wouldn’t even entertain. Even if the EHR software has some issues, the practices know the problems and have found ways to work around them. Plus, I’ve heard from many about the kinship they have with the EHR software that they’ve had for so long.

The real question for these EHR companies is how well they’ll be able to retain their existing EHR user base and/or how well can they acquire new EHR users. At some point if they aren’t maintaining or growing their EHR user base, they won’t have the cash flow needed to continually improve the EHR system with changing technology and clinical requirements. Plus, considering the fast pace of technology, time and their legacy software creation starts to catch up with them.

Many of the best specialty specific EHR companies have been able to reach this category. Some are still in the seed funded or well funded categories, but most of the specialty specific EHR companies I’ve seen have reached the cash flow positive category or are really close to getting there. Most of them realized that they had a very specific EHR market and so they had to grow it slow, steady and focus on revenues early.

Next up, we’ll look at Large EHR Companies. Read all the posts in the EHR Company Funding Risks series.

EHR Company Funding Risks – Well Funded EHR Companies

Posted on May 22, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This is the second post in my EHR Company Funding Risks series that was started in response to my original post about the The Current Health IT & EHR Bubble. In this series, we’re looking at the following EHR company categories: Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR. Next up is Well Funded EHR companies.

Well Funded EHR Companies
These EHR companies are those that have moved past the beta phase of their EHR and have usually gotten a large second round of funding that will allow them to work on scaling their EHR user base. This is where I see the largest number of what most would consider “startup” EHR companies. They usually have a few million in the bank and somewhere between 50-200 doctors on their platform.

With the money in the bank, most of these EHR companies have a number of years of runway to be able to see their EHR company play out. They still haven’t made it to what I call the EHR promise land of 1000+ doctors on their platform, but they have enough money to try and reach that goal over the next couple years.

The risk for a practice choosing one of these well funded EHR companies is what will the EHR vendor choose to do once they reach 1000+ doctors. Will they sell the company off to someone else (which almost never ends well for the practice)? Or do these EHR vendors have the staying power and desire to go after something much larger? The other risk is that the EHR company will only ever have a few hundred doctors. When you’re a well financed EHR company that doesn’t gain traction, this will usually end up in a fire sale of the EHR to some other company who wants to acquire the users you do have.

Despite the risks mentioned above, many really love these “startup” EHR companies that have plenty of funding. They’re usually very responsive companies that are able to have a real personal touch with their users. They usually have some unique selling proposition which the practice found so intriguing in the first place.

Most of the Free EHR vendors fit in this or the previous seed funded category as well. However, the amount of funding that the Free EHR vendors require is a multiple higher because they usually need to be able to reach a certain install base before their revenue model kicks in. The other principles are very much the same. Although, most of the free EHR vendor revenue models require a large user base. The Free EHR promise land is probably closer to 10,000 and some might argue that to really make it work they need 100,000+.

Next up, we’ll look at Positive Cash Flow EHR Companies. Read all the posts in the EHR Company Funding Risks series.

EHR Company Funding Risks – Seed Funded EHR Companies

Posted on May 18, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In my post called The Current Health IT & EHR Bubble a good conversation was started about the way EHR companies are funded and how many of them are at risk of running out of money. Obviously, this should be a concern to anyone selecting an EHR software. Once an EHR company runs out of money, it’s almost never pretty for their users. The EHR software is usually sold to a larger EHR vendor or other EHR competitor and you can imagine which EHR that vendor chooses to sunset.

Here’s a look at how I define the various funding for EHR companies and the risks associated with each EHR funding situation: Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR. I’m sure some of these categories could be divided other ways too. Plus, some EHR companies fall into the middle of 2 categories. However, hopefully you can use these categories to get an idea of how the EHR software you have or are looking at getting is positioned as far as EHR funding.

Over the next couple weeks, I’ll take each category (Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR) and discuss how I define each category and some of the characteristics and risks associated with each type of EHR vendor. First up is Seed Funded EHR companies.

Seed Funded EHR Companies
This is the relatively new EHR company. In most cases, these EHR companies have a very small set of basically beta EHR users. Most people see these companies as the most risky and that’s probably true. Small funding and small user base means you have less revenue and less cash in the bank. However, most of these companies also have smaller staff and burn through money much slower than large companies.

The question with seed funded companies is can they get to either the next round of funding (the more likely option) or enough users before they run out of money. This is often a hard question to answer. In the current EHR investment market, it seems most EHR companies in this stage have gone and gotten the next round of EHR funding while the funding market is good.

Some physicians love these companies. As one of their beta users, your feedback is heard and incorporated into the product. Plus, it’s exciting for many of us to see something build out over time. This is particularly true when the small EHR software company is doing something innovative and unique. The good part for the EHR market is that if a company like this runs out of money, only a few practices are affected. Plus, those practices that are affected usually knew what they were getting into when they chose the small EHR company.

If a seed funded EHR company is able to build a user base with just their seed funding combined with some good boot strapping, a number of them will be able to kick and scratch their way to profitability with a much smaller group of customers. Although, once they do that, they move from this category into the Cash Flow Positive category of EHR companies

Next up, we’ll look at Well Funded EHR Companies. Read all the posts in the EHR Company Funding Risks series.

Hello Health Raises $10 Million in Funding for Patient Management Platform (EHR Built In)

Posted on February 29, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The news recently came out that Hello Health has raised $10 million in funding. For those that aren’t familiar with Hello Health, here’s a pretty good description of what they do from the press release:

For years, physicians have experienced revenue reductions and, more recently, declining patient visits and must now look to ‘market their practices’ beyond quality of care to include: secure online communications that improve information and care team access, and provide greater convenience for patients. Hello Health is a Patient Management Platform that allows independent primary care physicians to transition from paper to electronic medical records and to provide a patient health portal through a subscription-based plan. Patients pay a small fee for the ability to schedule appointments, request lab results, renew prescriptions, share medical information and communicate (via HIPAA-compliant email, instant messaging and video consults) with their doctors and medical health professionals. The Hello Health Patient Management Platform was developed to provide an improved revenue stream for physicians while also enhancing patient engagement and providing better time and workflow management, all of which combine to strengthen the independence and sustainability of a practice.

I think it was a really interesting move for Hello Health to put a full blown EHR on top of their previous product offering. If you’re going to connect doctors with patients, then you really need to tap into the doctors EHR software. What better way to tap into that software than to just give the doctor the EHR software for free.

I also find it interesting that BlueCross BlueShield Venture Partners is part of the funding round. While this is the venture arm of BlueCross BlueShield, it’s still interesting to see a health plan get so close to EHR software. There are plenty of health plans getting connected to HIEs, but not as many to EHR software.

I think the model of healthcare that Hello Health is working on is quite interesting and could represent a larger trend in healthcare: technology facilitating lower cost healthcare. I’ll be writing more on this in the future.

DrChrono EMR Raises $2.8 million and Has 15,000 Registered Providers

Posted on January 30, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A few days ago the news came out that Y Combinator startup company DrChrono has raised another $2.8 million in funding. Here’s the summary from Techcrunch:

Drchrono, a startup that simplifies the professional lives of doctors by bringing electronic health records and much more to the iPad, has raised $2.8 million in funding led by Yuri Milner, with Google’s Matt Cutts and other investors participating. The startup had previously raised $1.3 million in seed funding from Milner, General Catalyst, Charles River Ventures, 500 Startups, Gmail creator and FriendFeed cofounder Paul Buchheit, Cutts, and the Start Fund.

It’s an interesting mix of people that are funding DrChrono. Matt Cutts interests me a bunch since he works on the search engine team at Google in charge of Spam. Obviously, this is a quite different space.

The most interesting information in the Techcrunch article is the number of providers and patients that DrChrono has in its system.

The company also announced it now has more than 15,000 registered providers, and more than 400,000 patients using the drchrono platform.

Of course, we know how EMR companies are with these numbers. It’s one thing to have a registered provider and it’s quite another to have them actually using the EHR software. Also, I can’t help but wonder if the 400,000 patients includes imports of a physicians past patients. I’d love to hear some real numbers. For example, how many daily active users (doctors) do they have using their iPad EHR?

I also find it interesting that DrChrono has only taken $4.1 million in funding versus funding like CareCloud’s $27.3 million and Practice Fusion’s $38 million. Seems like DrChrono has chosen the much more conservative EHR software route as opposed to the more ambitious healthcare platform route that the others are working on.

$2 Million More for Practice Fusion EHR

Posted on January 13, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

News travels fast on Twitter and I couldn’t help but notice this tweet about Practice Fusion raising another $2 million.

You can see the full press release from Practice Fusion about the new funding here. Here’s the most important section of the release:

Stremel, who led Facebook’s mobile efforts, joins existing investors Ali Partovi, angel investor and co-founder of LinkExchange, and Hadi Partovi, angel investor and co-founder of Tellme, in the current investment. Including the $23 million Series B round of financing led by Founders Fund in 2011, Practice Fusion has raised over $38 million in total funding with investments from Band of Angels, Felicis Ventures and others.

Considering this is only a $2 million investment, this seems more like a strategic investor as opposed to Practice Fusion needing some extra cash. Considering the mobile experience of these investors you can easily see this being Practice Fusion moving aggressively into the mobile space. It could be a smart move since past efforts by Practice Fusion to go mobile have basically been a flop.