Re: EMR questions

[Guest guest]

They actually make more money by selling your patient data to drug companies.

Here is the question...have read some and looked at Practice Fusion, internet based emr option, that is free.  My understanding is that the company makes their money by advertising.  Does anyone use Practice Fusion,  or have much of an opinion?  One of \-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

HiI am also looking at Practice Fusion and listened to an introductory web call. I believe I was told that they were planning on improving the appointment software to make it possible for pts to make changes. I also want to know if anyone has experience with Practice Fusion.KathySubject: EMR questionsTo: Date: Tuesday, March 16, 2010, 9:40 PM

Hello All

I was part of the list serve over 2 years ago with the vision of starting an IMP but then 2 years ago in April had a family tragedy, so put everything on hold. Now I'm back, more ready than ever. Two of us are looking to hopefully open our doors in early 2011. So...we are working hard on all the details right now. I am motivated to keep start up costs as low as possible, due to being a single parent and needing to insure my family, etc

Here is the question...have read some and looked at Practice Fusion, internet based emr option, that is free. My understanding is that the company makes their money by advertising. Does anyone use Practice Fusion, or have much of an opinion? One of the draw backs I have identified so far, is that patients are not able to go in and schedule their own appointments. Is there stand alone softwear that can do the scheduling piece.

Thanks for the input.

-----Inline Attachment Follows-----

[Guest guest]

so are you saying that patient data entered into Practice Fusion is not secure? Kathy

Here is the question...have read some and looked at Practice Fusion, internet based emr option, that is free. My understanding is that the company makes their money by advertising. Does anyone use Practice Fusion, or have much of an opinion? One of \-- Graham Chiuhttp://www.compkaro ri.co.nz: 8090/Synapse - the use from anywhere EMR.

[Guest guest]

Graham,I'm so glad you jumped in here. I thought one could opt out of PF's advertising and drug information selling 'activities' by paying a monthly fee. I need to clarify my notes arrrg!A few months ago you were very helpful with your thoughts on various options. I need to retrieve that series of postings. Quick question: I love my mac. Most/all web based emrs are compatible with macs, right?Kathleen Hello All I was part of the list serve over 2 years ago with the vision of starting an IMP but then 2 years ago in April had a family tragedy, so put everything on hold. Now I'm back, more ready than ever. Two of us are looking to hopefully open our doors in early 2011. So...we are working hard on all the details right now. I am motivated to keep start up costs as low as possible, due to being a single parent and needing to insure my family, etc Here is the question...have read some and looked at Practice Fusion, internet based emr option, that is free. My understanding is that the company makes their money by advertising. Does anyone use Practice Fusion, or have much of an opinion? One of the draw backs I have identified so far, is that patients are not able to go in and schedule their own appointments. Is there stand alone softwear that can do the scheduling piece. Thanks for the input.

[Guest guest]

Hi KathleenYes, most web based emrs are compatible with Macs.See here on PF's revenue model http://www.thehealthcareblog.com/the_health_care_blog/2009/08/practice-fusion-gets-investment-from-salesforcecom.html

billing is not going to cover those users who are not using the billing services, and they do not deny selling your patient data ... de-identifed or not.

As for adverts ... well, I suspect that it's a dubious practice to allow adverts to be shown that might influence your care.

Graham,I'm so glad you jumped in here.  I thought one could opt out of PF's advertising and drug information selling 'activities' by paying a monthly fee.  I need to clarify my notes arrrg!

A few months ago you were very helpful with your thoughts on various options.  I need to retrieve that series of postings. Quick question:  I love my mac.  Most/all web based emrs are compatible with macs, right?

Kathleen 

Hello All 

I was part of the list serve over 2 years ago with the vision of starting an IMP but then 2 years ago in April had a family tragedy, so put everything on hold.  Now I'm back, more ready than ever.  Two of us are looking to hopefully open our doors in early 2011.  So...we are working hard on all the details right now.  I am motivated to keep start up costs as low as possible, due to being a single parent and needing to insure my family, etc

 Here is the question...have read some and looked at Practice Fusion, internet based emr option, that is free.  My understanding is that the company makes their money by advertising.  Does anyone use Practice Fusion,  or have much of an opinion?  One of the draw backs I have identified so far, is that patients are not able to go in and schedule their own appointments.  Is there stand alone softwear that can do the scheduling piece.

 Thanks for the input. 

[Guest guest]

After previously using SpringCharts, I have been using Practice Fusion since October 2009 with my MacBook and I have been very pleased with it. It is consistently being upgraded and they have been very responsive to suggestions and bug reports. Their e-prescribing feature works well and I look forward to their lab integration service. I like not having to worry about backing up the data, and I love being able to use it on my Mac or any other computer with Internet access. I also like the price. I considered their business model before I chose to go with them. I knew about the advertisements on the side, and they are very unobtrusive and I rarely notice them. They occupy a 1 x 6 inch banner across the bottom of the screen. They must not have a lot of advertisers because for the last few months I have only seen ads from Practice Fusion itself. The fact that they have over 30,000 users is also an indication of their growth and stability; they are less likely to go out of business than other EMR companies which have much fewer users.I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data: http://content.nejm.org/cgi/content/full/354/26/2745I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product. Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it: http://www.ehrbloggers.com/2009/12/using-ehr-data-for-public-health-good.htmlI believe it is a reasonable tradeoff to have an easy to use and free EMR that continues to improve. Others such as Graham will disagree. But there is no such thing as the perfect EMR and there never will be. And the more secure a system is, the less compatible it is with other systems. So , Kathleen and Kathleen, I think Practice Fusion is an excellent and affordable EMR that is worthy of consideration, depending on your needs and priorities.I do not have any financial interest in Practice Fusion or any other EMR. Graham, what EMR would you recommend? SetoSouth Pasadena, CA

Hi KathleenYes, most web based emrs are compatible with Macs.See here on PF's revenue model http://www.thehealthcareblog.com/the_health_care_blog/2009/08/practice-fusion-gets-investment-from-salesforcecom.html

billing is not going to cover those users who are not using the billing services, and they do not deny selling your patient data ... de-identifed or not.

As for adverts ... well, I suspect that it's a dubious practice to allow adverts to be shown that might influence your care.On Wed, Mar 17, 2010 at 4:57 PM, Kathleen Patton <krpattoncomcast (DOT) net> wrote:

Graham,I'm so glad you jumped in here. I thought one could opt out of PF's advertising and drug information selling 'activities' by paying a monthly fee. I need to clarify my notes arrrg!

A few months ago you were very helpful with your thoughts on various options. I need to retrieve that series of postings. Quick question: I love my mac. Most/all web based emrs are compatible with macs, right?

Kathleen

Hello All

I was part of the list serve over 2 years ago with the vision of starting an IMP but then 2 years ago in April had a family tragedy, so put everything on hold. Now I'm back, more ready than ever. Two of us are looking to hopefully open our doors in early 2011. So...we are working hard on all the details right now. I am motivated to keep start up costs as low as possible, due to being a single parent and needing to insure my family, etc

Here is the question...have read some and looked at Practice Fusion, internet based emr option, that is free. My understanding is that the company makes their money by advertising. Does anyone use Practice Fusion, or have much of an opinion? One of the draw backs I have identified so far, is that patients are not able to go in and schedule their own appointments. Is there stand alone softwear that can do the scheduling piece.

Thanks for the input.

[Guest guest]

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data: 

http://content.nejm.org/cgi/content/full/354/26/2745Did you get a written assurance that no personal health information would be sold?

 I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

They can only do that if they have your data and most don't. 

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product. 

They could actually charge appropriately for the service. 

Graham, I think your statement: " ... and they do not deny selling your patient data ... de-identified or not. " is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it: 

What I meant by that is that it has been shown that deidentified data can be re-identified.  I previously posted a link to a paper on the subject. 

Graham, what EMR would you recommend?I have no significant experience outside of my own EMR.

In my recent talk, I made no recommendations except buyer beware.-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

Making a profit seems to have a higher correlation with business success than having 30,000 users. As you pointed out - where is the ad revenue to pay the bills coming from? Many a web based business has over reached for market share and fell flat. Actually, most of them fail. Now, what do we know about Practice Fusion's profitability? My guess is that we know nothing since they are probably a privately held company. Perhaps they will be very successful. Perhaps they will fold up tomorrow. The same could be said for many other EMR vendors. Personally, I would bet on an EMR with a cash flow situation that I could understand. Paying an EMR vendor a reasonable amount on a monthly basis provides a rationale for their being around in the future. Free could become expensive if you invest years of your time in a company that goes bankrupt and lacks the resources to turn the lights back on in their datacenter.

Neighbors, MD

Huntsville, Alabama

-----Original Message-----From: [mailto: ]On Behalf Of SetoSent: Wednesday, March 17, 2010 12:57 AMTo: Subject: Re: EMR questions

After previously using SpringCharts, I have been using Practice Fusion since October 2009 with my MacBook and I have been very pleased with it. It is consistently being upgraded and they have been very responsive to suggestions and bug reports. Their e-prescribing feature works well and I look forward to their lab integration service. I like not having to worry about backing up the data, and I love being able to use it on my Mac or any other computer with Internet access. I also like the price.

I considered their business model before I chose to go with them. I knew about the advertisements on the side, and they are very unobtrusive and I rarely notice them. They occupy a 1 x 6 inch banner across the bottom of the screen. They must not have a lot of advertisers because for the last few months I have only seen ads from Practice Fusion itself. The fact that they have over 30,000 users is also an indication of their growth and stability; they are less likely to go out of business than other EMR companies which have much fewer users.

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data:

http://content.nejm.org/cgi/content/full/354/26/2745

I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product.

Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it:

http://www.ehrbloggers.com/2009/12/using-ehr-data-for-public-health-good.html

I believe it is a reasonable tradeoff to have an easy to use and free EMR that continues to improve. Others such as Graham will disagree. But there is no such thing as the perfect EMR and there never will be. And the more secure a system is, the less compatible it is with other systems.

So , Kathleen and Kathleen, I think Practice Fusion is an excellent and affordable EMR that is worthy of consideration, depending on your needs and priorities.

I do not have any financial interest in Practice Fusion or any other EMR.

Graham, what EMR would you recommend?

Seto

South Pasadena, CA

Hi Kathleen

Yes, most web based emrs are compatible with Macs.

See here on PF's revenue model

http://www.thehealthcareblog.com/the_health_care_blog/2009/08/practice-fusion-gets-investment-from-salesforcecom.html

billing is not going to cover those users who are not using the billing services, and they do not deny selling your patient data ... de-identifed or not.

As for adverts ... well, I suspect that it's a dubious practice to allow adverts to be shown that might influence your care.

On Wed, Mar 17, 2010 at 4:57 PM, Kathleen Patton <krpattoncomcast (DOT) net> wrote:

Graham,

I'm so glad you jumped in here. I thought one could opt out of PF's advertising and drug information selling 'activities' by paying a monthly fee. I need to clarify my notes arrrg!

A few months ago you were very helpful with your thoughts on various options. I need to retrieve that series of postings.

Quick question: I love my mac. Most/all web based emrs are compatible with macs, right?

Kathleen

Hello All

I was part of the list serve over 2 years ago with the vision of starting an IMP but then 2 years ago in April had a family tragedy, so put everything on hold. Now I'm back, more ready than ever. Two of us are looking to hopefully open our doors in early 2011. So...we are working hard on all the details right now. I am motivated to keep start up costs as low as possible, due to being a single parent and needing to insure my family, etc

Here is the question...have read some and looked at Practice Fusion, internet based emr option, that is free. My understanding is that the company makes their money by advertising. Does anyone use Practice Fusion, or have much of an opinion? One of the draw backs I have identified so far, is that patients are not able to go in and schedule their own appointments. Is there stand alone softwear that can do the scheduling piece.

Thanks for the input.

[Guest guest]

Thank you and Graham,Apropos to the discussion of patient privacy:http://www.nytimes.com/2010/03/17/technology/17privacy.html?th & emc=thSegue:Can either one of you come up with a personal data scrambling program? Say, something that puts out so much competing, incorrect (and innocuous) information, that it becomes too 'noisy' to detect personal signatures. I am serious. I've been thinking about this for a long time. If we could come accomplish this, we'd all be able to retire to Belize, then fund any number of health initiatives for people in need. Maybe this already exists? KathleenI was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data: http://content.nejm.org/cgi/content/full/354/26/2745Did you get a written assurance that no personal health information would be sold? I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.They can only do that if they have your data and most don't. While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product. They could actually charge appropriately for the service. Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it: What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject. Graham, what EMR would you recommend?I have no significant experience outside of my own EMR.In my recent talk, I made no recommendations except buyer beware.-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

I use office ally EHR, billing and pratice mx. They have a online secure pt portal, pt can book their own appt ( I have only 3 pt using now). New version coming out in may. I works really well. Get my Medicare EOB online. Cost w the e-Rx is $60 per month

 

Thank you and Graham, Apropos to the discussion of patient privacy:

http://www.nytimes.com/2010/03/17/technology/17privacy.html?th & emc=th

Segue:

Can either one of you come up with a personal data scrambling program?  Say, something that puts out so much competing, incorrect (and innocuous) information, that it becomes too 'noisy' to detect personal signatures.  

I am serious.  I've been thinking about this for a long time.  If we could come  accomplish this, we'd all be able to retire to Belize, then fund any number of health initiatives for people in need. 

Maybe this already exists?  

Kathleen

On Wed, Mar 17, 2010 at 6:56 PM, Seto  wrote:

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data: 

http://content.nejm.org/cgi/content/full/354/26/2745

Did you get a written assurance that no personal health information would be sold?

 

I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

They can only do that if they have your data and most don't.

 

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product. 

They could actually charge appropriately for the service.

 

Graham, I think your statement: " ... and they do not deny selling your patient data ... de-identified or not. " is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it: 

What I meant by that is that it has been shown that deidentified data can be re-identified.  I previously posted a link to a paper on the subject.

 

Graham, what EMR would you recommend?

I have no significant experience outside of my own EMR.

In my recent talk, I made no recommendations except buyer beware.

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

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[Guest guest]

Graham,In response to your questions and comments:1. Did you get a written assurance that no personal health information would be sold?Yes. In their User Agreement they state: "In maintain, using and affording access to Your Health Information in accordance with this Agreement, we will:9.1 Not use or further disclose the information except as permitted or required by this Agreement or as required by law." It is a violation of HIPAA to release or sell any Personal Health Information.2. They can only do that if they have your data and most don't.I agree that most EMR companies do not currently have practice data. But the ones that are Web-based do. And the future of EMRs is towards greater connectivity, not less. So I will be more specific and revise my earlier statement to say that I would not be surprised if other web-based EMR companies also sell data to third parties. I see that a version of your Synapse EMR is ASP-based. Do you give written assurance that no personal health information will be sold?3. They could actually charge appropriately for the service.What is an appropriate charge for the service? Are EMRs that cost $20,000+ really worth that much more than Amazing Charts? Even a version of your EMR is free. My point is that each EMR company sets its own price for its product and the market then determine its degree of success. I would argue that a significant number of physicians consider the Practice Fusion model a worthwhile trade and its price, reasonable.4. What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject.There is no free lunch. There are no absolute guarantees of safety or privacy. Each time we get out of bed, we risk being run over by a bus, eating tainted mangos or being mugged. Every time we go on the Internet, we risk computer viruses, trojans and other malware. Every time we use a credit card, we risk our account numbers, assets and identity being stolen. Every time we type in personal health information into an EMR, there is a risk of that data being stolen, lost or corrupted whether it is connected to the Internet or not. And yet, we continue to do these things every day. Even if the data can be re-identified with a specific patient, what value would it have? You could blackmail someone on Viagra or an antiretroviral perhaps. You could send marketing information to them, but there are easier ways to get this information. If I were a criminal, I'd go after the big fish and that would be in the financial sector, not piecing back together medical information. So I acknowledge that re-identifying data can be done, but so is gluing together all the pieces of paper that are run through a shredder. I don't think it is easy or worth it for companies to do.5. I have no significant experience outside of my own EMR.I rest my case. SetoSouth Pasadena, CA

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data:

http://content.nejm.org/cgi/content/full/354/26/2745Did you get a written assurance that no personal health information would be sold?

I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

They can only do that if they have your data and most don't.

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product.

They could actually charge appropriately for the service.

Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it:

What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject.

Graham, what EMR would you recommend?I have no significant experience outside of my own EMR.

In my recent talk, I made no recommendations except buyer beware.-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

.....There  are  no buses in my bedroom. The last time I saw a mango was. um...... ThanksYou a re a voice of reason.Jean  aka    an4fun1a my new password.

 

Graham,In response to your questions and comments:1. Did you get a written assurance that no personal health information would be sold?

Yes. In their User Agreement they state: " In maintain, using and affording access to Your Health Information in accordance with this Agreement, we will:

9.1 Not use or further disclose the information except as permitted or required by this Agreement or as required by law. " It is a violation of HIPAA to release or sell any Personal Health Information.

2. They can only do that if they have your data and most don't.

I agree that most EMR companies do not currently have practice data. But the ones that are Web-based do. And the future of EMRs is towards greater connectivity, not less. So I will be more specific and revise my earlier statement to say that I would not be surprised if other web-based EMR companies also sell data to third parties. I see that a version of your Synapse EMR is ASP-based. Do you give written assurance that no personal health information will be sold?

3. They could actually charge appropriately for the service.

What is an appropriate charge for the service? Are EMRs that cost $20,000+ really worth that much more than Amazing Charts? Even a version of your EMR is free. My point is that each EMR company sets its own price for its product and the market then determine its degree of success. I would argue that a significant number of physicians consider the Practice Fusion model a worthwhile trade and its price, reasonable.

4. What I meant by that is that it has been shown that deidentified data can be re-identified.  I previously posted a link to a paper on the subject.

There is no free lunch. There are no absolute guarantees of safety or privacy. Each time we get out of bed, we risk being run over by a bus, eating tainted mangos or being mugged. Every time we go on the Internet, we risk computer viruses, trojans and other malware. Every time we use a credit card, we risk our account numbers, assets and identity being stolen. Every time we type in personal health information into an EMR, there is a risk of that data being stolen, lost or corrupted whether it is connected to the Internet or not. And yet, we continue to do these things every day. Even if the data can be re-identified with a specific patient, what value would it have? You could blackmail someone on Viagra or an antiretroviral perhaps. You could send marketing information to them, but there are easier ways to get this information. If I were a criminal, I'd go after the big fish and that would be in the financial sector, not piecing back together medical information. So I acknowledge that re-identifying data can be done, but so is gluing together all the pieces of paper that are run through a shredder. I don't think it is easy or worth it for companies to do.

5. I have no significant experience outside of my own EMR.

I rest my case. Seto

South Pasadena, CA

 

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data: 

http://content.nejm.org/cgi/content/full/354/26/2745Did you get a written assurance that no personal health information would be sold?

 I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

They can only do that if they have your data and most don't. 

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product. 

They could actually charge appropriately for the service. 

Graham, I think your statement: " ... and they do not deny selling your patient data ... de-identified or not. " is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it: 

What I meant by that is that it has been shown that deidentified data can be re-identified.  I previously posted a link to a paper on the subject. 

Graham, what EMR would you recommend?I have no significant experience outside of my own EMR.

In my recent talk, I made no recommendations except buyer beware.-- Graham Chiuhttp://www.compkarori.co.nz:8090/

Synapse - the use from anywhere EMR.

-- PATIENTS,please remember email may not be entirely secure and that Email is part of the medical  record and is placed into the chart ( be careful what you say!)Email is best used for appointment making and  brief  questions

Email replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD         ph   fax

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[Guest guest]

It happens.http://www.wirralnews.co.uk/wirral-news/local-wirral-news/west-wirral-news/2009/12/30/wirral-mum-tells-how-a-bus-crashed-into-her-bedroom-as-she-sat-on-her-bed-80491-25478045/Wirral mum tells how a bus crashed into her bedroom as she sat on her bed SetoSouth Pasadena, CA

.....There are no buses in my bedroom. The last time I saw a mango was. um...... ThanksYou a re a voice of reason. aka an4fun1a my new password.

Graham,In response to your questions and comments:1. Did you get a written assurance that no personal health information would be sold?

Yes. In their User Agreement they state: "In maintain, using and affording access to Your Health Information in accordance with this Agreement, we will:

9.1 Not use or further disclose the information except as permitted or required by this Agreement or as required by law." It is a violation of HIPAA to release or sell any Personal Health Information.

2. They can only do that if they have your data and most don't.

I agree that most EMR companies do not currently have practice data. But the ones that are Web-based do. And the future of EMRs is towards greater connectivity, not less. So I will be more specific and revise my earlier statement to say that I would not be surprised if other web-based EMR companies also sell data to third parties. I see that a version of your Synapse EMR is ASP-based. Do you give written assurance that no personal health information will be sold?

3. They could actually charge appropriately for the service.

What is an appropriate charge for the service? Are EMRs that cost $20,000+ really worth that much more than Amazing Charts? Even a version of your EMR is free. My point is that each EMR company sets its own price for its product and the market then determine its degree of success. I would argue that a significant number of physicians consider the Practice Fusion model a worthwhile trade and its price, reasonable.

4. What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject.

There is no free lunch. There are no absolute guarantees of safety or privacy. Each time we get out of bed, we risk being run over by a bus, eating tainted mangos or being mugged. Every time we go on the Internet, we risk computer viruses, trojans and other malware. Every time we use a credit card, we risk our account numbers, assets and identity being stolen. Every time we type in personal health information into an EMR, there is a risk of that data being stolen, lost or corrupted whether it is connected to the Internet or not. And yet, we continue to do these things every day. Even if the data can be re-identified with a specific patient, what value would it have? You could blackmail someone on Viagra or an antiretroviral perhaps. You could send marketing information to them, but there are easier ways to get this information. If I were a criminal, I'd go after the big fish and that would be in the financial sector, not piecing back together medical information. So I acknowledge that re-identifying data can be done, but so is gluing together all the pieces of paper that are run through a shredder. I don't think it is easy or worth it for companies to do.

5. I have no significant experience outside of my own EMR.

I rest my case. Seto

South Pasadena, CA

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data:

http://content.nejm.org/cgi/content/full/354/26/2745Did you get a written assurance that no personal health information would be sold?

I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

They can only do that if they have your data and most don't.

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product.

They could actually charge appropriately for the service.

Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it:

What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject.

Graham, what EMR would you recommend?I have no significant experience outside of my own EMR.

In my recent talk, I made no recommendations except buyer beware.-- Graham Chiuhttp://www.compkarori.co.nz:8090/

Synapse - the use from anywhere EMR.

-- PATIENTS,please remember email may not be entirely secure and that Email is part of the medical record and is placed into the chart ( be careful what you say!)Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax

impcenter.org

[Guest guest]

Graham,In response to your questions and comments:1. Did you get a written assurance that no personal health information would be sold?

Yes. In their User Agreement they state: " In maintain, using and affording access to Your Health Information in accordance with this Agreement, we will:

9.1 Not use or further disclose the information except as permitted or required by this Agreement or as required by law. " It is a violation of HIPAA to release or sell any Personal Health Information.

Their model is based on selling your data. 

2. They can only do that if they have your data and most don't.

I agree that most EMR companies do not currently have practice data. But the ones that are Web-based do. And the future of EMRs is towards greater connectivity, not less. So I will be more specific and revise my earlier statement to say that I would not be surprised if other web-based EMR companies also sell data to third parties. I see that a version of your Synapse EMR is ASP-based. Do you give written assurance that no personal health information will be sold?

Sure.  And other web based EMR companies do not sell data, at least the vendors I have spoken with. 

3. They could actually charge appropriately for the service.

What is an appropriate charge for the service? Are EMRs that cost $20,000+ really worth that much more than Amazing Charts? Even a version of your EMR is free. My point is that each EMR company sets its own price for its product and the market then determine its degree of success. I would argue that a significant number of physicians consider the Practice Fusion model a worthwhile trade and its price, reasonable.

Giving software away costs nothing.  Hosting someone's data and proving support does.

 4. What I meant by that is that it has been shown that deidentified data can be re-identified.  I previously posted a link to a paper on the subject.

There is no free lunch. There are no absolute guarantees of safety or privacy. Each time we get out of bed, we risk being run over by a bus, eating tainted mangos or being mugged. Every time we go on the Internet, we risk computer viruses, trojans and other malware. Every time we use a credit card, we risk our account numbers, assets and identity being stolen. Every time we type in personal health information into an EMR, there is a risk of that data being stolen, lost or corrupted whether it is connected to the Internet or not. And yet, we continue to do these things every day. Even if the data can be re-identified with a specific patient, what value would it have? You could blackmail someone on Viagra or an antiretroviral perhaps. You could send marketing information to them, but there are easier ways to get this information. If I were a criminal, I'd go after the big fish and that would be in the financial sector, not piecing back together medical information. So I acknowledge that re-identifying data can be done, but so is gluing together all the pieces of paper that are run through a shredder. I don't think it is easy or worth it for companies to do.

My patient data is worth more than a free web service.  I suspect my patients also feel the same.

 5. I have no significant experience outside of my own EMR.

I rest my case.

SetoSouth Pasadena, CA

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

I agree with on this issue.

Also, FYI, I spoke with a Practice Fusion rep. a couple of weeks ago, who

affirmed that even though PF may in the future sell the de-personalized data to

third parties, they have not done so yet, not once (so I was told).

We are opening our practice in early May and are about to pick our EMR. It seems

we will first go with either PF or the Office Ally suite. I'd like to ask

and other PF users what practice management/billing software you use? I looked

into the Kareo software that PF just partnered with (seamless transfer of info

between the two softwares), and am wondering what are the best PM/billing

software to use with PF? Any comment on this would be very welcome.

Thank you,

Breuvart

Marfa Country Clinic

PO Box 368

Marfa, Texas 79843

> >

> > I was aware of Practice Fusion's practice of selling de-identified data as

another revenue source before I signed on with them. After doing research into

the subject I felt reassured that they would not sell any Personal Health

Information to any third parties, which would be a HIPAA violation. I felt that

it was no worse than other companies and industries that already sell data for

money, such as financial companies or even the AMA which sells physician

prescribing data:

> > http://content.nejm.org/cgi/content/full/354/26/2745

> >

> >

> > Did you get a written assurance that no personal health information would be

sold?

> >

> > I have no evidence for it, but I would not be surprised if other EMR

companies also sell data to third parties.

> >

> > They can only do that if they have your data and most don't.

> >

> >

> > While it would be ideal (for physicians) for Practice Fusion not to sell any

data and give away its services for free, I understand that there is no such

thing as a free lunch, and that they need some way to generate income in order

to continue to improve and maintain the product.

> >

> >

> > They could actually charge appropriately for the service.

> >

> >

> > Graham, I think your statement: " ... and they do not deny selling your

patient data ... de-identified or not. " is inaccurate and suggests that Practice

Fusion sells data that has not been de-identified. On the contrary, Practice

Fusion states that they double-scrub their data of any personal identifiers

before releasing it:

> >

> > What I meant by that is that it has been shown that deidentified data can be

re-identified. I previously posted a link to a paper on the subject.

> >

> > Graham, what EMR would you recommend?

> >

> >

> > I have no significant experience outside of my own EMR.

> >

> > In my recent talk, I made no recommendations except buyer beware.

> >

> >

> > --

> > Graham Chiu

> > http://www.compkarori.co.nz:8090/

> > Synapse - the use from anywhere EMR.

> >

> >

>

[Guest guest]

It's good to have different opinions so that we can discuss the pros and cons.

Here's another opinion piece that I am throwing in the mix

http://www.thinkgene.com/practice-fusion-class-d-felony/

> I agree with on this issue.

>

> Also, FYI, I spoke with a Practice Fusion rep. a couple of weeks ago, who

affirmed that even though PF may in the future sell the de-personalized data to

third parties, they have not done so yet, not once (so I was told).

>

> We are opening our practice in early May and are about to pick our EMR. It

seems we will first go with either PF or the Office Ally suite. I'd like to ask

and other PF users what practice management/billing software you use? I

looked into the Kareo software that PF just partnered with (seamless transfer of

info between the two softwares), and am wondering what are the best PM/billing

software to use with PF? Any comment on this would be very welcome.

>

> Thank you,

>

> Breuvart

> Marfa Country Clinic

> PO Box 368

> Marfa, Texas 79843

>

>

>> >

>> > I was aware of Practice Fusion's practice of selling de-identified data as

another revenue source before I signed on with them. After doing research into

the subject I felt reassured that they would not sell any Personal Health

Information to any third parties, which would be a HIPAA violation. I felt that

it was no worse than other companies and industries that already sell data for

money, such as financial companies or even the AMA which sells physician

prescribing data:

>> > http://content.nejm.org/cgi/content/full/354/26/2745

>> >

>> >

>> > Did you get a written assurance that no personal health information would

be sold?

>> >

>> > I have no evidence for it, but I would not be surprised if other EMR

companies also sell data to third parties.

>> >

>> > They can only do that if they have your data and most don't.

>> >

>> >

>> > While it would be ideal (for physicians) for Practice Fusion not to sell

any data and give away its services for free, I understand that there is no such

thing as a free lunch, and that they need some way to generate income in order

to continue to improve and maintain the product.

>> >

>> >

>> > They could actually charge appropriately for the service.

>> >

>> >

>> > Graham, I think your statement: " ... and they do not deny selling your

patient data ... de-identified or not. " is inaccurate and suggests that Practice

Fusion sells data that has not been de-identified. On the contrary, Practice

Fusion states that they double-scrub their data of any personal identifiers

before releasing it:

>> >

>> > What I meant by that is that it has been shown that deidentified data can

be re-identified.  I previously posted a link to a paper on the subject.

>> >

>> > Graham, what EMR would you recommend?

>> >

>> >

>> > I have no significant experience outside of my own EMR.

>> >

>> > In my recent talk, I made no recommendations except buyer beware.

>> >

>> >

>> > --

>> > Graham Chiu

>> > http://www.compkarori.co.nz:8090/

>> > Synapse - the use from anywhere EMR.

>> >

>> >

>>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Are already public key encryption programs -- I also use a portal Relayhealth for $270/year.

Many folks still email me directly, but I won't give them confidential info that way.

No retirement................

Matt in Western PA

Re: EMR questions

Thank you and Graham,

Apropos to the discussion of patient privacy:

http://www.nytimes.com/2010/03/17/technology/17privacy.html?th & emc=th

Segue:

Can either one of you come up with a personal data scrambling program? Say, something that puts out so much competing, incorrect (and innocuous) information, that it becomes too 'noisy' to detect personal signatures.

I am serious. I've been thinking about this for a long time. If we could come accomplish this, we'd all be able to retire to Belize, then fund any number of health initiatives for people in need.

Maybe this already exists?

Kathleen

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data:

http://content.nejm.org/cgi/content/full/354/26/2745

Did you get a written assurance that no personal health information would be sold?

I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

They can only do that if they have your data and most don't.

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product.

They could actually charge appropriately for the service.

Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it:

What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject.

Graham, what EMR would you recommend?

I have no significant experience outside of my own EMR.

In my recent talk, I made no recommendations except buyer beware.

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

Matt, No retirement for me either. I plan to keep going until I fall out of the saddle with my boots still on. KathleenAre already public key encryption programs -- I also use a portal Relayhealth for $270/year. Many folks still email me directly, but I won't give them confidential info that way. No retirement................ Matt in Western PA Re: EMR questions Thank you and Graham,Apropos to the discussion of patient privacy:http://www.nytimes.com/2010/03/17/technology/17privacy.html?th & emc=thSegue:Can either one of you come up with a personal data scrambling program? Say, something that puts out so much competing, incorrect (and innocuous) information, that it becomes too 'noisy' to detect personal signatures. I am serious. I've been thinking about this for a long time. If we could come accomplish this, we'd all be able to retire to Belize, then fund any number of health initiatives for people in need. Maybe this already exists? KathleenI was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data: http://content.nejm.org/cgi/content/full/354/26/2745Did you get a written assurance that no personal health information would be sold? I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.They can only do that if they have your data and most don't. While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product. They could actually charge appropriately for the service. Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it: What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject. Graham, what EMR would you recommend?I have no significant experience outside of my own EMR.In my recent talk, I made no recommendations except buyer beware.-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

Kathleen, I am in Belieze (actually non-British Honduras) as I write this,  but not reitred but working in villages, and I will have to come home to the US  rat race in a week.  So solving encryption wont help avoid the goat rope of US  health insurance morass I am afraid.  Of course, here you trade the problem of unnecessary care provided at ultra high prices, for the problem of unavailable care  or unaaffordable care due to poverty and where the safety net does not exist.  . 

 

Are already public key encryption programs -- I also use a portal Relayhealth for $270/year.

 

Many folks still email me directly, but I won't give them confidential info that way.

 

No retirement................

 

Matt in Western PA

Re: EMR questions

 

Thank you and Graham, Apropos to the discussion of patient privacy:

http://www.nytimes.com/2010/03/17/technology/17privacy.html?th & emc=th

Segue:

Can either one of you come up with a personal data scrambling program?  Say, something that puts out so much competing, incorrect (and innocuous) information, that it becomes too 'noisy' to detect personal signatures.  

I am serious.  I've been thinking about this for a long time.  If we could come  accomplish this, we'd all be able to retire to Belize, then fund any number of health initiatives for people in need. 

Maybe this already exists?  

Kathleen

On Wed, Mar 17, 2010 at 6:56 PM, Seto  wrote:

I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data: 

http://content.nejm.org/cgi/content/full/354/26/2745

Did you get a written assurance that no personal health information would be sold?

 

I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

They can only do that if they have your data and most don't.

 

While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product. 

They could actually charge appropriately for the service.

 

Graham, I think your statement: " ... and they do not deny selling your patient data ... de-identified or not. " is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it: 

What I meant by that is that it has been shown that deidentified data can be re-identified.  I previously posted a link to a paper on the subject.

 

Graham, what EMR would you recommend?

I have no significant experience outside of my own EMR.

In my recent talk, I made no recommendations except buyer beware.

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

No opinion on Practice Fusion, but just noticed you are in Marfa!

Cool! I spent a great vacation there in 1991 flying in a glider

meet. Check out my YouTube videos - sorry about the poor quality of

the VHS to digital conversion. But you can see the courthouse, Ft. , the

Thunderbird Motel, I think the Dairy Queen, and various other sites around Marfa

circa 1991!

Caldwell M.D.

Tulare, CA

> > >

> > > I was aware of Practice Fusion's practice of selling de-identified data as

another revenue source before I signed on with them. After doing research into

the subject I felt reassured that they would not sell any Personal Health

Information to any third parties, which would be a HIPAA violation. I felt that

it was no worse than other companies and industries that already sell data for

money, such as financial companies or even the AMA which sells physician

prescribing data:

> > > http://content.nejm.org/cgi/content/full/354/26/2745

> > >

> > >

> > > Did you get a written assurance that no personal health information would

be sold?

> > >

> > > I have no evidence for it, but I would not be surprised if other EMR

companies also sell data to third parties.

> > >

> > > They can only do that if they have your data and most don't.

> > >

> > >

> > > While it would be ideal (for physicians) for Practice Fusion not to sell

any data and give away its services for free, I understand that there is no such

thing as a free lunch, and that they need some way to generate income in order

to continue to improve and maintain the product.

> > >

> > >

> > > They could actually charge appropriately for the service.

> > >

> > >

> > > Graham, I think your statement: " ... and they do not deny selling your

patient data ... de-identified or not. " is inaccurate and suggests that Practice

Fusion sells data that has not been de-identified. On the contrary, Practice

Fusion states that they double-scrub their data of any personal identifiers

before releasing it:

> > >

> > > What I meant by that is that it has been shown that deidentified data can

be re-identified. I previously posted a link to a paper on the subject.

> > >

> > > Graham, what EMR would you recommend?

> > >

> > >

> > > I have no significant experience outside of my own EMR.

> > >

> > > In my recent talk, I made no recommendations except buyer beware.

> > >

> > >

> > > --

> > > Graham Chiu

> > > http://www.compkarori.co.nz:8090/

> > > Synapse - the use from anywhere EMR.

> > >

> > >

> >

>

[Guest guest]

---

Have you used Practice Fusion's billing? They say they have a service

where you do the billing but they follow up on claims and charge a low

fee/claim. Sounded pretty good.

My biller says I have very few problems and few re-submissions....so I

may not even need them. I first found Practice Fusion when I was looking

up local billers.

Ellen

Seto wrote:

>

> After previously using SpringCharts, I have been using Practice Fusion

> since October 2009 with my MacBook and I have been very pleased with

> it. It is consistently being upgraded and they have been very

> responsive to suggestions and bug reports. Their e-prescribing feature

> works well and I look forward to their lab integration service. I like

> not having to worry about backing up the data, and I love being able

> to use it on my Mac or any other computer with Internet access. I also

> like the price.

>

>

> I considered their business model before I chose to go with them. I

> knew about the advertisements on the side, and they are very

> unobtrusive and I rarely notice them. They occupy a 1 x 6 inch banner

> across the bottom of the screen. They must not have a lot of

> advertisers because for the last few months I have only seen ads from

> Practice Fusion itself. The fact that they have over 30,000 users is

> also an indication of their growth and stability; they are less likely

> to go out of business than other EMR companies which have much fewer

> users.

>

> I was aware of Practice Fusion's practice of selling de-identified

> data as another revenue source before I signed on with them. After

> doing research into the subject I felt reassured that they would not

> sell any Personal Health Information to any third parties, which would

> be a HIPAA violation. I felt that it was no worse than other companies

> and industries that already sell data for money, such as financial

> companies or even the AMA which sells physician prescribing data:

> http://content.nejm.org/cgi/content/full/354/26/2745

> <http://content.nejm.org/cgi/content/full/354/26/2745>

>

> I have no evidence for it, but I would not be surprised if other EMR

> companies also sell data to third parties.

>

> While it would be ideal (for physicians) for Practice Fusion not to

> sell any data and give away its services for free, I understand that

> there is no such thing as a free lunch, and that they need some way to

> generate income in order to continue to improve and maintain the product.

>

> Graham, I think your statement: " ... and they do not deny selling your

> patient data ... de-identified or not. " is inaccurate and suggests

> that Practice Fusion sells data that has not been de-identified. On

> the contrary, Practice Fusion states that they double-scrub their data

> of any personal identifiers before releasing it:

> http://www.ehrbloggers.com/2009/12/using-ehr-data-for-public-health-good.html

>

<http://www.ehrbloggers.com/2009/12/using-ehr-data-for-public-health-good.html>

>

> I believe it is a reasonable tradeoff to have an easy to use and free

> EMR that continues to improve. Others such as Graham will disagree.

> But there is no such thing as the perfect EMR and there never will be.

> And the more secure a system is, the less compatible it is with other

> systems.

>

> So , Kathleen and Kathleen, I think Practice Fusion is an

> excellent and affordable EMR that is worthy of consideration,

> depending on your needs and priorities.

>

> I do not have any financial interest in Practice Fusion or any other EMR.

>

> Graham, what EMR would you recommend?

>

> Seto

> South Pasadena, CA

>

>

>

>> Hi Kathleen

>>

>>

>> Yes, most web based emrs are compatible with Macs.

>>

>> See here on PF's revenue model

>>

>>

http://www.thehealthcareblog.com/the_health_care_blog/2009/08/practice-fusion-ge\

ts-investment-from-salesforcecom.html

>>

<http://www.thehealthcareblog.com/the_health_care_blog/2009/08/practice-fusion-g\

ets-investment-from-salesforcecom.html>

>>

>> billing is not going to cover those users who are not using the

>> billing services, and they do not deny selling your patient data ...

>> de-identifed or not.

>>

>> As for adverts ... well, I suspect that it's a dubious practice to

>> allow adverts to be shown that might influence your care.

>>

>> On Wed, Mar 17, 2010 at 4:57 PM, Kathleen Patton

>> > wrote:

>>

>>

>>

>> Graham,

>> I'm so glad you jumped in here. I thought one could opt out of

>> PF's advertising and drug information selling 'activities' by

>> paying a monthly fee. I need to clarify my notes arrrg!

>> A few months ago you were very helpful with your thoughts on

>> various options. I need to retrieve that series of postings.

>> Quick question: I love my mac. Most/all web based emrs are

>> compatible with macs, right?

>> Kathleen

>>

>>

>>>

>>> Hello All

>>> I was part of the list serve over 2 years ago with the vision of

>>> starting an IMP but then 2 years ago in April had a family

>>> tragedy, so put everything on hold. Now I'm back, more ready

>>> than ever. Two of us are looking to hopefully open our doors in

>>> early 2011. So...we are working hard on all the details right

>>> now. I am motivated to keep start up costs as low as possible,

>>> due to being a single parent and needing to insure my family, etc

>>> Here is the question...have read some and looked at Practice

>>> Fusion, internet based emr option, that is free. My

>>> understanding is that the company makes their money by

>>> advertising. Does anyone use Practice Fusion, or have much of an

>>> opinion? One of the draw backs I have identified so far, is that

>>> patients are not able to go in and schedule their own

>>> appointments. Is there stand alone softwear that can do the

>>> scheduling piece.

>>> Thanks for the input.

>>>

>>>

[Guest guest]

Graham,You don't like Practice Fusion. I get it. I appreciate thoughtful discussion of the pros and cons of issues. Throwing in an article that accuses Practice Fusion of committing a felony is not what I would call thoughtful discussion. For the record, Practice Fusion posted a rebuttal in the comments section of that opinion piece refuting the writer's claims. I don't see this EMR privacy issue as any different than the choices we make every day in medicine. We prescribe medications and treatments that have potential risks and benefits for our patients. We explain how it may help them or harm them. We do our research. We make our best recommendation based on the evidence or despite the lack of it. In the end, the patient decides, based on their own preferences and values. Same for EMRs. In the end, each physician ends up with the EMR they think will work best for them, for good or ill.So I don't think I can convince you that Practice Fusion is a reasonable EMR choice and you can't convince me that Practice Fusion is pure evil. So let's agree to disagree. And if Practice Fusion gets convicted of a felony breach of privacy, I'll concede that you were right. And if Practice Fusion survives longer than your EMR, you can concede that maybe Practice Fusion's business model isn't so reprehensible to the public after all. SetoSouth Pasadena, CA

It's good to have different opinions so that we can discuss the pros and cons.

Here's another opinion piece that I am throwing in the mix

http://www.thinkgene.com/practice-fusion-class-d-felony/

On Thu, Mar 18, 2010 at 12:56 PM, <vbreuvartgmail> wrote:

> I agree with on this issue.

>

> Also, FYI, I spoke with a Practice Fusion rep. a couple of weeks ago, who affirmed that even though PF may in the future sell the de-personalized data to third parties, they have not done so yet, not once (so I was told).

>

> We are opening our practice in early May and are about to pick our EMR. It seems we will first go with either PF or the Office Ally suite. I'd like to ask and other PF users what practice management/billing software you use? I looked into the Kareo software that PF just partnered with (seamless transfer of info between the two softwares), and am wondering what are the best PM/billing software to use with PF? Any comment on this would be very welcome.

>

> Thank you,

>

> Breuvart

> Marfa Country Clinic

> PO Box 368

> Marfa, Texas 79843

>

>

>> >

>> > I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data:

>> > http://content.nejm.org/cgi/content/full/354/26/2745

>> >

>> >

>> > Did you get a written assurance that no personal health information would be sold?

>> >

>> > I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

>> >

>> > They can only do that if they have your data and most don't.

>> >

>> >

>> > While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product.

>> >

>> >

>> > They could actually charge appropriately for the service.

>> >

>> >

>> > Graham, I think your statement: "... and they do not deny selling your patient data ... de-identified or not." is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it:

>> >

>> > What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject.

>> >

>> > Graham, what EMR would you recommend?

>> >

>> >

>> > I have no significant experience outside of my own EMR.

>> >

>> > In my recent talk, I made no recommendations except buyer beware.

>> >

>> >

>> > --

>> > Graham Chiu

>> > http://www.compkarori.co.nz:8090/

>> > Synapse - the use from anywhere EMR.

>> >

>> >

>>

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

You have it wrong.  I have tried PF and thought it worked okay.  I just disagree with their business model which involves selling patient data, and they have stated this publicly.

And yes, I read the whole discussion and rebuttal from PF .. which is why I referenced it.

Graham,You don't like Practice Fusion. I get it. I appreciate thoughtful discussion of the pros and cons of issues. Throwing in an article that accuses Practice Fusion of committing a felony is not what I would call thoughtful discussion. For the record, Practice Fusion posted a rebuttal in the comments section of that opinion piece refuting the writer's claims. 

I don't see this EMR privacy issue as any different than the choices we make every day in medicine. We prescribe medications and treatments that have potential risks and benefits for our patients. We explain how it may help them or harm them. We do our research. We make our best recommendation based on the evidence or despite the lack of it. In the end, the patient decides, based on their own preferences and values. Same for EMRs. In the end, each physician ends up with the EMR they think will work best for them, for good or ill.

Please explain to your patients that you may be disclosing their data to unknown third, fourth and fifth parties ad infinitum as part of your treatment as part of the informed consent process.

 So I don't think I can convince you that Practice Fusion is a reasonable EMR choice and you can't convince me that Practice Fusion is pure evil. So let's agree to disagree. And if Practice Fusion gets convicted of a felony breach of privacy, I'll concede that you were right. And if Practice Fusion survives longer than your EMR, you can concede that maybe Practice Fusion's business model isn't so reprehensible to the public after all.

SetoWhether my EMR survives or not is irrelevant.  And you have 30,000 colleagues who agree with you.  Just not me.

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

,

Come by again!

The gliders meeting is still happening every year.

.

> > > >

> > > > I was aware of Practice Fusion's practice of selling de-identified data

as another revenue source before I signed on with them. After doing research

into the subject I felt reassured that they would not sell any Personal Health

Information to any third parties, which would be a HIPAA violation. I felt that

it was no worse than other companies and industries that already sell data for

money, such as financial companies or even the AMA which sells physician

prescribing data:

> > > > http://content.nejm.org/cgi/content/full/354/26/2745

> > > >

> > > >

> > > > Did you get a written assurance that no personal health information

would be sold?

> > > >

> > > > I have no evidence for it, but I would not be surprised if other EMR

companies also sell data to third parties.

> > > >

> > > > They can only do that if they have your data and most don't.

> > > >

> > > >

> > > > While it would be ideal (for physicians) for Practice Fusion not to sell

any data and give away its services for free, I understand that there is no such

thing as a free lunch, and that they need some way to generate income in order

to continue to improve and maintain the product.

> > > >

> > > >

> > > > They could actually charge appropriately for the service.

> > > >

> > > >

> > > > Graham, I think your statement: " ... and they do not deny selling your

patient data ... de-identified or not. " is inaccurate and suggests that Practice

Fusion sells data that has not been de-identified. On the contrary, Practice

Fusion states that they double-scrub their data of any personal identifiers

before releasing it:

> > > >

> > > > What I meant by that is that it has been shown that deidentified data

can be re-identified. I previously posted a link to a paper on the subject.

> > > >

> > > > Graham, what EMR would you recommend?

> > > >

> > > >

> > > > I have no significant experience outside of my own EMR.

> > > >

> > > > In my recent talk, I made no recommendations except buyer beware.

> > > >

> > > >

> > > > --

> > > > Graham Chiu

> > > > http://www.compkarori.co.nz:8090/

> > > > Synapse - the use from anywhere EMR.

> > > >

> > > >

> > >

> >

>

[Guest guest]

I am signing up for Kareo practice fusion integration mostly because it makes so much sense and there is no duplication . I dont expect it to be easy initially especially during setup. I will still have my billers working on this ( my hospitalist stuff keeps me otherwise busy) Currently I pay 7% of revenue for ffs. What is  a fair  billing fee ?  they no longer have to do data entry, there  might be less misentries etc. I do appreciate that they only a year ago got me set up with their clearing houses..and will have to go through a bunch of that again no doubT. ( they are still working on my medi-cal stuff, -medical now wants a letter saying I no longer work at an address I worked at 5 yrs ago- a change of address letter is not good enough. the letter must not just say I moved here. It must say I am NOT working there)

Thoughts/ideas? ( not on medi-cal- on billing fees)

 

,I am still using the MacPractice practice management software that I have been using for the past 3-4 years. I have a part-time biller who gets the job done, but I am debating whether I should go with an online billing service that integrates with Practice Fusion instead. I'd have to crunch the numbers to see which method works out best financially. Maybe others using Practice Fusion will share how they do billing. can give you her thoughts on Office Ally.

Good luck with opening your practice! SetoSouth Pasadena, CA

 

I agree with on this issue.

Also, FYI, I spoke with a Practice Fusion rep. a couple of weeks ago, who affirmed that even though PF may in the future sell the de-personalized data to third parties, they have not done so yet, not once (so I was told).

We are opening our practice in early May and are about to pick our EMR. It seems we will first go with either PF or the Office Ally suite. I'd like to ask and other PF users what practice management/billing software you use? I looked into the Kareo software that PF just partnered with (seamless transfer of info between the two softwares), and am wondering what are the best PM/billing software to use with PF? Any comment on this would be very welcome.

Thank you,

Breuvart

Marfa Country Clinic

PO Box 368

Marfa, Texas 79843

> >

> > I was aware of Practice Fusion's practice of selling de-identified data as another revenue source before I signed on with them. After doing research into the subject I felt reassured that they would not sell any Personal Health Information to any third parties, which would be a HIPAA violation. I felt that it was no worse than other companies and industries that already sell data for money, such as financial companies or even the AMA which sells physician prescribing data:

> > http://content.nejm.org/cgi/content/full/354/26/2745

> >

> >

> > Did you get a written assurance that no personal health information would be sold?

> >

> > I have no evidence for it, but I would not be surprised if other EMR companies also sell data to third parties.

> >

> > They can only do that if they have your data and most don't.

> >

> >

> > While it would be ideal (for physicians) for Practice Fusion not to sell any data and give away its services for free, I understand that there is no such thing as a free lunch, and that they need some way to generate income in order to continue to improve and maintain the product.

> >

> >

> > They could actually charge appropriately for the service.

> >

> >

> > Graham, I think your statement: " ... and they do not deny selling your patient data ... de-identified or not. " is inaccurate and suggests that Practice Fusion sells data that has not been de-identified. On the contrary, Practice Fusion states that they double-scrub their data of any personal identifiers before releasing it:

> >

> > What I meant by that is that it has been shown that deidentified data can be re-identified. I previously posted a link to a paper on the subject.

> >

> > Graham, what EMR would you recommend?

> >

> >

> > I have no significant experience outside of my own EMR.

> >

> > In my recent talk, I made no recommendations except buyer beware.

> >

> >

> > --

> > Graham Chiu

> > http://www.compkarori.co.nz:8090/

> > Synapse - the use from anywhere EMR.

> >

> >

>

-- Sangeetha Murthy M.D