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Tuesday, April 9, 2013

A Medical Service Using the Cloud

Practice Fusion is a company that offers doctors cloud-based electronic medical records software for managing relationships with patients and big parts of the health care industry. It also seems like a good place to explore feelings about privacy, and the business of Big Data.

The company, privately held and based in San Francisco, says it has 150,000 health care providers using its free service and medical records on 60 million patients. On Tuesday Practice Fusion announced a new service, called Patient Fusion, which enables people using the system to schedule appointments with any participating doctor.

If enough people use Patient Fusion, it should increase traffic for Practice Fusion’s main business, which is putting advertising on those online health records. The company has relationships with lab testing companies and pharmacies. If a patient’s records indicate, say, high cholesterol, a banner on top of the records may ask the doctor if a test should be scheduled, or a drug supplied. Practice Fusion is paid by labs to connect them to doctors.

Patient Fusion, the new service, is a way for people to book appointments at times that work for them. It combines permission-based access to those patient records, the software’s calendar appointment service for doctors, and Practice Fusion’s collection of patient reviews of their doctors, which it typically solicits after each visit.

“If you want to see a doctor at 3 p.m. and your doctor is booked, I can put you in touch with every other local specialist who is available at that time,” said Ryan Howard, chief executive of Practice Fusion. The doctor would have to be part of the Practice Fusion network, he said. “You’ll be able to see patient reviews of the doctor, and if you book with one of them, that doctor will automatically get your health history from Practice Fusion.”

The company’s ad business may give some pause, though Mr. Howard said that Practice Fusion, which he began as a service in 2007, does not give advertisers patient names or other identifiable information. The intention, he said, is to add efficiency to a system in which drug companies and labs often connect with doctors in clumsier ways, and in which patients often think their doctor is good without much empirical evidence.

To date, 27,000 of the network’s doctors have agreed to participate in Patient Fusion. Even at that level, Mr. Howard said, Practice Fusion can draw off 1.5 million reviews, and offer three million appointments just in the month of April.

Patient reviews of doctors, he said, are an important and lasting part of our health care system. “I can get more information on a restaurant I’m going to than I can about a doctor,” he said. “I think my doctor is good. I think so. But I don’t really know it.”

Whether Yelp-like reviews of doctors are a full and fair picture is not a well-addressed question. On Patient Fusion’s Web site, the doctors have a 98 percent “recommended” rating, which suggests we tend to overvalue the quality of the people ensuring our well-being.

Yelp also has doctor reviews, a nonscientific examination of which shows a tendency to rate doctors highly and, if the experience is not good, the doctor gets just one star, not the two stars of a so-so restaurant.

But there is certain to be even more data. In the future, Mr. Howard said, he would like to add information about which doctors have the best patient outcomes.

As the system grows, and the data it collects grows too, other products are likely to be introduced. “Think about a Bloomberg terminal for health,” Mr. Howard said. “We could have real-time information on what drugs are being prescribed. That is information about market share, and whether you are losing it because patients are having adverse reactions, or doctors are prescribing generics. You can see how that would be interesting to a product manager at a pharmaceutical company. Also to a hedge fund manager.”