Practice Fusion EMR – Live in Five

It must have been a couple years ago when I first heard about a Free EMR called Practice Fusion. Shortly after hearing about this Free EMR, I got a note saying that Practice Fusion had a Live in Five program that would get a practice live on the Practice Fusion EMR in 5 minutes. Check out my initial reaction to the Practice Fusion Live in Five program from early 2009.

Since that point, I’d wanted to try out this Live in Five challenge to see really how much I could get started in Five minutes with Practice Fusion. I still have the email from 9/15/09 when I first wanted to try this. Suffice it to say that I’ve been sufficiently busy with all the talk of the EMR stimulus that I hadn’t taken the chance to try it out myself. Plus, when I did it, I wanted to do a good job. Especially since I knew it would take more than 5 minutes.

Well, tomorrow I’m heading to the Practice Fusion user group meeting to meet with the people at Practice Fusion and to do some interviews for the XM Radio station ReachMD. That should be fun and you’ll certainly hear more about the interviews later. Since I was going to the Practice Fusion user group, I figured it was time to try the Live in Five challenge and see what I could do. So, that’s what I did.

Signing Up
I started at their standard Practice Fusion EMR sign up page. It’s free so I filled out their simple forms. I think the whole sign up process only took me 2-3 minutes. Granted, I’m pretty fast with computers and online forms. I was a little disappointed that they didn’t let me choose my own username and my own PracticeID. I’m not sure there reasoning with this, but likely it would take people longer to come up with their own. It’s just hard for me to remember the username jlynn677. Plus, it takes me back to the days of AOL, and that’s not pretty. Although, this wasn’t a huge problem for me since I was only using one computer and it remembered the info for me.

As any good system would do, it made me use a more complex password. Yes, I deliberately used an easy one to see what it would do. Good thing it asked me to make it more complex. Annoying for many users, but definitely necessary. I also specified myself as a doctor so I could test the doctor interface.

Well, I was quickly logged in and the first thing I see after logging in is the Practice Fusion training page. I must admit that I was touch overwhelmed by all the training videos. Although, I also was glad there was so many and that I could train at my own rate on whichever features I wanted to train on.

I had to get a taste for the videos and so I clicked the first one to see what they were like. The pace of the video was a bit slow for me, but I could see how this would be extremely beneficial to a new user of the system. The only problem is that the video was cutting into my 5 minute test very quickly. So, I clicked off the video to go and click around the system on my own. I figured the videos would be there later if I couldn’t figure something out myself.

First Impressions
Once I started clicking around I saw this layer of tabs to choose from. As I clicked on each one I was a little confused why these prominent tabs were all for things like To Do List (which was empty of course), Community, Forums, Activity Feed, etc. I was looking for schedule, patients, and charts. Took me a minute to realize that the other buttons above those tabs would get me where I really wanted to go. I guess I’m just so use to tabs being the navigation.

I did notice a prominent button that I thought would be very useful. It was a link to a Live Chat with a support specialist. I’m kind of arrogant like that and wasn’t sure I wanted to ask for help, but I was glad to know it was there in case I needed help of some sort.

Appointment Scheduler
Of course, this was well past the five minute mark. I certainly had been logged in and provisioned on the Practice Fusion EMR in well under five minutes, but as I expected it would take longer than five minutes for me to do a good walk through of their EMR.

I then proceeded to check out the Schedule section. It took me to a “Daily Calendar” section which was of course empty. I started to look around for a button to add an appointment (since I assumed there weren’t any). I even right clicked on the grid to try and add an appointment. The right click revealed the all too familiar Flash Player options. Something that I would see multiple times as I tested the system. I guess I’m just too used to right clicking.

I decided the Daily Calendar didn’t have the option to add an appointment and so I clicked on the Weekly Calendar tab and it worked as expected for scheduling an appointment. I would have loved to have a quick patient creation area when creating the appointment, but overall it was pretty easy to schedule an appointment. It was funny when I was trying to select the patient for the appointment, I went to the bottom right corner of the screen to click the OK (or in this case Select) button. Turns out, I almost clicked on the ad that had a button like image on it. Then, I realized that the Select button I wanted was at the top instead of the bottom.

I also tried to drag and drop the appointment to a new time, but sadly no dice there. I guess Flash doesn’t support drag and drop like that very well? I did like how the patient had a space for an email so it could send an email reminder. I wonder if text message reminders are next.

I then played a bit more with the schedule and found it pretty straightforward. After going back to the Daily Schedule (which now had the appointment I made) I saw a drop down for status. I marked my patient as Arrived and the Status drop down box changed to a new set of statuses. I thought this was really cool, because it only presented you the statuses that you would need. I’m not sure how you’d go back if you changed the status on the wrong one though.

Patient Chart
Now with an appointment scheduled it was time to check out the chart for that patient and start a note. I clicked on the hyper-linked name of the patient in my “Daily Schedule” and was taken to the chart. I was a little confused by where it sent me. It was basically a history page of what had been done on the patient. I saw a lot of other options to click, but I was surprised this was the page I got clicking into the patient chart.

I later realized that I should have clicked on the hyper-linked date and it would have taken me to the note in the chart for that day. Although, since I didn’t I must admit that I was searching for a little while to find out where I could create a note for the patient. I finally found the note listed under the title “Events” with today’s date. That felt a little awkward to me.

Before finding the note, I did see a bunch of history items like PMH, Dx History, Rx list, Allergies, etc. I did find the allergies a bit confusing since it was under the PMH (free text) and then there was a separate tab for Allergies (very specific) and they weren’t tied together in any way. If I have a medical history of allergies shouldn’t that go under my allergies? I think they showed both at other places in the chart, but deciding where to add the allergies and how to add them would be important.

Turns out the Allergies were confusing, but there was a link that said “Learn to add allergies” and so I clicked it and it took me to a training video for allergies. Only problem was the training video was for the allergies tab and I was on the PMH tab. So, it took me a minute to figure out that there were the 2 places. Although, the video introduced me to the other area. Balancing free text entry of allergies with specific allergies are a challenge for every EMR. Not to mention even harder with the Rx list. For example, I didn’t see a way in Practice Fusion to enter some Chinese Herbal Medication in the list. One that’s not likely in the database. Let alone if the patient says, I’m taking the pink pill. I’m not sure how I’d have documented that in the Rx List in Practice Fusion.

I like how simple and easy to use the SOAP note was in Practice Fusion. It was really straight forward to go in and chart items. Not to mention how easy it was to add your own templates to any section of the SOAP note. I did wonder if any of the vital signs section could be adjusted, added to or modified. It certainly has the base needs, but I know in the clinic I worked in we had a pretty customized intake process for collecting vital signs. For example, our intake asked questions based on the gender (ie. last pap smear for females). I didn’t see any sort of advanced templating like this in the documentation areas. Maybe I just missed it.

I did like the way the dxn sections worked and the integrated ePrescribing. In fact, even with my 30 minutes in, I prescribed a drug and sent it to ePrescribing. Yeah, I had to see what would happen if I tried to ePrescribe since it gave me the option. The system then told me that I needed to fax in a form to get ePrescribing set up and I had a link to download the form (which I think was already filled in with my info). I was glad that it wouldn’t let me ePrescribe, and it was pretty slick to prompt me to sign up for ePrescribing that way.

I also found the script printing page to work really well. You had options to add or remove the signature section or header section of the script. This is a good feature if you prefer to use a stamp or are printing on letterhead already.

The signing of the note was easy and straightforward. I of course wondered how and if I’d be able to make corrections to the note after it was signed. At first I couldn’t find anything, but then in a bit of an obscure location, I found an “Addendum” button that allowed me to add a comment to a signed note.

I did wonder how I’d chart a note for that patient for say a phone call. I didn’t see an easy way in the chart to create a simple note like this. I’m guessing it must be done from some other screen, but I didn’t see a way.

Document Management
I liked the Document Management functions built into Practice Fusion. They were quite slick and I love the way that you can sign off documents. The upload process was easy. On my first upload I completely missed the section to assign the uploaded document to a patient. So, later I had to figure out how to assign it after upload. Not a big deal once I figured out where I missed it.

I was missing the Fax Management section. I’d seen a button to Fax a referral earlier and so I wondered how they dealt with faxes. I knew there had to be an answer so I clicked that “Live Help” button to get an answer to my question. Plus, I must admit that I wondered how quickly they would respond and how the Live Help would work.

After a minute or two I got a live person who told me that they only do outgoing Fax Referrals. They didn’t have any feature for incoming faxes yet. That’s too bad since it would have been a killer feature. Although, a fax server is still killer and easy to set up in an office. I also asked the support person about bulk upload of documents and they said I could only upload one at a time. Not a horrible thing, but I could see bulk upload being a useful feature. Then, just assign them after the bulk upload.

Multiple Logins
One problem with the chat with the Live Support person was that the chat took over my whole Practice Fusion browser session and I couldn’t do anything while we were chatting. The tech person that I am, I decided to open up a new Practice Fusion window on my other monitor. Plus, that would be a good test if I wanted to have 2 windows open at the same time.

Only problem was that once I logged into the new window, the old window logged out. Yep, I guess you can only have one browser session logged in at a time. I even tried to lock the browser session (which is a nice feature) and then log into another browser window. Once I logged back into the locked browser session, I was kicked out again since I had opened the other session. So much for having 2 windows open with Practice Fusion.

Second Login Configuration
I did find it really interesting what happened the second time I logged into Practice Fusion. It gave me a series of screens to configure. Simple things like address, phone, etc of my location. It also asked about any lab interfaces I might need. Definitely a good idea to wait until the second time I logged in to ask me these things.

I also wanted to see what kind of configuration options were available. I thought that it would be utterly overwhelming, but it really wasn’t. Pretty straightforward stuff and easy to add new users, new payers, new facilities, etc. If anything, I wonder if it might need more options.

Overall Thoughts on Practice Fusion EMR
About an hour and twenty minutes later I completed my perusal of Practice Fusion’s EHR. A little longer than the 5 minutes, but that was to be expected. An hour and twenty minutes on my own to go through an EMR is pretty good. I think I could log in right now and easily schedule a patient, chart a note and get them their scripts, referrals etc with no problem. I’d say that’s a pretty simple design.

I do wonder if I’d hit a wall when it came to how simple it is. I wonder if there are other features I’d be wishing they had that they don’t yet have implemented. I’ll be asking some of the doctors that I meet tomorrow this question.

I’m sure this is very purposeful on Practice Fusion’s part, but the EMR is pretty much void of billing. I think I saw one button that said “Send Superbill.” So, I’m mostly evaluating it on the EMR basis and not the billing portion. My understanding is that they work with a Practice Management System for this. I’ll find out more on this tomorrow as well.

As far as the ads, they really weren’t that intrusive. It was fun to see who they had advertising. I saw a few Dell ads along with what looks like an IT consultant that specializes in supporting Practice Fusion implementations. Not to mention a number of pharmaceutical ads and an ad for their user conference tomorrow.

Overall, I found Practice Fusion simple and intuitive to use. There is certainly room for improvement in usability in some aspects of the design, but I didn’t find anything that was too hard to figure out. The fact that it’s a SaaS based EHR bodes well for future development of features and usability as well. Plus, for the price (Free), it’s definitely worth an hour and 20 minute test drive to see for yourself.

Full Disclosure: Practice Fusion is an advertiser on this site and is paying for my flight and hotel to attend their user group meeting as a moderator and for the ReachMD interviews. Although, they didn’t pay me to do this review.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Good review. Just as an FYI – I’ve developed apps in Flex and AIR, and Flash does indeed support drag and drop. You can also add your items to the context (right-click) menu, though I’m not sure if you can take away the default Flash items. Maybe Practice Fusion will add those functions in the future since you brought it to their attention.

  • Greg,
    I thought it might be possible. I don’t use enough flash apps. I generally hate them, but I admit that the Practice Fusion flash implementation felt like most other websites, so it wasn’t too bad.

    I guess I should have mentioned that they implemented some right click options. I think cut, copy and paste was available on occasion. I’m sure they’ll add more over time. Although, that doesn’t work so good on mobile.

    I’m guessing that drag and drop will be added at some point. It’s kind of a no-brainer feature for a calendar. It’s much easier to do that visually.

  • John,

    I am the Director of Product Management at Practice Fusion and would like to thank you for taking the time to walk through the Live in Five process and share your thoughts here.

    You’ll be happy to know that we recently took a hard look at our initial user experience and came to many of the same conclusions as you. As a result, we have some exciting enhancements slated for delivery over the next two releases, including the following:

    – A new welcome message to help guide new users through the steps for getting started so they are not overwhelmed by lots of options upon initial login

    – Removing a majority of the tabs on the Home screen and consolidating them in a more user friendly manner so they can be leveraged from anywhere in product without interrupting workflow

    – More prominent ways to add and search for patients and add appointments

    – More test data for our existing test patients that come with the system, including appointments, prescriptions, and documents

    We are dedicated to creating a phenomenal user experience and feedback like yours is absolutely vital as we make enhancements – thanks again!

  • Hi John. It was a great experience meeting you on Friday at the user group conference. I agree with your blog comments. As a user myself, I think this is the best available EHR/EMR for small group and solo practices (such as my own), and the pricelessness of it is … well … priceless. At 10 months into using it, and 900 or so patients later, I’m still loving it’s ease of use and would highly recommend anyone running their own practice to try it.

  • Greg,
    Thanks for reading my thoughts and I hope they are useful in helping you create a better product for doctors. That’s my main goal. Feel free to drop me a line after the redesign and I can do a follow up post looking at the changes you’ve made.

    More test data is good, but I think along with that is really making it apparent to new users what’s test and what’s not test and that it’s OK for them to go in and really test the system. I’m not sure if the key is creating an “audit log” which you can turn on to track someone until they officially “go live” with the system. Or if it’s a set of test user accounts that could be used and tracked so that the test data could be removed.

    I mentioned this at the user conference. The real challenge with the test data is balancing which items are test data and which are not. For example, if I add a patient, it’s probably test. However, if I add the address/phone number for the clinic, it’s likely not test.

    Either way, making this clear to new users that they can test all they want and that the data can be inactivated/removed after the test period is another thing that could benefit the initial user experience.

  • Michael,
    It was a pleasure meeting you as well. Practice Fusion is lucky to have a doctor like you that’s such a strong advocate for their system. There’s definitely a compelling case to use Practice Fusion in the small practice/solo doctor’s office.

  • The flaw in the practice fusion model is that it is simply giving you an electronic pencil with little or no workflow redesign which is where the power of an EHR comes from.. It is nothing more then a fancy pencil. I wonder if most providers do what you did. log in and try it out but then move on to a real system.. There is also a real question of the legality of their business model of selling patient data under the new ARRA privacy rules.

  • Brian,
    Do you know of a good EMR that has good workflow design?

    I don’t think there’s much question about selling patient data as long as it’s been de-identified. I’ve heard of other EMR vendors doing it already. They just do it behind people’s backs instead of out in the open like Practice Fusion. How well Practice Fusion will do at selling this information is yet to be seen. Even if it is legal, it doesn’t preclude someone from bringing a case against them regardless of the legality.

  • I appreciated your review and appreciate the unbiased observations. I received a phone call after the conference from a physician that attended the conference and they too wanted to upload documents in batch mode to Practice Fusion. We were asked to investigate and were informed as you were that you can upload one at a time.

    There did not seem to be an awareness that a physician may want to abstract the active patient charts and upload these documents to the EHR for reference so they can eliminate the chart room. It has also been our observation that many physicians are still receiving a number of documents on a daily basis that need to be added to the chart.

    Did you hear anything at the user meeting that leads you to believe there is something special about Practice Fusion or the targeted physicians that would eliminate the need to efficiently import active charts and daily loose filing?

  • Dane,
    I don’t feel like it’s onerous to upload as they have it now for those daily loose filing. Plus, I bet this will improve over time.

    As far as importing active charts into Practice Fusion might be a different issue. You can easily scan it as one document with a nice scanner and then it’s an easy upload. However, I’m still a proponent for outsourcing the scanning of old paper charts. It’s more accurate, more efficient and less expensive than you’d think.

  • The tasks all add up over time and the scan, search, link and upload process of most EMR’s leaves a little to be desired.

    If you get a second and can review two short videos on Youtube I would be curious about your input. Search on “Inofile” and look at ChartMD (for the physican office that may not be ready yet for an EMR or for batch scanning and uploading to an EMR) and the Inofile Appliance (which connects directly to the EMR) providing batch scanning, look up to the EMR database and uploading to the patient file in the EMR.

    Is this more efficient and valuable in the initial conversion to the EMR and for the daily loose filing like Lab Reports, Referrals and new patients?

  • Dane,
    I checked out the Inofile videos. Interesting idea and I like what seems to be a deep integration with the ScanSnap. I’ve heard good things about the ScanSnap scanners.

    How many EMR vendors have you integrated with? I know the video says you could integrate with any EMR through web services, but this still requires the EMR to support and integrate as a web service. Which EMRs have you created integrations with?

    How much does the Inofile add-on cost on top of the ScanSnap scanner?

  • That is good to hear.

    For those EMR’s that are not capable of exposing web services or are two busy with ONC certification, we have the module called Inofile ChartMD. This wil take advantage of an EMR’s ability to do batch imports from scanning companies and for documents that may come from an HIE (CCD / CDA formatted). IN some cases the physician could scan using Inofile ChartMD and then just leave those named files on their server and retrieve them electronicallym using the standard Windows Explorer Serach functionaliy.

    That is why we were a little suprised by the stance of Practice Fusion, as though the physician would have time to import large numbers of documents manually. That is the equivalent of losing your GPS and going back to a paper map. The transition to an EMR has to be simplified and easy.

    In large part, the EMR”s have misunderstood the value of the current paper and the amount of paper that a practice will receive over the next 5-10 years. We will be virtually paper less in Healthcare in time, but in the mean time we can make the practices fileless.

    Out of respect for the forum I would be glad to handle your other questions regarding availability and costs if you would email me at or call me at 208-830-8978.

    Again thank you for the observations about Practice Fusion and this interesting model for the Healthcare community.

  • Mitochon Systems Inc is also a fully certified and free
    EMR/PHR/HIE with optional E Prescribe. The advantage is a fully integrated system with HIE as its design point- this pays big dividends in terms of user friendly workflow, intuitive process and physician to physician collaboration.

  • I have been using practice fusion for 9 months in my solo practice and I find it satisfactory. I have used more powerful EHRs that I think were overall better, but this one works well for me (and it’s free). I sort of miss the “check-the-box” feature of some EHRs, because this one is all text-based. I type my notes in Microsoft Word and then cut and paste into Practice Fusion. I don’t use the templating feature. I have a completely paperless office. I scan all of my documents into practice fusion, including registration documents, credit card receipts, insurance cards, EOBs, photographs, outside records, etc. It’s really nice to have everything in one spot, even if the interface is sort of clunky. This program has its idiosyncracies that take a lot of getting used to, but once you do, it’s fine. One of the biggest problems is this annoying snap-to “feature.” There is a banner ad at the bottom of the screen, and every time that ad changes, the PF screen moves to the front…no matter if I am in MS word, another IE window, whatever. It can be very disruptive, and I have not found a way around it. I can send superbills to my biller, who then logs in and can see them. PF has integrated billing with Kareo, which I don’t use, because it’s not free. I have my biller put everything into Practicemate, an arm of Office Ally (free!). It does end up being repeat work, but you can’t beat the price, and I have the process down pretty good. The only demographic info that ends up in PF is name and birthday, because that is what is required. I LOVE LOVE LOVE that I can print the plan in PF and give it to my patients, I use that feature for every single patient. I hope this review has been helpful, and that you are successful in your practice.

  • Bradley Jellerichs,
    Thanks for sharing the first hand experience with the product. Reviews like this are very helpful to doctors.

  • Anyone using Practice Fusion has been duped. Anyone using Practice Fusion has NOT received the $18,000 from Hitech. Why?! because it was not certified in April 2011 when registration for attestation began. And now that it is “certified” the “certified” version has not been released. If you were counting on $18,000 this year, good luck getting it.

  • Hi Mikki/Alice – I’m sorry to hear your concerns about Practice Fusion’s certification status. We completed our full certification in late May and will be rolling out the certified features to users in the next few weeks. Our users will certainly be able to complete their 90-day attestation for 2011 incentives. We’re here to help them every step of the way. Feel free to email me at if you’d like more details for using Practice Fusion to qualify for HITECH incentives.

  • Alice,
    You act as if this is just an issue for Practice Fusion. There’s at least 100 or so EHR vendors that are working on the same timeline. As Emily says, you only have to show 90 days of meaningful use. So, having it ready to go this month will leave plenty of time for those who want to show meaningful use in 2011. Plus, the incentive is the same if you show meaningful use in 2011 or 2012.

    I do find it a little surprising that the full EHR certification is complete, but it’s not yet been rolled out to users. What’s the delay Emily?

  • We’re completing usability testing and training materials for each of the new certified features before rolling them out over the next few weeks. With 90,000 users on our EHR today, we need to be sure that any major feature releases aren’t disruptive to the daily workflow.

    It’s an interesting dichotomy with the rest of the EHR sector. Our certification process has taken longer, but in a few weeks we’ll have 100% of our users on the certified version. Meanwhile, many EHR systems have a certified product but only a very small percentage of users live with it due to cost, upgrade backlogs and other constraints.

  • I was interested in the comment that John made re: “So, having it ready to go this month will leave plenty of time for those who want to show meaningful use in 2011. Plus, the incentive is the same if you show meaningful use in 2011 or 2012.”.
    My understanding is that if you want to receive the full $44,000 incentive you need to complete attestation by the close of 2011. Is this incorrect?

  • Emily,
    That is an interesting dichotomy. I might have to do a post about it.

    There are some advantages and disadvantages to showing meaningful use in 2011 versus 2012. Although, EHR Stimulus (HITECH) dollars is not one of them. Check out the slides on this post: Slide 3 has the payment schedule for Medicare. You’ll see the total amount is the same if you start in 2011 or 2012.

    Now if you start taking in other factors, there are reasons to do it in 2011 or 2012. For example, if you’re doing the ePrescribing incentives this year, then you should wait until next year to do the EHR incentive, because you can’t do both at the same time.

    I hope this helps.

  • “Up in 5”. Give me a break. The licensing agreement and privacy policy look to be 15-20 pages. That would take a minimum of 20 minutes just to read and understand.

  • EBIO-Metronics offers a great EMR, certified for meaningful use. Very extensive in features, great usability, developed by a team of doctors, great price just 300$ / provider with unlimited features with customized changes. Must give a try, I am using it. feel great.

  • Thank you John for your review. VERY HELPFUL! I am curious about one of your bloggers Bradley Jellerichs if he still feels “satisfactory” with the new certified version of the EHR???? When you were charting, was it only text format or were able to check off boxes to create text in the HPI??? Did you find the Ads annoying??? Thanks

  • So Sorry! Mr Jellerichs wrote a comment on May 6th,2011. I have spoken with Dr West who is very happy with this EMR. I needed another contact who may have had some negative experiences with Practice Fusion. Thanks for the info!

  • I have not noticed a significant change in the EMR since becoming certified. I will say that I tend to stick with what I know, so I have not done any exploring in the EMR in several months. I stick with the cut/paste motif that works well for me. My practice is such that I do not require certification or meaningful use. And yes, I’m just a user of PF, not an official or paid blogger.

  • Bradley,
    I think the idea that nothing seems different since starting to use the certified version of the EMR is a very good thing. I’ve heard many EHR vendors talk about their challenge and efforts to make adherence with meaningful use as simple as possible.

  • Though the price tag of PF would seem to make it an appealing EMR choice, the fact that PF completely ignores the repeated requests for manual entry of discrete lab values. It offers only integration with outside lab companies. Any practice that does any labs in house will find no lab tables in PF for that locally generated data.

  • We support many Practice Fusion (and Kareo) practices that wanted automated reminder messages. For just pennies a reminder, we can call or text appointment reminders to any Practice Fusion patient.

    We’ve tried contacting Practice Fusion personnel to white-label our service to them, but as of today have not been able to reach the proper person.

    See out facebook page at to see a few of our customers, or feel free to give us a call at 888-341-8388 ext 1 to learn more about our service.

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