"Free" EMR system comes with fee for support services

Practice Fusion is acknowledging on its Web site that its free electronic medical record system is not completely without cost.

Gail Romano, the company's vice president of marketing, said that in order to be "completely aboveboard" the company added the sentence: "There is only a nominal support fee for practitioners."

That sentence appears under a bullet point with the word "free" in bold letters, explaining that the licensing and hosting is free of charge. While not listed on the Web site, the support cost is $50 per physician, per month, Romano said.

The change was made after a complaint by one physician who sat through a Practice Fusion product demonstration.

That physician, who declined to be identified for this article, wrote a letter to Romano to dispute the company's use of the word "free" in its marketing materials when it also listed the $50 per physician, per month support charge.

Romano confirmed the $50 support fee, but defended the company's use of "free" because the hosting and software licensing are offered at no cost.

The San Francisco-based company entered the EMR market with a splash earlier this year when it claimed to offer a Web-based system for free.

In exchange, doctors would allow a link to Google's AdSense program, which uses key words to link to advertisements that would generate revenue for Practice Fusion.

Practice Fusion CEO Ryan Howard said the company was never dishonest, as the Web site never said support was free, only licensing and hosting.

Practice Fusion's Web site did not previously claim to offer free support, nor did the company's news releases.

However, support -- free or otherwise -- was never mentioned. News coverage of Practice Fusion did not mention any support costs.

"Everyone else has understood the difference between free software licensing and data hosting and support and saw value in the support," Romano said, adding that this particular physician was the first to challenge the company on the use of the word free.

Howard said even with the support fee, Practice Fusion is still the best-valued EMR system available. If the company offered support at no charge, "we would lose money on this," he said.

Practice Fusion, which has about 300 clients, according to Romano, also offers a version of the product without the Google ads for $250 per physician, per month, which includes the support fees.

This is not the first time there has been confusion over Practice Fusion's business arrangements.

The company in March announced a partnership with Google to use its AdSense program to help cover costs of its "free" system.

But Google later issued its own news release clarifying that Practice Fusion's adoption of AdSense "is not exclusive and should not be read as an indication of any product plans by Google." AdSense is used by "hundreds of thousands" of Web sites, Google said.