Practice Fusion, Inc.
IndustryHealthcare Information Technology
Key people
Ryan Howard, Founder, Former CEO until 2015
Tom Langan, CEO
Alan Wong, Co-Founder
Jonathan Malek, Co-Founder & CTO
Matthew Douglass, Co-Founder[1]
ProductsElectronic health records, Personal health record, Patient portals, Data analysis, Health care analytics
ParentAllscripts (2018–present)

Practice Fusion is a web-based electronic health record (EHR) company based in San Francisco, CA. The company was founded in 2005 by Ryan Howard and acquired by Allscripts in 2018.[2]

In 2013 the company was said to be valued at $700M[3] and in 2014, Practice Fusion was the largest cloud-based electronic health record (EHR) platform for doctors and patients,[4] . Practice Fusion is used by more than 112,000 monthly active healthcare professionals with over 100 million patient records under management. In 2014, Practice Fusion’s EHR facilitated over 56 million patient visits (approximately 6% of all ambulatory visits in the US) and was the fastest growing EHR in the US.[4]

In 2015, Howard left the company[5] and Tom Langan became interim CEO.[6][7] Under Langan's leadership, the company contributed to the opioid epidemic in the United States by engaging in a kickback scheme to increase the volume of opioid prescriptions amidst its clients and their respective patients.[8] The company has been charged a $145 million fine, the largest criminal fine in Vermont’s history.[8] According to Bloomberg: "Practice Fusion admitted to the scheme with an unnamed opioid maker, though the details of the government case closely match a public research partnership between Practice Fusion and Purdue Pharma Inc., which makes OxyContin".[9] In June 2018 the company transitioned over to a paid subscription based system.[10] Practice Fusion is available to users in the USA only.


Practice Fusion is an electronic health record (EHR) company, founded in 2005 by Ryan Howard, Alan Wong, Jonathan Malek, and Matthew Douglass.[11] The first version of the product was launched in 2007 and initially gained little traction in the tough economy.[12]

The company began to grow in 2009, when the EHR and customer support were made free of charge.[13] In May 2009, Band of Angels and Felicis Ventures became the first major investors in the company, followed by in June, Morgenthaler Ventures in December 2010,[13][14] and Founders Fund in April 2011.[13] The company closed a $70 million Series D round of financing led by Kleiner Perkins Caufield & Byers in September 2013, followed by a $15 million Series D extension in December 2013 led by Qualcomm Ventures, bringing total funding to date to $149 million.[15]

In June 2011, the product achieved Office of the National Coordinator for Health Information Technology Meaningful Use Certification.[16] From 2011 to 2013, it was named the No. 1 EMR for customer satisfaction among primary care providers in addition to being named No. 1 for e-prescribing client satisfaction and helping doctors achieve Meaningful Use by Brown-Wilson's Black Book Rankings.[17][18] In September 2013, KLAS Reports named it the No. 1 EHR system for value among ambulatory professionals.[19]

In 2013, a State of the Small Practice survey conducted by Practice Fusion indicated that 36 percent of providers were using three- to six-year-old computers. In response, the company launched a "Free EHR + Free Laptop" campaign in 2014. The campaign supplied a complimentary Google Chromebook to new physician users of Practice Fusion's EHR platform to increase incentive.[citation needed]

In 2015, Howard left the company[5] and Practice Fusion was starting to look for a buyer. In 2016, an IPO valued the company at up to $1.5 billion.[20]

In the fall of 2016, under Tom Langan's leadership,[6] the company accepted remuneration from a "major" manufacturer of opioids, referred to as "Pharma Co. X" in exchange for clinical decision support, to prompt doctors to take certain clinical actions in order to increase prescriptions of extended-release opioids.[21]

However, in 2018 Practice Fusion was sold to Allscripts for only $100 million. While its ordinary 200 employees and common stockholders made no profit or lost money, managers, including Tom Langan, Jonathan Malek, Matthew Douglass, Rich Loomis, Stephen Byrnes, Riyad Omar, Stacey Rubin, Derek Tan, and Eric Weis,[22] made millions in profit from a pre-arranged carve-out.[20]

In January 2020, the company (as a subsidiary of Allscripts) admitted in court to have accepted $1 million in kickbacks by "Pharma Co. X" in return for a deferred prosecution agreement.[8] Practice Fusion was fined $145 million for the misconduct by the Department of Justice for the District of Vermont.[23] In the DOJ investigation, Langan and Loomis are identified as the primary operates in the scheme.[24]

Subsequently, Howard published, "How to Prevent Your Company from Being Used for Evil From a Founder Who's Been There,"[25] and has become an advocate to other founders to help them prevent their companies from being corrupted and being used for evil.


The Software as a service startup has been providing physicians and medical professionals with advertising-supported electronic health records and medical practice management technology[26] which included charting, scheduling, e-prescribing (eRx),[27] medical billing,[28] laboratory and imaging center integrations,[29] referral letters, Meaningful Use certification,[16] training, support and a personal health record for patients.[30]

Products (2013)


  1. ^ "Practice Fusion's Executive Team". Archived from the original on 2010-03-06. Retrieved 2010-03-15.
  2. ^ "About Practice Fusion".
  3. ^ "Practice Fusion Said to Be Valued at $700 Million". Bloomberg. 2013-09-24. Retrieved 2020-02-09.
  4. ^ a b Glatter, Robert (29 June 2015). "Why Practice Fusion Is The Dominant Player In Cloud-Based Electronic Health Records". Forbes. Retrieved 2020-09-22.
  5. ^ a b "Behind the Practice Fusion CEO Switch". Fortune. Fortune. Retrieved 8 August 2015.
  6. ^ a b "Practice Fusion Announces Appointment of Tom Langan as Permanent CEO". Practice Fusion. 2015-11-12. Retrieved 2020-12-10.
  7. ^ Andersen, Ted (28 January 2020). "S.F.-based Practice Fusion Inc. admits to opioid kickback scheme". San Francisco Business Times.
  8. ^ a b c Antonia Noori Farzan (2020-01-28). "A tech company gave doctors free software — rigged to encourage them to prescribe opioids, prosecutors say". Washington Post.
  9. ^ "Health-Records Company Pushed Opioids to Doctors in Secret Deal With Drugmaker". 29 January 2020. Retrieved 2020-09-22.
  10. ^ EHRIntelligence (23 February 2018). "Practice Fusion No Longer Offering Free EHR System Software". EHRIntelligence.
  11. ^ Practice Fusion (2017-01-01). "Practice Fusion Founders". Practice Fusion. Retrieved 2017-01-01.
  12. ^ Herel, Suzanne (2011-09-30). "Meet the Boss: Ryan Howard, CEO of Practice Fusion". San Francisco Chronicle. Retrieved 2012-04-11.
  13. ^ a b c Roush, Wade (2011-11-10). "Practice Fusion Bids for Dominance in the Doctor's Office with a Free, Ad-Supported Electronic Health Record System". Xconomy. Retrieved 2012-04-11.
  14. ^ Dougherty, Conor & Tam, Pui-Wing (2010-04-01). "Start-Ups Cash Cash as Funds Trickle Back". The Wall Street Journal. Retrieved 2012-04-11.
  15. ^ Empson, Rip (9 December 2013). "Practice Fusion Adds Another $15M From Qualcomm To Help Fuel Growth, Acquisitions & Mobile Push". TechCrunch.
  16. ^ a b Campbell, Steve (2011-06-07). "Practice Fusion's Electronic Health Record System Achieves Complete ONC-ATCB Meaningful Use Certification". EMR Daily News. Retrieved 2012-04-11.
  17. ^ "Report: Practice Fusion Voted No. 1 Overall EHR in "Year of the EHR Switch"". Archived from the original on 2013-10-22. Retrieved 2013-11-06.
  18. ^ "2012 Black Book Rankings Top EHR & EMR Vendors: E-Prescribing". Archived from the original on 2012-04-19. Retrieved 2012-04-12.
  19. ^ "2013 Ambulatory EMR Performance (1-10 Physicians) The Quest for Value Amid Rising Expectations - KLAS Report". KLAS. 2013-09-04. Retrieved 2020-01-28.
  20. ^ a b Farr, Christina (2018-01-23). "Employees at Practice Fusion expected IPO riches, but got nothing as execs pocketed millions". Retrieved 2020-01-28.
  22. ^ Farr, Christina (2018-01-23). "Employees at Practice Fusion expected IPO riches, but got nothing as execs pocketed millions". CNBC. Retrieved 2020-12-10.
  23. ^ EHRIntelligence (2020-01-28). "Practice Fusion Fined $145M for Opioid Prescribing Kickback Scheme". EHRIntelligence. Retrieved 2020-04-22.
  24. ^ Department of Justice. (PDF) ((cite web)): Missing or empty |title= (help)
  25. ^ Howard, Ryan (2020-11-25). "How to Prevent Your Company from Being Used for Evil From a Founder Who's Been There". Entrepreneur. Retrieved 2021-05-17.
  26. ^ Blankenhorn, Dana (2008-07-31). "Psst. Want a free Electronic Medical Records system?". ZDNET.
  27. ^ "Free EHR Adds E-Prescribing". Health Data Management. 2010-01-13.
  28. ^ Colliver, Victoria (2007-03-16). "Medical site is on a mission to set records". San Francisco Chronicle. Retrieved 2009-07-06.
  29. ^ "HISTalk News 3/22/2012".
  30. ^ "EHR Features".
  31. ^ "Practice Fusion Continues To Reach Beyond Digital Health Records, Adds Free Expense Tracking To New Booking Engine". TechCrunch. 2013-05-22. Retrieved 2020-01-28.
  32. ^ "Practice Fusion pulls back the curtain on its electronic health data – for a fee". 4 June 2013.