Practice Fusion Wants to Be Free

A startup grows by giving its technology away to doctors
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The San Francisco headquarters of Practice Fusion contains a vivid reminder of the startup’s lean early days. Sitting in the lobby is a red and white 2001 Ducati 996S motorcycle under the words “Be Scrappy.” Ryan Howard, who founded the medical software company in 2005, once covered payroll using the insurance payment he received for an accident he had on that bike.

In 2007, Practice Fusion’s Web-based electronic health record (EHR) system was used by 92 medical professionals. Today the company has a customer base of more than 100,000 doctors and clinical office staff, making it the fourth-largest vendor of EHR systems for physicians in the U.S., according to industry researcher SK&A.