Exposed: Practice Fusion

Practice Fusion was a free electronic health records (EHR) system used by thousands of medical practices across the United States, and it stands as one of the most egregious examples of healthcare technology corruption in American history. In January 2020, the Department of Justice announced that Practice Fusion would pay $145 million to resolve criminal and civil investigations for accepting kickbacks from a major opioid manufacturer to implement clinical decision support alerts in its EHR software that pushed doctors to prescribe opioid painkillers to patients. The company embedded alerts in the software that triggered during patient encounters and prompted physicians to prescribe extended-release opioid medications, contributing to the opioid epidemic that has killed hundreds of thousands of Americans. The kickback scheme operated from 2016 to 2019, during which Practice Fusion received payments from the pharmaceutical company in exchange for implementing these prescribing alerts across its network of medical practices. Beyond the opioid scandal, Practice Fusion monetized patient data by selling de-identified but re-identifiable health records to pharmaceutical companies, insurers, and researchers. The free business model was sustained by treating patient medical records as a product to be sold, creating a perverse incentive structure where the users of the software were not the customers but the commodity being traded.