Clinic software
Practice Fusion, and an alert that was a kickback
In 2020 the Justice Department announced that Practice Fusion, then a San Francisco electronic-health-record vendor, would pay $145 million to resolve criminal and civil investigations of its software. The firm admitted it solicited and received kickbacks from a major opioid manufacturer in exchange for clinical-decision-support alerts designed to push extended-release opioids.
The criminal piece was a deferred prosecution agreement: more than $26 million in fine and forfeiture, and an admission that the alerts were bought. Civil settlements added about $118.6 million over kickbacks from that manufacturer and other drug companies, and over federal incentive payments the government said were tainted because the EHR’s certification claims were false. Purdue later admitted, in its own resolution, that it paid Practice Fusion nearly $1 million from marketing budgets so the Pain CDS would run on the free EHR. The alert, DOJ has written, fired more than 230 million times. Physicians who saw it prescribed extended-release opioids at a higher rate than those who did not.
The Vermont U.S. Attorney’s Office required a public document repository of the underlying files. That repository is itself a public record of how an inbox-style alert inside a chart can be a paid product.
The date is 2020. It remains the file that later clinic-software cases are read against: the chart is not a neutral page if someone else paid for the prompt.
justice.gov — Practice Fusion $145 million resolution — 01/27/2020
These notes paraphrase a public Department of Justice announcement. A settlement resolving allegations is not a finding by a court unless the announcement says otherwise.