From Homeless to Unicorn Founder — The Billion Dollar Free Health Tech Startup Story

Ikpeme Neto
Digital Health Nigeria
3 min readNov 11, 2016

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I love to read stories of entrepreneurs. A particular one I enjoy is that of Ryan Howard, founder of Practice fusion. It packs plenty of learning points and inspiration to get you through a tough day.

Practice fusion is an American startup that offers free, cloud based EHR software for health care professionals. Its software is delivered as a service (SaaS). A model now much loved by many tech companies. This EHR startup is reportedly the largest cloud based EHR in the world and is widely successful. Like many startup stories, it wasn’t always a success.

Once upon a time, Ryan who’d worked several IT jobs, including being an IT billings consultant in healthcare, took a bold step. He saw first hand how broken health data management was and set out to fix it. He founded practice fusion in 2005 and set to work. They launched their first product circa 2007 and gained minimal traction. They continued to work hard but seemed to fail at every turn. With no traction, fund raising was difficult. Ryan had to sell his house, his car and take on massive debts to keep the lights on. Fortunately for him he was involved in a motorbike accident that provided a large settlement. It was money from this settlement that kept the company going a little longer.

Finally he caught a break. The HITECH act was passed by the U.S Congress. It provided $25 billion to promote and expand the adoption of health information technology. Individual practices would receive monetary benefits of up to $63,750, if they were able to show ‘meaningful use’ of EHR’s. With this new development, Practice fusion finally were able to raise funding. Eminent investors and companies like Peter Thiel and Salesforce got behind them. They’ve since gone on to raise over $150 million in venture funding. This has enabled them provide their software for free and hire a slew of sales people to help them grow.

Today practice fusion has over 150,000 healthcare professional users. It houses the data of over 110 million patients and reportedly looking to IPO soon. With a valuation of $1.5 billion, it joins the unicorn club and is a true health tech startup success story.

Ryan stuck it out in tough situations for a long time despite every sign to do otherwise. Similarly, Nigerian health tech founders in tough situations need to stick it out. Success will not come in 1 or 2 months, it may not even come in 1–2 years. Most startup advice suggests preparing yourself to stick it out for at least 5 years before you can achieve any real enduring success.

So dear founder, take heart and persevere. You may triumph in the end but you’ll never know for sure if you quit too early. Just don’t build another EHR application. I’ll tell you why in an upcoming post titled ‘5 reasons you should stop building your EHR startup now’.

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Ikpeme Neto
Digital Health Nigeria

I build and write about companies, communities and culture