How Goliath lost to David in race to the best Clinic Management Solution- Part I


An EMR (Electronic Medical Record) is software that you as a Physician would use to prescribe medications, order investigations, schedule follow-ups, write medical certificates and more.

However, an EMR is not to be confused with only prescription writing software. It does help with prescription writing, but that is only a subset of what it can do. The software helps record all information pertaining to a patient’s visit, such as patient history, allergies, immunization, recalls, care plans and more.

A PMS (Practice Management Software) on the other hand, lets you manage the non-medical aspects of your clinic i.e. such as appointment scheduling, SMS reminders, billing, receipts, reporting and more.

Back in the 90s and as late as the mid-2000s, in developed markets such as Australia, EMR and PMS would be sold as two different software systems that needed to be integrated with each other. The idea being, that a Clinic could well do by buying only the EMR or only the PMS, without needing both. So a clinic may buy an EMR to digitize the writing of consultation notes and still use a paper-based system for appointment scheduling, billing and other administrative aspects of their clinic. Or, vice versa with the clinic buying a PMS and avoiding an EMR, stick to writing prescriptions by hand.

Back then, in Australia, 2 products ruled the roost. Medical Director, was the largest selling EMR, and PracSoft was the market leader in PMS. Together they owned 85% + of the market share in Australia. The interesting bit is both Medical Director and PracSoft were owned by the same company Health Communication Network. This led to a situation where competing companies could enter on lower budgets to build only an EMR and compete with the Medical Director, or build a product to handle the admin end of things and compete only with Pracsoft on the PMS front. This encouraged software systems with a very limited feature set to hit the market and created awareness and acceptability amongst Clinicians towards complexity and costs of integration. Having 2 different systems to manage the Clinic was the norm. It cost twice as more, and updates to any of 1 the 2 systems would cause heartburn, but the tone had been set and it was followed ever since.

Fortunately for India, not much was happening on the technology front for Clinics, during this phase. The only name that rings a bell back then was Prescription Pad – a Delhi-based initiative, that was commendable in what it was trying to achieve. However, Prescription Pad was way behind the curve of what had become technically possible. So by the time the likes of Easy Clinic, Doctor Sahaab, Plus 91 Technologies, and TurboDoc (later went on to be called Practo), came knocking in the Indian market, there was no precedent to fall back on and hence all of the companies tried to build a complete product inclusive of EMR + PMS. It would save the Indian Clinicians from the complexities and costs that Integrated Systems were produced in Australia.

Part II will reveal what happened next in the Indian market.