It wouldn’t have been too surprising had Jim Murry, CIO of UC [University of California] Irvine Healthcare, an academic medical center based in Irvine, Calif., had his confidence in Allscripts slightly rattled over the past year. Murry’s UC Irvine Healthcare has heavily invested in the Chicago-based EHR software company’s Sunrise suite, and, quite frankly, it wasn’t exactly the smoothest year to be closely tied to the company.

In the wake of fierce, accelerated competition in the electronic health record (EHR) industry, Allscripts had to deal with considerable instability, some of it emanating from the 2010, $1.3 billion merger with Eclipsys, which ultimately achieved mixed results. As the market pushed towards integration, says Coray Tate,  vice president of research at the Orem, Utah-based research and consulting firm, KLAS,  the company failed to execute on achieving true interoperability between the core Allscripts and Eclipsys solutions.

In a May 2012 interview, Tate said, “They are the kind of company that bought the various pieces. And as they’ve tried to put those pieces together, they haven’t delivered in the way the customers expect.”

Around that time, several members of the company’s board of directors, some of who were tied to Eclipsys, departed, after what had been characterized by some in the trade and mainstream press as something akin to a failed palace coup against then-CEO Glen Tullman. Among those forced to exit were Phil Pead, the former CEO of Eclipsys, who had become the chairman of Allscripts’ board.

The year only got more tumultuous as the company, which had seen its stock price take a dip, begun to deal with a consistent buzz about possible interest from third-party private equity firms. In December, things reached a head when Tullman, who had helped build and grow the company, but whose leadership had been under challenge, resigned. 

Black In, dbMotion In

With all of this going on, Murry never lost faith in the company. When members of his c-suite approached him with curiosity regarding some of Allscripts’ well publicized issues, he told them flat out that he thought good things were happening at the company. Paul Black’s emergence as the new CEO of the company last December was certainly one of those good things, Murry says.

Black was originally brought on to Allscripts in May as a member of the Board of Directors. When Tullman stepped down in December, the long-time industry veteran, and former COO of Cerner, was immediately appointed CEO. In his brief tenure so far, he has already made a notable splash that has won over customers and industry observers alike. In March, the company formerly acquired dbMotion, a Pittsburgh-based company, for $235 million. The core semantic interoperability solution from dbMotion normalizes patient data, while creating point-of-care tools, a physician portal, population management tools, and an analytics platform.

Paul Black

dbMotion, Black says, will allow Allscripts to integrate with several other EHR systems. It’s technology that will allow for identifiable patient records, where they can be put in a community record that sits above different architectures. “Once you have that virtualized community record, you can run analytics. That’s the name of the game in terms of care management,” he says. Then you can better manage different populations of patients, whether they have chronic obstructive pulmonary disease (COPD), diabetics, or any kind of chronic condition.

Population Health Push

The dbMotion buy, along with the company’s acquisition of Jardogs, EMR agnostic patient engagement software that allows providers and patients to connect in real-time, is all part of Allscripts’ population health management focus. According to Black, the vision of population health, through integration, analytics, and engagement technologies, is where everything is headed. 

“This day-and-age, the rip-and-replace strategy across an entire health system, with multiple inpatient and outpatient facilities, home health systems, hospice, and even retail clinics, I don’t think is the conversation that people want to have,” Black says. “They want to talk about how they can view a single patient’s record. That’s the conversation they want to have in regards to population health management.”

While it may have not received the same kind of recognition as dbMotion, the Jardogs acquisition is a large part of this push, Black says. He calls the kind of patient information that is obtainable through the Jardogs platform, “the layer above the layer.” It allows patients to interact with their record. It’s something that customers like Murry are strongly endorsing because having that kind of portal is part of the larger population health management picture.

“When I look strategically, if I’m doing the right things for organization, I look at my EMR platform as a critical piece, my HIE [health information exchange] platform, I need a good patient portal, and a good analytics platform. When you look at Jardogs, DbMotion, and the Sunrise, I’m going to get 90 percent of that. So I feel we’re riding the right horse right now with the vision Paul that has, with the money they’re investing, and what they’re doing,” Murry says.

Jim Murry

Open Architecture

Not to be forgotten, Allscripts’ open-architecture EMR philosophy and a focus on interoperability has remained a priority throughout the year. The company has created an atmosphere whereby providers can get developers to create specific clinically focused applications that interface with its EMR through this open-architecture. Lennox Hoyte, M.D., CMIO of USF [University of Southern Florida] Health, a Tampa-based academic medical center, is one Allscripts customer to ardently use this philosophy.

Lennox Hoyte, M.D.

USF Health, Dr. Hoyte says, created an application that interfaces with the EMR and measures patients’ bladder function. In the past, he says, this kind of tool would have had to have been typed and interpreted in the EMR. With the open-architecture, he says, its translated and goes directly in and saves clinicians roughly 15 minutes per patient. “It’s huge because now our instruments can talk directly to the EMR,” he says.

At UC Irvine, Murry and his team are using the open architecture to think outside the box, he says. With it, they have developed a separate EMR system designed specifically for the organization’s ophthalmology team that can integrate data across the enterprise. “The users don’t even know they are leaving the EMR,” Murry says, adding they used open architecture for similar integrations with the operating room’s surgical information systems.

“The Way it Should Be”

The way Hoyte sees it, the open architecture promoted heavily by Allscripts is exactly the way technology should be. He likens it to an electric plug or the components of a car, they’re standardized interfaces that allow for people to go in and create specific things that work for them. He says EMRs should be made in the same vein.          

“Allscripts has figured out the action of entering and removing data from the EMR and storing the data are two separate entities. And they’ve figured out the end-user actually know more about patient care than the EMR company and the end-user ought to develop applications that operates on the data for better clinical care,” Hoyte says.

The organization’s participation in the CommonWell Health Alliance, which is comprised of four other major healthcare IT vendors—Cerner, McKesson, athenahealth, and Greenway (also participating is McKesson subsidiary Relay Health)—speaks to its efforts to promote interoperability and population health. The alliance, which was formerly announced at HIMSS, is an effort to create a national patient identifier, says Black.

While it’s still in the early stages of development, Hoyte says combing this alliance with dbMotion could be a big win for Allscripts. “If dbMotion can be the thing that unites all of them together, that will be huge,” Hoyte says.

Leaders at the company are curbing expectations in the immediate future. In a recent earnings call, Black said 2013 was a “rebuilding year” for Allscripts. However, it’s clear that Black and Allscripts’ customers are confident that eventually the company will be the standard bearer and the tumult from 2012 will be nothing but a distant memory.