Allscripts CEO Paul Black talks McKesson acquisition, 2018 goals: 6 questions

Earlier this year, Allscripts closed its acquisition of McKesson's health IT business — a $185 million deal CEO Paul Black says will help position the company as a leading EHR supplier.

"It puts us into a very [unique] position in the marketplace of being the second-largest publicly-traded health IT supplier with the revenues we gained," Mr. Black says. 

Allscripts, which started as a relatively small medication management company in 1986, has blossomed into a multifaceted health IT vendor. Today, the Chicago-based company serves 2,500 hospitals, 45,000 physician practices and 19,000 post-acute agencies. It offers an EHR dubbed Sunrise, a population health management platform called CareInMotion, a precision medicine tool known as 2bPrecise and a financial management solution called EPSi.

Allscripts is the seventh most-used certified health IT vendor reported by hospitals participating in the Medicare EHR Incentive Program, according to ONC data released in July. The company was recognized as an EHR vendor with a comprehensive population health management solution from Black Book in 2017, and Frost & Sullivan awarded it company of the year in its ambulatory RCM category for 2017.

Mr. Black, who has served as CEO of Allscripts since 2012, truly believes in the Allscripts mission — "enable smarter care, delivered with greater precision, for healthier patients, populations and communities." It's a belief instilled in him throughout his childhood, around the dinner table.

"My father was the director of the pharmacy department at the University of Iowa Hospitals and Clinics [in Iowa City]," he says, explaining his earliest interest in the health IT space. "So, as a kid, I grew up [watching him] ... concentrate on patient safety."

Prior to joining Allscripts, Mr. Black worked at IBM for about 12 years before moving on to Cerner, where he served for more than 13 years in various executive roles, ultimately retiring as COO in 2007. He is immediate past chairman and an officer of Truman Medical Center, a 400-bed safety net academic hospital in Kansas City, Mo.

Becker's Hospital Review caught up with Mr. Black to discuss Allscripts' goals in the post-McKesson acquisition era, working with third-party app developers and health IT trends to watch in 2018.

Editor's note: Responses have been lightly edited for length and clarity.

Question: McKesson had reportedly been looking to sell its IT business for some time. What value did Allscripts see in acquiring this portion of McKesson's business in October?

Paul Black: The acquisition doubled our client base on the inpatient side, and it's something that, from our perspective, helped us distinguish Allscripts from many other players in the market based on breadth, depth and scale. It put us in the "top tier," if you will, with Epic and Cerner, and below that tier, you've got a number of players like NextGen, Meditech, General Electric, Greenway, Practice Fusion and Medhost, all which equal about another $2 billion by themselves. It really solidifies our position in the marketplace.

Q: How will the acquisition affect Allscripts' EHR product lines?

PB: McKesson had already made some historical decisions to no longer offer two of its EMRs, which will be discontinued in March. For the McKesson Paragon EHR, we will maintain those products. We are going to pull those operations into ours, from a development, sales and services standpoint and make Paragon a great community hospital solution that's got inpatient, outpatient and revenue cycle all baked into one EMR. We will continue to build and support McKesson's accounts payable solutions, Medstar and Medipac. We also see opportunities for the McKesson install base to have access to Allscripts solutions it historically did not have. Lastly, both Allscripts' and McKesson's clients will benefit from servicing capabilities both of the companies have around remote hosting, revenue cycle management, total IT outsourcing, precision medicine and professional services. Those are things we looked at as able to take the company and catapult it into a new position in the marketplace.

Q: With the majority of hospitals using EHRs, what do you see as the next major industry challenge in terms of health IT?

PB: There's never been an environment as bright as it has been over the past two years. Now, pretty much everybody is on an EHR. Going forward, I think the digital platform needs to ensure the data come out of all the different EHRs and are implemented into a single integrated record, and that's something we do at Allscripts. Once you have the information in that record, you have the totality about that person, how they are doing and how their health is progressing. As I look to the future, I see everything digital: I see interoperability questions being resolved, and we want to connect the consumer, or the citizen, to their own information so they can be active participants in the healthcare process. Within the next 10 years, I also think everyone will have some piece of their gene sequence on their EHR to ensure they are on the right protocol and taking the right medications.

Q: What interoperability efforts has Allscripts been working on this year?

PB: We create interoperable platforms with our solutions, and we invite people to build solutions on top of our EMRs in a couple of different ways. We have our application development program, where third-party developers can build possible solutions for the Allscripts app store. We're looking for developers who are innovative and bring something new to the market. They might be introducing something that sounds simple, like a solution to notify a physician when they have openings in their schedule for the day. Things like that, which may not sound earth-shattering, but if you are a physician, it might be handy. Today, we have 6,614 registered developers using our intelligent application programming interfaces. We've had almost 3 billion data shares since 2013. We have 40 people whose place in the company is to help programmers be successful with their business to create value on top of the Allscripts platform.

Q: What do you think about growing interest in longitudinal health records, which integrate social determinants of health into EHRs?

PB: Allscripts has been investing in the post-acute arenas, including behavioral health, mental health, substance abuse, long-term care and home health. Those are all areas of care that exist outside the four walls of the hospital or clinic, but we feel they are extraordinarily important for managing the totality of the human patient. It's not only the physical nature of a broken arm or something in the emergency room, but the mental health component, as well. Some of the social determinants of health are zip-code-based, some of them are historically-based and some of them are based on other conditions or diagnoses that may exist in different EMRs than those that are seen by the emergency room physician or primary care physician. At Allscripts, we think bringing that data together with the right kind of security clearance, et cetera, is instrumental to having a total view of the patient, of the person, as they come in for care.

Q: What are your top priorities for Allscripts in 2018?

PB: We will continue to do what we've been doing over the course of the last five years, which is to think strategically about how we can be of assistance and how we can be relevant to the healthcare IT industry globally. We have a core set of EMRs out there that need to be upgraded to enhance our core capabilities: the hosting, revenue cycle, total IT outsourcing and professional services. We're also working on our value-based tools, our cost-accounting solutions, our interoperability platform and our payer and life sciences suite of solutions, as well as what we're doing around the topic of the consumer. The next imperative we have is to continue to expand our international business. We've had a lot of success over the course of the last three-plus years, where we've gained some very large clients outside of the United States in Australia, Singapore and the United Kingdom. The last priority would be to continue our post-acute care platform expansion and the work we're doing there.

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