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Glen Tullman on the Merger of Allscripts and Misys Healthcare

October 13, 2008 News 16 Comments

Allscripts CEO Glen Tullman finished this article early Monday morning to share his Day One thoughts on the newly merged Allscripts and Misys Healthcare with the readers of HIStalk. Completion of the merger was announced this morning. Glen will participate in a live chat on HIStalk Wednesday evening at 7:00 Eastern.

Software Silos – The End of the Beginning
By Glen Tullman, Chief Executive Officer, AllscriptsMisys

allscripts_120x240 This morning we announced that the merger of Allscripts and Misys Healthcare has been finalized, creating a new company with a client base of nearly one out of every three physicians and one of every five hospitals, as well as thousands of post-acute organizations. Clearly, this is a great opportunity for the company and for our shareholders.

However, I look at it in a very different way. I see this merger, not only as an opportunity, but as a responsibility as well. We simply must use our new size/scale, our set of solutions and our reach to radically accelerate the movement to create a truly interconnected healthcare system in order to eliminate errors, improve quality and better manage cost.

But we believe this must be a mandate not just for Allscripts, but for all vendors. While Allscripts and others provide applications that help address the issues I outlined above, the core problem is that healthcare is not connected – functionally, financially or technically. That can’t continue and we collectively have the tools to ensure it doesn’t.

Consider this a call to action to eliminate what I call “software silos.” Now is the time to come together as an industry to create standards, to ensure our systems are actual solutions, and that what we provide is the fix, not the problem.

What do I mean by “software silos?” Simply stated, vendors today often provide stand-alone applications. They are not connected to other systems or to information that is vital to our end users – the equivalent of a computer that’s not connected to the Internet.

Yet connecting to information is the very essence of what we are being asked to do, because healthcare is at its roots an “information business.” Without just the right information at the right place and the right time, providers can’t improve the health of their patients or their bottom line.

Today we have taken a significant step in this direction by bringing together two of the major players in the market. In doing so, we have already spurred additional consolidation. And more is coming.

But it will take more than consolidation. As an industry, we have to begin to move with urgency, because this is not a “problem” we are trying to solve – it’s a crisis. The stakes are too great to wait – 98,000 deaths per year from medical errors, clinical outcomes that are given a “D” on every report card relative to other industrialized nations, and $700 billion wasted every year (ironically, the same amount of the recent Wall Street bailout).

image Given what’s at stake, it’s disappointing that there are companies in our market who, when it comes to interoperability, can’t spare the time to help find a solution or lend a word of support to the many efforts that are in motion right now between many of us.  In fact, it’s worse than that. For literally everything that is done, they undermine it, preferring to use a “no, because” approach versus a “yes, if.”  Their attitude shows a fundamental lack of leadership.  Simply stated, walls between systems create chaos for patients and providers. We can’t allow this to continue.

A few years ago, I had an experience that I wouldn’t wish on any parent. While I was running another software company, I was in the operating room with my son Sam. As he was being put under, he looked up at a monitor and said “Hey Dad, isn’t that your company?” When I looked up, I saw an older version of our software and knew that we could do, and had done, better.

At that moment I realized that what flows through our systems is not bits and bytes, but human lives. The lives of our families and of our friends.

When Allscripts partnered with Dell, Microsoft, Google, Fujitsu and a number of other organizations to launch the National ePrescribing Patient Safety Initiative to provide electronic prescribing to every physician in the country for free, everyone thought I was a little bit crazy … including our Board of Directors, who reminded me we were in the business of selling software. But I wasn’t crazy (OK, maybe a little bit) – I was actually still, in a sense, in that operating room with Sam with a promise I made that day, which has turned into an obligation to get life saving technology into the hands of healthcare providers.

And that’s exactly why many of us entered healthcare to begin with and why we wake up every day with the passion to make a difference. But we can only deliver on that promise if we connect our efforts.

I am proud of the work both Allscripts and Misys have done through the years to move beyond software silos. We’ve played an active leadership role in developing standards, demonstrating interoperability in live settings with other Electronic Health Records (IHE Connecthathon, HIMSS Interoperability Showcase, etc.) and connecting patients to a variety of personal health record platforms including Microsoft HealthVault, Google Health and Medem. And, on Day One of our merger, our solutions will connect to others in our portfolio, from Emergency Department physicians who can view a patient’s ambulatory health record to hospital care managers who can share records with home care agencies. We’ll focus on leveraging our footprint to drive connectivity across the care continuum from ambulatory to acute and post-acute.

And just as we’re investing our resources in expanding across all settings and enhancing the interoperability of our solutions, it should be the commitment of every CEO in every healthcare IT company to dedicate the time (not just of their people, but their own personal time) and resources necessary to make their solutions fully interoperable.

We all need to recognize that our industry – and the healthcare providers we serve – is at an inflection point. We’ve succeeded in delivering solutions that help hundreds of thousands of providers deliver safer, more effective and more efficient care. But we’ve also helped to perpetuate the information silos that keep our healthcare system from achieving true connectivity and true health.

To paraphrase Winston Churchill, this is ‘the end of the beginning.’ And now the real fun begins …

We can learn from cell phones and computers, two other technology revolutions that changed our lives, and understand that the basic software and technology are a start, but they are just the first step. The real magic comes when you connect – just as cell phones of different manufacturers and carriers are connected. It seems basic, but it’s exactly what we need to do for healthcare. Not at some point in the future, but right now.

When our industry decides to make interoperability a priority, then we can begin to claim that we are truly delivering on the promise of healthcare information technology. With our solutions connected not only across all care settings but across all vendor platforms, we will deliver higher quality, lower cost patient care through an interoperable system that enables all providers everywhere to Connect to Health. The health of patients, of providers and of healthcare is on the line. The beginning has ended and we all now have a responsibility to deliver.

That’s our goal and that’s why Allscripts and Misys came together. Personally, I can’t imagine a better outcome.

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Currently there are "16 comments" on this Article:

  1. Glen Tullman is a very cool customer and elegant speaker. Allscripts is tremendous at selling vision. The problem is that in many cases, the vision was a hallucination. Certainly the industry does need to make major steps for interoperability. I’d be curious to see where the Allscripts User Interface is that was promoted 3 years ago to address connectivity. Touchworks version 11 was put to market way before it had any right to be there. Now, merge Allscripts wth Misys who has their own skeletons in the closet. I wonder how many Misys EMR users are looking forward to changing clinical systems. It might not be right now, but you can darn well bet it will be soon coming. In conclusion, I just hope Glen can deliver because as he says it, Allscripts has a responsibility to deliver.

  2. It is great to hear someone talk about changing the industry. The problem is when the person yelling the loudest from the mountain top, Glen Tullman, can’t even integrate his own products. Ask a customer if they want to change from TouchWorks to HealthMatics, can my data be converted…. NO. If you can’t have interoperabilty with your own products you can’t be a true leader. So in calling out other HIT executives Mr Tullman should look hard at his own company who hasn’t built a software application in ever. They have bought and put together different source codes to come up with their own silos that can’t connect to each other. It will be interesting to see what happens when the flood gates open and the Allsripts sales folks leave for greener pastures.

  3. Mr. Tullman,
    I must say that your comments are interesting, but really just sounded like a great infomercial for Allscripts/Misys. You make some very valid points, of course, but as one who has worked for 2 major national vendors (including Misys) and collaborated with many others in vendor neutral roles, I’m surprised that you don’t say much about the one thing I’ve observed that impacts interoperability….the COST of an interface.

    “the core problem is that healthcare is not connected – functionally, financially or technically. That can’t continue and we collectively have the tools to ensure it doesn’t. ”
    Quite right, but as you know well, physicians can barely afford the EMR software, let alone the high cost of interfaces to connect disparate systems. I’ve always wondered…….what does it REALLY cost to do this?
    Misys would often refuse to interface with a competitor saying “we have our own EMR”. I have seen other vendors do the same.

    “What do I mean by “software silos?” Simply stated, vendors today often provide stand-alone applications. They are not connected to other systems or to information that is vital to our end users – the equivalent of a computer that’s not connected to the Internet.”

    I remain unconvinced that vendors REALLY want to connect with each other. They still want a bigger share of the pie. And until they all realize that some is better than none and curtail their corporate greediness, we probably won’t advance the penetration of EMRs in this country very quickly. Sigh.
    I would challenge ALL vendors to consider “yes, if” and I suspect we’ll see IT happen more quickly.

  4. Didn’t we hear “inflection point” about 5 years ago from another Misys CEO? Didn’t we also hear interoperability about 5 years ago from another Misys CEO?
    It is deflating to see yet another merger of HIT companies with absolute focus on bottom line results and shareholders vs. client satisfaction.
    Strong marks to Allscripts/Misys Healthcare..er. Allscripts/Misys er.. Allscripts for attempting to brand themselves away from Misys altogether. I’m sorry to see so many talented people lose jobs and amazed once again how you can move the shells around to avoid close inspection of performance post take -over (Mike Lawrie should run for political office)

  5. The irony of the two companies with the least integrated products (in the ambulatory space) somehow now the champion of interoperability among all HIT vendors. They have a hard enough time when all the code is under their own umbrella much less all the disparate systems out there. Wow, just wow.

  6. From today’s News & Observer

    Allscripts-Misys hopes to sell Allscripts medical-records software to some 90,000 physicians who are customers of Misys.

    “Our sales people think every one of those 90,000 physicians is a great prospect,” Tullman said. “Everyone will be watching how well we’ll execute.”

    Wow. A “great prospect”? Dude, they paid all of our bills that generated the profits that funded OUR ACQUISITION of Allscripts. Great prospects? How about a little respect for YOUR/OUR customers. In addition to the lack of respect, you just turned the entire market loose on 90,000 (really more like 70,000) of our physicians.

    If you thought we had problems retaining customers and staff before, how does it look going forward? We haven’t seen quotes this goofy since Dominic Cadbury and Mike Lawrie gave negative product reviews during analyst briefings.

  7. Allscripts and Misys are at the beginning of a great opportunity. Glen Tullman never said that either company had a solution ready to go or that they were so very far ahead of the world in interoperability. What he says, and what is clearly the case, is that we MUST get started on this road. We have all heard the sermon of the “Road to Interoperability” and like any sermon, it can get old. His words should be seen as encouragement to the other vendors. Let them take this as a challenge, as a bar to strive for. In my own practice, I see every day how our EMR (HealthMatics), which we bought from Glaxo Pharmaceuticals in 1998, serves our patients so well as long as they are in our space.

    We should all remember that this is not a problem that belongs to the vendors. Our inability to connect one system to another is due to many varied issues. These belong to the vendors, the tech world, and the users as well. Doing this will require cooperation among all stakeholders and it involves three of the toughest hurdles in this entire process: time, money and change. And the importance of these may be in the reverse of that order. No one company can do this alone, that’s why it is called “inter”operability.

    Until more people at a very high level stand up and say it is important and that they are willing to take the lead, our patients will not witness any real benefit from all this IT.

    The standards are getting there, the technology is there already and has been. Some hospitals are afraid to share data because they may then have to share patients. Labs and doctors may feel the same.

    What Glen Tullman has done is to lay it out there, to express what everyone knows and what few have been willing to say (and even fewer with their real names attached to it). I have been a loud proponent of HIT for years and I have heard many people in the industry talk about interoperability. It’s awfully good to hear it from the CEO of one of the now largest companies in the field.

    Do you know Glen? Well, I do and I can promise you that if he says he is going to work on interoperability, then ALL of Allscripts/Misys will be doing that very thing.

    Can you say that for your vendor? Or are you still using paper?

  8. 1) To “Local Guy” (clearly Misys)… uhhhh… it wasn’t Misys profits that funded the controlling stakes in Allscripts. Going out and having to find new funding when Lehman Bros failed ring a bell? Misys BORROWED to fund the acquistion.

    2) Though “Local Guy’s” recollection of Cadbury and Lawrie spitting on the MHC products to the street is accurate and a hilarious, jaw-dropping memory. If I hadn’t heard it with my own ears, I’d not have believed it.

    3) Notice the Allscripts web site? Tough to find the name “Allscripts-Misys” anywhere. Accept it folks, Misys in Healthcare is good as GONE.

    4) The headloss count in Raleigh is proportedly 44. Wise it up, Six Forks Peeps, you have to keep each RIF “event” under 50 in order to avoid the “WARN Act” (look it up). More is a comin’.

    5) Hopefully, a slew of the 44 was Managers. If so, GT might see some success. Many of them reported to me, and they were a group of completely unqualified hens who only wanted to protect themselves and their flock of chickadees, had no accountability to poor product, poor process, poor customer satisfaction, and too in-love with the past to be able to make real change for the good of the business or for HIT.

    6) If GT got Misys plc out of his Software Development business, he’s got a shot. If Software Development is still being run with the “Global Entity”, LOL folks… LOL.

    7) In Summary, I think GT’s article is a joke. I think those who have posted that vendors don’t really want interoperability, only larger slices of the pie, are absolutely correct. What needs to happen to HIT is essentially the same thing that happened in accounting which created what all public (American, at least) companies are ruled by today, GAAP, those principles driving accounting practices. Until a few (and I mean just A FEW, FOUR TOPS) of the big-boys in HIT get together and set the standards, just like what happened with accounting principles, there will never be interoperability. And trust me… Misys wasn’t one of those big few, Allscripts wasn’t one of those big few, and the combination of Misys and Allscripts ISN’T one of those big few.

  9. Mr Tullman’s “call to action” is a moment that many of us on the provider side have been waiting for. The reaction to it, while predictable, stands in the way of electronic health records moving from where they are today to being the nidus for a new era of quality, safety and coordination in health care.

    As a leader of a four hundred member physician group, and as a client of Allscripts, we have seen the potential that exists by “jumping into the pool” of paperless records and e-prescribing. It has defined our ambulatory strategy and set a bar for care throughout the community. The untapped potential, however, will remain untapped until we can “communicate” with our hospital partners and other affiliates, all of whom have different and non-coordinated systems.

    In fact, in a recent survey that we performed for a HIMMs discussion that I was leading, we asked 200 physician groups who “did not plan on making the leap into electronic health records in the next three years” what the drivers were that would get them to make that leap. Interoperability and compatibility with the hospital and their colleagues was cited in 83% of the answers. The endusers have recognized the necessity to use the power of the EMR to coordinate their office practice with the hospital, their practice with their colleagues and utilize the technology as a tool to bridge the disparate pieces of information that affect patient quality and safety.

    So, I applaud Glen’s call to arms. It is good business and great medicine. Rather than dwelling on the past mistakes of industry and physicians in implementing a functional EMR across all providers for the benefit of our patients and our practices, we should start thinking about a bold future where we as providers and the software companies that serve us work together to realize the awesome potential that the technology could unleash. Glen apparently sees that future and as CEO of a company that can do something about it, I applaud him.

  10. I find most of the comments in response to Mr. Tullman’s blog extremely disheartening. Being the CIO of one of the most prestigious healthcare providers I have looked long and hard at all other solutions out there and believe it or not, Touchworks V11 (EHR Enterprise) may not be perfect but it has done what the others have failed to do.

    Mr. Tullman, Kudos to you for this great merger. Now Allscripts and Mysis can put their heads together, share the lessons they have learned and create an environment that can manage the ever-increasing demand of interoperability. Healthcare Information Technology is integral to improving the quality of care and with the two giants in the field getting together we have big hope from you not only for more interoperable application but also for bringing down the cost and making it more affordable for the common practitioner to be a part of the globalization of HIT.

    It is easy to sit on the side line and criticize, but let’s not do that, instead let us unite and encourage and help Mr. Tullman deliver his promise to us.

  11. As a user of Allscripts Enterprise EHR in 4 physician ortho group (ASP Model), I’ve seen what v11 can do, and I agree entirely with Praveen. It’s a product that has caught up with Glen’s vision. No EHR is perfect, and Enterprise EHR is no exception, but even in a small practice, it has not only proven to be effective, but a decision I would make 100 times over.

    As far as Glen’s comments on interoperability, we may look back in 5 years and say “Glen Tullman led the charge for HIT interoperability”.

  12. Glen is a visionary and so are the deal makers on the Misys side. This new company has the best of both worlds – the innovative solutioning strategy of Allscripts and the R&D capacity of Misys – together they are going to make a really big impact. Allscripts-Misys will emerge as the bloomberg of healthcare. This merger is the best thing that could have happened to the US healthcare IT industry.

  13. Regarding R&D capacity at Misys, not real familiar with any innovations they have come up with, but then I may be wrong. Please enlighten me.

  14. I see the Allscripts defenders are out in force. Is there any Touchworks v11 customer that uses all of the modules across the whole enterprise? Praveen – would you care to share what percentage of your physicians are using v11 and charting with it? And zero sum – Misys’ R&D capacity – are you serious. I applaud GT for stepping up and speaking about interoperability. Now, the company needs to execute the vision.

    I also find the term silos very interesting – especially since there are 15-20 different silos underneath the Allscripts/Misys umbrella.

  15. After using, supporting both systems (Touchworks and Misys) I can only hope that this merger will finally bury the misys emr system. Misys is not very user friendly. The template building is extremely cumbersome to say the least. The entire application is not geared towards the work flow of the physician. This in it’s self makes many Doc’s reluctant to use the product. Click out of this to get to this.

    Although, touchworks V11 has it’s glitches, it certainly offers a much better user friendly environment.

    Fingers crossed!

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