Eric Fishman, MD speaks with CEO, Glen Tullman, of Allscripts, about Allscripts terminology/phrases, his thoughts on the Stimulus as well as the future of the company. Allscripts is extremely well positioned in the industry to take advantage of new technology (i.e. iPad) and is excited to see what will happen in the HIT industry within the next three years.
Dr. Eric Fishman: This is Dr. Eric Fishman for EHRtv and once again, we have the pleasure of speaking with Glen Tullman, Chief Executive Officer of Allscripts. We're here at HIMSS10 in Atlanta, Georgia. Glen, thank you once again for taking your time.
Glen Tullman: Good morning.
Dr. Eric Fishman: A lot has happened in this industry since we've spoken most recently. Tell us what is most interesting at HIMSS today.
Glen Tullman: Well, this is a very exciting show. You know, we're at the beginning of the fastest transformation of an industry in the history of the United States and you're feeling that at the HIMSS show today. We talked about this as the year of the electronic health record and really, what we're seeing is a dramatic level or interest from physicians, from organizations and from the entire industry and we're feeling that today. We see the traffic at the booth, not right now because it's closed, but generally, we're feeling that energy behind health care transformation.
Dr. Eric Fishman: I've passed by this booth a couple of times in the last couple days. It's hard to get into it sometimes.
Glen Tullman: Well, that's a good thing. That's a good thing.
Dr. Eric Fishman: I understand that. Now, you have a couple new phrases or maybe one comes from ACE, Connect to Health. If I could ask you the difference between connect to health and connect to health care. I understand that those are different concepts.
Glen Tullman: Sure, well, what we're really talking about when we say connect to health is the President's vision that he set out was a vision of a connected system of health. What that really meant is we were going to connect all these physicians, all the caregivers, all the different providers that make up health care. And the idea was when you connect them and when you provide our physicians, what we think of as the best physicians in the world, with the right information that instead of doing health care which is after the fact, you can actually start to preventably manage health and take care of people. So we have a system of health that occasionally responds to health care needs as opposed to a system that is totally responsive. It's the difference between being responsive and pro-active. And what we all hope for is a system that's much more pro-active.
Dr. Eric Fishman: And that's the connect to health?
Glen Tullman: That's right.
Dr. Eric Fishman: And it's wonderful. Most recently, just the last couple days, you've come up with a pithy statement, "Go". Maybe you could explain that a little bit.
Glen Tullman: Well, I've been working in health care for more than 10 years and we've been getting ready and ready and ready for this transformation and more recently, we saw the table being set and it was set by incentives, it was set my meaningful use standards, and so it's kind of ready, set, now's the time to go. And again I talk about that energy. We see it happening, we see great clients making the decision with and without the federal incentives to drive forward, to automate health care. When we talk about automating health care and getting physicians electronic health records that's really the first step in health care automation because what we're doing is we're equipping them with the tools to deliver the information they need to deliver better care. It's kind of that old phrase, information at your fingertips. That's what we're delivering because we think if we give our physicians, the best physicians in the world, the right information at the right time, and that is when they're patient facing, then what you're going to see is not only higher quality but lower costs. They're going to not do extra tests, they're going to prevent medication errors, so safer health care and generally, deliver better care.
Dr. Eric Fishman: In order, Glen to have that immediate availability, information is being put into the cloud. I've been hearing about cloud computing all day long. Tell us where Allscripts fits into that. I would guess that you (inaudible).
Glen Tullman: Well, if you look at Allscripts as a company, you know we have about a third of our revenues that are tied to software as a service and that's kind of information in a cloud. But we need to be a little careful. What we're really focused on is delivering physicians what they want when they need it. So sometimes that's an iphone, and they want their information right on an iphone or a Blackberry or a Windows mobile device. They may want it on the new Apple Tablet and we're going to have it on there. Others want it in a client server environment and some want it from the cloud which makes it accessible anywhere. So the technology is less important. People are making way too much of the technology. When you're using your cell phone, you're not concerned what kind of switching network AT & T or Verizon has, all you want to do is when you turn it on it works. What physicians want is easy to install, intuitive to use, make it work. In fact, in a lot of cases, when physicians talk about software as a service, what they really mean is monthly billing.
Dr. Eric Fishman: Right. That can be done, financing of a client but that's a very, very different concept.
Glen Tullman: Exactly. So what I can assure is that Allscripts is going to have what physicians want when they need it and the technology will handle that. But we are big in software as a service, we're big in hosted applications, we're big in client server and of course we have the best partners in the world, Microsoft and Intel and Cisco and the like all helping to deliver these services and of course Del Pereau.
Dr. Eric Fishman: All great companies. The last number I'd heard you talking about big was 160,000 physicians using your products.
Glen Tullman: That's currently where we are, but it's not just 160,000 physicians. It's 160, 000 physicians, it's 800 hospitals, it's 8,000 extended care facilities, and that translates into almost 100 million electronic prescriptions written and 500 million revenue cycle management payment transactions. So again, our reach is expanding and that's that idea of connected health care, right? Connecting all the parts of healthcare together, because if you look at a recent agreement we had with North Shore Long Island Jewish, not only did they say, we're going to automate 1,200 of our employee physicians, they said, we're going to also connect 7,000 of our affiliated physicians. We're going to tie them into the emergency departments at 13 hospitals, we're going to tie that into the largest home care network on Long Island and in New York and when you put that all together, it makes for connected health care which is better for patients. And that's what we're all after.
Dr. Eric Fishman: Now, you brought up Apple, they've got the Ipad. Tell me, if you will what type of traction that's going to have. Do you expect your physicians to be using it in the near future?
Glen Tullman: Well, again if you look at our physician base, we came out first with the iphone, and what we found out was about a third of our physicians were really excited about it and two thirds said, we use Blackberry, we use Windows mobile. So we developed our applications on Windows mobile and Blackberry.
Dr. Eric Fishman: And have those been released now?
Glen Tullman: Yes, they have and then along comes Droid and some say I have Droid. Now a smaller penetration but they want that. There are a sub segment of the population that's going to use the IPAD. We're going to accommodate them. We're absolutely going to be available on it and the IPAD development is actually easier because if you've already done it on the IPhone, by and large you have the core of that application to now begin development on the broader functionality that's available there.
Dr. Eric Fishman: Glen, you're obviously very close to Washington. I have a couple of questions on that. First, we'll start with stimulus funding. You mentioned meaningful use and I'm sure you have a very big footprint in that arena. Tell us about your relationship there.
Glen Tullman: Well, from that perspective, we're watching very closely what's happening with the final piece of meaningful use and how it's being defined. We've obviously submitted public comments and we're hopeful that those are taken account of because generally, we think this legislation is very healthy for health care IT. The good news is it's locked in, the funding is there so it's not a part of the general reform debate going on now.
Dr. Eric Fishman: We'll talk about that in a moment.
Glen Tullman: But the good news is that's not touched. So now we're just talking about how we define it. We're very focused on making sure smaller physician groups are taken care of, we'd like to see pediatricians included, they've been excluded. We'd like to make sure that physicians who are employed by hospitals get the right kind of coverage and reporting and frankly we'd like to see more automation. We’d like to see the legislation push for more interoperability. Force vendors to connect with each other because again, what we should have is a system where you throw information to another system and you catch and it looks like your own information. So we're actually pushing the envelope to say, force the industry to do more because if you're investing $40 billion we want to make sure the tax payers get value for the money they're investing.
Dr. Eric Fishman: I was speaking to Chuck Jaffee the other day from HL7. He indicated that many European countries are far ahead in that. So it doesn't seem like a technological hurdle, it just has to get accomplished.
Glen Tullman: It really does. I mean, this is not a technology question. This is a question of leadership in health care. And what we see is, we see the future of health care at a lot of our top leading customers. They're making it happen today. You know, Bill Spooner who last night was honored as the Chime HIM CIO of the year is a great example of leadership. He was honored for that. He's one of our leading electronic health record providers at Sharp in San Diego and their patients get better health care because of that technology but it took leadership to make that happen.
Dr. Eric Fishman: Now, let's talk about the other things that are going on Washington and healthcare if you can give an opinion on that.
Glen Tullman: Well, look, it's a very challenging situation right now. Health care reform is really not about quality, unfortunately, and it's not about cost. This is about payment and about coverage. And I think we've seen a lot of jousting back and forth. Today, the President is releasing a letter to Congress that tries to bridge some kind of compromise that talks about a public option being eliminated. That was a big lightening rod for Republicans, talks about more incorporation of health care IT, more incorporation of auditing capability, so I think it's a bridge proposal that I hope will allow us to move forward without reconciliation. You know, that said, reconciliation has been used a number to times by both parties and we'll see what happens, but we're hopeful that we can reach some kind of compromise and move forward. Now, the fact of the matter is 90 percent of the American public agrees with, number one, the fact that we should have no pre-existing condition. Whether you're a Republican or a Democrat, people agree with that. And secondarily, people seem to agree with broad coverage for all Americans. I mean, in America, everyone should get basic health care. That's a general agreement whether you're a Republican or Democrat.
Dr. Eric Fishman: Just to accomplish it.
Glen Tullman: Question then becomes how do you deliver it, how do you pay for it, and again, some very sticky items that relate to competition, public option and the like. So I'm hopeful that we'll see some progress today but hopeful would be the best description I could --
Dr. Eric Fishman: We'll all be watching. And finally, let's just talk about the next year in health IT and with Allscripts in particular. What do you see, what do you envision?
Glen Tullman: Well, we're very excited about the year ahead. I mean, we think the entire industry is going to grow dramatically. We've talked about the fact that you're taken $40 billion injecting it in a $4 billion industry and 70 percent of that comes within three years. So when you look at that and you start to do the math, it means that everyone in the industry is going to benefit. Not just the electronic health record providers, the connectivity providers. We already see dramatic increases in employment in the industry and you've talked about that I know, but the reality is this is a place where the stimulus is working. Better health care, we're going to have more automated health care, we're creating employment, long-term investment. So from that perspective, we think the future is bright for Allscripts and now is the time to go.
Dr. Eric Fishman: I've heard that expression. Glen, always a pleasure.
Glen Tullman: Great, thanks very much
Dr. Eric Fishman: This is Dr. Eric Fishman. We’ve been speaking with Glen Tullman. Chief Executive Officer of Allscripts. Thank you.