“Open architecture is almost a philosophy,” Tullman says. The company, he notes, is not so arrogant as to believe it will figure out every aspect of the integration puzzle, but will work with other major players to interoperate with their systems, he adds. If an organization has a great financial system and is buying a clinical system from Allscripts, “We don’t say ‘rip it out,’ we’ll work with it,” he adds. “Being open is a state of mind.”
At the same time, the company continues to work toward better integration among its own product portfolio. It has beta sites integrating the inpatient Sunrise Clinical and ambulatory Enterprise electronic health records systems, with Blessing Hospital in Quincy, Ill., having full information and discrete data exchange among the systems, Tullman says.
Allscripts is not moving toward open source systems, but uses some open source applications in its products, as do many other vendors, Meltzer says. Under open source, an organization releases a free public version of a proprietary application, including the source code, to facilitate expanded utilization and enhancement of the application.
Allscripts has an app store with 200 products from various vendors covering provider and consumer needs, such as diabetic management tools. And the company also offers a platform of well-defined application programming interfaces and software development kits to develop and test interfaces, and other applications that enhance functionality, according to Meltzer.
The company this fall will introduce new versions of existing apps that will provide full functionality of its inpatient and ambulatory electronic health records systems on an iPad. And it has full integration between its practice management software and the EHRs, Meltzer says. “Anything you want, you can see in the PM or EHR.”
Meltzer takes issue with the notion that true integration means having various systems working off a single database. Providers and payers want one view of data, but that doesn’t mean all the data has to sit in one spot. Bank ATMs, he notes, don’t have one database.
However, Allscripts and other major vendors are having difficulty competing for business, particularly from larger organizations, against powerhouse Epic Systems Corp., which has a single database architecture. Epic has done very well, Tullman acknowledges, but he notes that the software is very expensive, based on MUMPS and doesn’t link well with other systems, nor does Epic play well with other vendors.
Epic’s “go it alone” philosophy won’t be sustainable, Tullman contends. “I think it will become increasingly clear that it’s not the right system for health care. Our whole strategy has been on open, and open is common in every other industry.”