This Race May Just be Getting Started

Aug. 9, 2013
One of the most exciting moments in sports is in horse racing, when a horse makes a fantastic surge towards the end providing a photo finish. In a crowded EHR vendor market, is one vendor making a turnaround that could provide similar intrigue?

Those who know me, know how much I love the sport of football. What many people don't know is that another one of my favorite sports to watch is horse racing. The gallantry, the excitement, the underdogs, the's a 19th century sport that has made a smooth transition into the 21st century.

Personally, I think horse racing will be in our lives for years to come. It has a basic premise that has the ability to capture anyone's interest.

My favorite moment of any horse race is when a horse that was sitting in fifth or sixth for much of the race suddenly starts to surge towards the front of the pack during the stretch run. The announcer usually bellows out with excitement, "Wait a minute, here comes...(the name of the horse)."

In many races, the surging horse and the pack leader usually tussle it out and provide a photo finish. There is nothing like it in sports. (And yes, I'm aware that in the Olympics, actual humans run. For some reason, I don't find this just as exciting.)

What does ANY of this have to do with healthcare informatics? Well, I may have just stumbled upon a surging horse in the crowded, intense race for electronic health record (EHR) and health IT supremacy.

For a long while, the pack leader has been Epic (Verona, Wisc.). This is no secret. Epic is Seattle Slew and Secretariat rolled into one. It's dominance is unmatched in EHR vendor market share. Will it ever face a challenge? That question may go unanswered for now, but as a horse racing fan I'd like to think there will be some excitement in this contest.

There are plenty of possibilities--McKesson, Siemens, Cerner, GE Healthcare, and Allscripts--to name a few. Wait (you likely just said), Allscripts? The same Allscripts that has dealt with turmoil and executive turnover in the last year? The same Allscripts that has struggled with integration, according to KLAS' Coray Tate? Yes, that Allscripts.

Covering this space, I try to get a look at the financial statements of the publicly funded EHR vendors. And I tend to look at one particular statistic in those earnings reports: bookings. That statistic tells me who is getting future business in this time of digitization. For the past year, Allscripts' numbers haven't looked so great in this spot. I've even highlighted this in a few news items.

However, it may have started to turn around. In the second quarter of 2013, Allscripts achieved its highest number of new bookings since 2011. The bookings number totaled $214.1 million last quarter, compared to $194.1 million in the second quarter of 2012 and $177.7 million in the first quarter of 2013. This is a jump of 10 and 20 percent respectively.

What's most exciting if you're Allscripts is where many of these bookings came from. According to Allscripts, one-third came from population health management solutions, which is comprised of internal products, dbMotion (a company which Allscripts acquired in 2013), its patient portal, and a few other offerings. The population health management side is sold outside of the core EHR client base. Putting that fact at the top of the press release announcing the earnings was no mistake by Allscripts. That area represents a wealth of opportunity for the company.

Still, before you think I'm doing side work for Allscripts, I'd like to clarify something. The company has a long way to go before it fulfills any of this potential. A long way. I'm guessing Paul Black, the CEO of Allscripts, would be the first to admit that.

Investors are still fairly negative on the company's financial outlook, and its shares are trading down because it missed estimates and its revenue decreased from a year ago. One analyst was quoted as saying he thinks the company is headed in the right direction, but the turnaround will be longer than he expected.

Even beyond those financial challenges is the reality that it's got a long ways to go to recapture, and then make gains, in market share. Not only has Allscripts lost customers to Epic, but Dallas-based Aprima recently announced it was pilfering dissatisfied former MyWay users. I won't even get into the interoperability challenges that lie ahead for Allscripts, even with dbMotion.

So yes, there is still a long way to go. A long way--I can't stress that enough. This much is clear. But remember, the most exciting moment of a horse race is just when you think it's decided, and then suddenly... "WAIT ONE MINUTE, HERE COMES..."

What are your thoughts? Feel free to leave comments below or respond to me on Twitter by following me at @HCI_GPerna

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