HIMSS16: Allscripts trying to stay 'ahead of the curve'

Visitors to the Allscripts booth at HIMSS16 will have a lot to take in. The EHR vendor will showcase its efforts to adapt to the changing healthcare landscape, addressing all the most buzzworthy topics.

“We’ve been a couple years ahead of the curve whether with EHRs or APIs, population health or precision medicine—these are investments we’ve been building on for years,” said Erik Kins, the company’s vice president of innovation, speaking to Clinical Innovation + Technology.

Allscripts’ Open platform began as a tool for academic medical centers and integrated delivery networks to link data from vital capture devices and EHRs without having to write an interface, Kins explained. The work first began around the same time as the iPhone launch, which “underscored the importance of having these APIs available. Mobile phones need APIs available to connect to so that really cemented the direction in which we were heading.”

The company started building out its Open business unit in 2012 with a separate cost center for building these relationships, Kins said. “We’re really happy the industry is in the place now where this is the norm, the expectation everyone has. More and more vendors are having similar programs in place.”

Allscripts realized early on that it’s not enough to have the technology, so they built a formal developer program. There is a whole team available to help third parties and even clients who have been working on new solutions, not just on the technical side but also on the business side devoted to “making sure a third-party company that wants to build an app that interfaces with an Allscripts product is technically successful but also successful in the market.”

The team in place can now offer that assistance quickly and with no upfront costs. When something is ready for the market, there are contracts in place for revenue sharing. The product can enter into Allscripts’ sales streams and existing client marketplace.

The formal program is needed, he said, “because...after years and years of doing this, you have to hit people on all those cylinders to teach them how to integrate their solutions into Allscripts.”

Technical assistance includes regular face-to-face developer summits or “geeks meeting up to solve a technical problem. We bring our developers, the same ones writing APIs, to help them navigate that. There is a lot you can do with this platform.”

The company has been publishing documentation online for its partners for at least 3 years and just hit its one billionth data share on Dec. 24. They are poised to do another billion this year. The Open platform is installed on 10,000 servers today.

Kins said he believes FHIR and other interoperability efforts as well as the consumerization of healthcare will be major topics at this year’s conference. While there are around a half-million clinical providers and a couple million support staff, there are hundreds of millions of consumers. “From a market perspective, that’s really big. The patient has never had a relationship with vendors. I can see that changing a little bit.”

Another big theme, he said, is driven by acquisitions occurring in the population heath space. “Every website has got a nice story about population health management, but we’ve been doing it for several years now.” Allscripts’ solutions sit above the EHR and can agnostically connect disparate systems to “glue together the whole patient story.”

On the privacy and security front, Allscripts has a security officer and team because it’s not if you will have a problem, it’s when. The real question is how to mitigate an incident as quickly as possible. “From our perspective, it’s always a balance between security and usability,” Kins said.

“We’re using the most modern security algorithms available.” Allscripts does “exhaustive penetration testing,” he said, and constantly looks at patterns to see if people asking for data are coming from rogue IP addresses or unexpected places. Kins said it’s a tough balance between preventing access from unauthorized people but making sure access is available when it’s needed.

When asked about the Office of the National Coordinator for Health IT’s information blocking report, Kins said the agency was looking for proof of the practice, but “no one who spent $300 million buying a solution wants to throw their vendor under the bus.”

No company can really say they’re open until other people say the company is open, he said. “Frankly, access to data is not the competitive advantage. It can’t be and shouldn’t be. We have several hundred companies working with us. More developers outside of Allscripts are writing to Allscripts than developers inside.” He asks them how other vendors are doing with this and they all say it’s very difficult to get anything in or out of an EHR system.  

That also raises questions about ownership of data. Kins said vendors are stewards of the data. “It’s not our data to block.

The true value is in the aggregated data, he said. “New” value “can’t be at the individual patient level.”