"Concerned, but not panicking," is how Allscripts’ biggest customer describes his reaction to the EHR vendor’s switch at the top -- one that has CEO Glen Tullman stepping down, and former Cerner executive Paul Black, a new member of the Allscripts board of directors, now steering the ship. Allscripts customers give both men kudos for leadership, but say the turnaround has to be decisive -- and quick.

When Allscripts released the announcement at the close of the business day on Dec. 19, it came as the most recent in a long string of disturbances over the past year. There was the ousting of board chairman Phil Pead and the resignation of three other board members in protest. The CFO had already turned in his resignation. Product integration issues continued to dog the company, and the stock price was plummeting.

[See also: Tullman out at Allscripts, Black in.]

“I think that all the Allscripts customers are very concerned,” said John Bosco, CIO at North Shore Long Island Jewish Health System. “This has been a year with disappointing financial results, a turnover of people earlier in the year, with Phil Pead leaving and the CFO and the others at the time. That was very tumultuous – and now this kind of a change. None of those things are things that you want to see happen to a company, especially if you’ve invested a lot in their products – and we have.”

[See also: Allscripts in skid mode as shares plunge, chairman ousted.]

North Shore-LIJ has invested $400 million in its EHR initiative to connect 15 hospitals, 2,500 employed physicians and 8,000 affiliated physicians. It is touted as the largest program in the New York metro area, and one of the largest in the nation.

“So, we are concerned,” Bosco says. “We’re not panicking. We’re not pulling away and thinking of going to other vendors. But, we’ll want to hear from Paul Black how he’s going to turn the company around. It’s going to be very important I think that he shows people very quickly that he understands what the things are that need to be done to make them successful again and that he’s taking the right steps to get that done.”

Black recognizes clients are worried. "I don't think right now that all of our clients are happy,” he said on a Dec. 20 conference call. “We've got a lot of work to do in that space."

"There will be no substitute for results," he said. "We need to move quickly."

At Sharp Healthcare in San Diego, CIO William Spooner (pcitured at right) employs both Cerner and Allscripts technology – Cerner on the hospital side and Allscripts for physician practices. He calls the recent Allscripts announcement “a bittersweet moment.”

“One fine leader has been replaced by another,” he says, and I regard both as friends.

Spooner calls Tullman “one of the most visionary HIT leaders in the business.

“He led Allscripts through an incredible growth period,” he says. “I admire his vision of connected systems and his work towards that goal. Unfortunately the execution has proven more difficult than Glen expected.”