It's been a big year for Allscripts. And not just because of the $185 million acquisition of McKesson Enterprise Information Solutions that closed in October. 

On the interoperability front, the company hit a milestone this year too: a whopping one billion API data exchange transactions in 2017, touted as the most-ever in a calendar year. 

[Also: Allscripts CEO Paul Black talks AI, machine learning and precision medicine]

Now, with much of the hard work of meaningful use in the rearview mirror, Allscripts CEO Paul Black says the time has come to have some fun with innovation. Healthcare IT News spoke with Black about that data exchange milestone, his to-do list for the year ahead and how the company plans to continue serving its clients, new and old, having grown into one of the largest health IT companies in the world.

Q. You've got a much larger footprint across the U.S. now. What are some of the things you hope to accomplish following the McKesson deal, strategically, in the near future? 

A. It is early yet, we just closed on October 2, but the response thus far has been very positive. We'll end 2017, going into 2018, with Cerner and Epic, having created a real separation of the pack. There will be three large organizations, if you will, at the top of the heap. And then you go from $2 billion plus, down to about a billion with our friends at athenahealth, and then the rest of the group, at $500 or $600 million and below, there's a group of eight or nine of those in the EMR business.

So there's a clear separation that's gone on and we find ourselves in the position we've been coveting for a long time. And we’ve done it both organically and now a bit inorganically. We've done it through investments in R&D, and we've done it through investments in assets we think give us the scale and impact we're trying to create in the marketplace.

It gives us marketshare in the inpatient space and we're very proud of that. And it also gives us a low-end solution in Paragon that will create a clear distinction in our marketspace, just as others have done, by taking the solution they have and minimizing its functionality in some cases and in other cases by creating a service orientation to the offering, to create a distinct offering for community hospitals – and there's still a lot of opportunity there.

And then lastly the cross-sell opportunities that we have by taking our population health solutions into that McKesson space. As well as some of the solutions that McKesson has that will go into the Sunrise space – around OneContent, lab and some of the other solutions that they have. So, we're all in. We're pleased. So far, so good. There's a lot of very positive momentum coming out of that.

Q. As you cast a wider net, what are the biggest imperatives you're trying to help hospitals and other clients solve?

A. We made a pivot to play more offense than defence the first couple years I was here. We had to tank the P&L to make some investments in R&D to make sure we took care of some of our client obligations on the meaningful use side, and just doing what we had to do there. We were very proud of our ONC certification, very proud of getting our clients to attest for those important milestones.

But amid that, we also got back to our entrepreneurial roots inside the company where we have, in some cases, a couple in-house startups where we actually have the CEO of this and the CEO of that and a separate and distinct organization that is built around an entrepreneurial idea. We continue to innovate on top of the platforms we have and continue to spend money on the R&D side.

On a go-forward basis, the thing I said in 2012 is still true: Being a really great EMR company isn't going to be enough. You have to have – and we have continued to evolve – a population health platform, a post-acute care platform, a consumer platform and, what we've been working on for the past 24 months, a precision medicine platform. 

In the marketplace, those are all resonating quite well, and I think that vision of not only being important transaction machine, if you will, at the EMR level, and all the attendant accountability and obligations you have as a result of being the system that people use and interact with every day, that's not enough.

Q. You mentioned meaningful use, and while it continues to be a going concern, it's not quite hovering over everything to the extent it was five or so years ago. Now it seems like there's space is to really start innovating to tackle an array of real-world challenges –  for lack of a better term, to have some fun. Does it feel that way to you?

A. I think that's a great word. I've not heard it described as fun, but I think it is, seriously. Because for the first time in the history of the universe, this platform is all digital. There's been yeoman's work to do it; we can just dust our shoulders off and say, ‘That was hard.’ But now it is time to have fun. To understand all the data coming out of these systems that for the first time are automated. To make sense of it – operationally, clinically, quality wise – and to do things that you would not historically be able to do because you lacked information.

How do you repurpose networks for quality? How do you repurpose relationships for financial synergies, how do you connect with consumers and enable them self-schedule and do a bunch of the work that the airlines have been doing for a long period of time, in order to create a more efficient and effective exchange not only of clinical information but of access to healthcare in the appropriate venue with a consumer who's going to be demanding that?

We're training a whole generation of humans to consume things and interact with services differently. And healthcare is going – I think – to get turned upside down over the next five years because of the power that the consumer has at their fingertips and the demands they will make on an industry that is in some cases ready for it, and some of our clients have been thinking about it this way, but the organizations who get there soonest will have the most market share in the communities they serve. And I think that will be a lot of fun.

Q. For all the fun, however, there are still some pretty big challenges out there. Interoperability, for instance. How are we doing there, from your point of view, and how does Allscripts plan to move the needle on data exchange in 2018?

A. We just passed the billion mark for data shares for the first time in a single year. We've been monitoring how many API calls have been made at that level inside our ecosystem, and thus far this year we've had a billion. We don't know of anyone else in the industry who has hit that level of interoperability, or has created an ecosystem that allows that number of shares to occur.

We think that's a really big deal. The number of registered developers is now 6,600. There have been 1,580 client activations by third-party API solutions – that's a lot. We're at 111 million API data shares just in the month of October, and 2.95 billion data shares since 2013 when we first started counting it.

We've been talking about open connected communities of health, open systems, for 10 years. And I think it's very important to say we've had a billion transactions: Real information is being exchanged and people are getting value out of it, otherwise they wouldn't be doing it.

Part two of our Q&A with Paul Black can be found here.