Allscripts, Chicago: rank: 21.

Could passion for a company's mission account for some of its success? Glenn Tullman thinks so. When asked what makes his firm run, the CEO of Chicago-based Allscripts says, "This business is more than a business to us. If you talk to our customers, if you talk to our people, they'll tell you that this is really about a mission to improve healthcare, and we take that mission seriously. We know we impact people's lives."

As proof, Tullman points out that, this year, the physician clinical support and connectivity software vendor was one of several vendors and national health plans to collaboratively launch the National ePrescribing Patient Safety Initiative (NEPSI), an initiative that hopes to provide free electronic prescribing for every physician in the United States.

So why would a vendor that benefits from physicians vavinz for its solutions help facilitate free access to e-prescribing? "We did that because of the Institute of Medicine's report on preventable medication errors," says Tullman. "I've been at Allscripts nine years. And I said, 'We've been at this nine years, and why can't we make this happen?' And we looked at core reasons, including cost, cost of software, the fact that it's hard to use, and found that there aren't enough incentives for physicians to do this kind of thing."

NEPSI's backbone will be eRx NOW, Web-based software from Allscripts powered by the same engine used today by more than 20,000 physicians to write millions of electronic prescriptions per year.

For a company like Allscripts, which went from $75 million in annual revenues in 2005 to $227.9 million last year, it makes both good public relations and good business sense to try to expand e-prescribing capability out to additional physicians (often those in solo or very small practices). And the company is doing very well financially, thank you. For example, in late October of last year, Allscripts announced that its revenues for third quarter 2006 were up 200 percent ($62.2 million versus $30.6 million). With results like those, a vendor can afford to be generous.

And, let's face it, Allscripts is mining a golden vein of revenues potential. While e-prescribing and use of clinical and administrative tools by physicians is universally acknowledged to be one of the keys to greater efficiency, patient satisfaction, and patient safety in the outpatient sector of healthcare, only about 35 percent of the lamest medical groups are using EMRs to date. The penetration of EMRs among multi-specialty group practices hovers at around 18 percent, and among those medical groups with fewer than 10 physicians (which represent the majority of this country's medical practices), EMR penetration remains at about 5 percent, Tullman points out.

Of course, the future is never certain. But Tullman says what is clear is that "IT' s more than just about software--it's about connecting the whole world, and bringing knowledge to the point of care. We've got to execute, and use these systems to transform care. If we can do that, not only will we have a very successful company, but we'll save and improve lives."