VA to update VistA EHR
Joseph Conn
The Veterans Affairs Department is moving forward with a massive open-source software development program to update its venerable VistA electronic health-records system.
The announcement comes after more than a year of deliberation at the VA over a way forward for VistA, which traces its development roots to 1977. "We can do better for the VA and for the country by democratizing VistA," said Roger Baker, assistant secretary for information technology at the VA.
Baker delivered the news last week to members of WorldVistA, a not-for-profit organization promoting the use of an open-source version of VistA outside of the VA. The group met last week at George Mason University in Fairfax, Va.
The decision to move ahead with open source came only after an "extremely deliberative process" dating to a June 2009 meeting with Dr. Rob Kolodner, former head of the National Coordinator for Health Information Technology at HHS and a VA health IT pioneer, and Dr. Peter Levin, chief technology officer at the VA, and others.
One goal of the open platform is to accelerate improvements to the EHR to keep pace with change in healthcare, Baker said. Another is to get full value from spending on an EHR that's central to healthcare operations at the VA.
The VA solicited bids this year for what's described as a "custodial agent" to oversee future open-source development of the VA's EHR system. The deadline for bid submissions was May 20, and the VA aims to select an agent by summer. It is withholding the names of organizations applying for the job.
Meanwhile, the VA and the Defense Department are committed to having a unified EHR running in their separate healthcare systems, although details of that arrangement are incomplete. For now, Baker said, the VA will retain majority control of the board of the open-source custodial agent, but the Defense Department will have a board seat. To develop the joint IT system, he said, "We've got four to six years of an awful lot of work ahead of us."
Edward Meagher, a senior executive adviser to Computer Sciences Corp., said during a panel discussion at the WorldVista meeting that Baker "has $3 billion to fund this." Meagher led an IT industry consortium last year that recommended the VA use an open-source model to overhaul VistA for about $5 billion to $7 billion.
Dr. Nancy Anthracite, president of WorldVistA, said she was cautiously optimistic about what she heard. WorldVistA is not vying to be the VistA custodial agent and did not formally comment on the VA's request for proposals. Anthracite said, however, that what was in the request "was not great," but that the project remains malleable. "I think we're going to have to work hard to make it work," she said.