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Health Care: VA to team with DoD for Open Source VistA EHR Software Development

By Dick Weisinger

The Veterans Administration and the Department of Defense are teaming up to build a common Electronic Health Record (EHR) system.  The new system is to be based on the VA’s Open Source software known as VistA (Veterans Health Information Systems and Technology Architecture).  An Open Source version of the VA’s VistA project, known as OpenVistA, has been available for download for some time of SourceForge.

Work on VistA actually dates back as far as 1968, but it wasn’t until 2003 that parts of the code was made available as Open Source.  The current version of VistA was designed to handle both inpatient and outpatient information.  Features of VistA include a patient information systems, scheduling, A/D/T/Registration, HL7 interface infrastructure, clinical documentation, vitals, medication management, order management, computerized physician order entry, chart reporting, pharmacy, barcode medication administration, laboratory, radiology, and nutrition.

But over the last few years the code base for VistA has not changed significantly.  The VA felt that a new initiative was needed to spur further development and new innovations.  As a result, the VA devised a new plan that made Open Source the central focus of the system.  The new plan brings together both the VA and Department of Defense to work together on a common EHR system, and it brings in the Open Source community to assist and share in the development of the software.  As part of the reasoning for why the VA choose to go this route, the report cites “opportunities to Reduce Potential Duplication in Government Programs”.  With both VA and DoD working on a common system the VA will be able to  “save system development and operation costs while supporting higher quality healthcare for service members and veterans.”

Veterans Administration CIO Roger Baker siad that “No matter what happens on a joint system with the DoD, we have to increase the pace of modernizing VistA–and that’s why we’re exploring the open source avenue to see if that would be useful to us…  I can assure you, it will be very close cooperation between DoD and VA, whatever the right technical solution recommended is.”

To date, the VA’s investment in VistA has been a sound one.  A report by Center for Information Technology Leadership published in April 2010 found that through investments in Health Care IT, with VistA being the centerpiece, the VA has saved $3.09 billion over a ten year period.  The report found that “while the VA historically has spent a higher proportion of its budget on health IT, it has achieved a very high level of HIT adoption when compared to industry norms, the VHA greatly exceeds industry norms in outpatient electronic health record (EHR) adoption and in selected outpatient quality measures that are reflective of the use of automated clinical reminders. The VA’s quality measures for diabetes care averaged around 16 percentile points higher than private sector benchmarks based on the Medicare population.”

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