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WASHINGTON – Open source software is catching on and taking a bigger role in solving health system challenges and to accelerate innovation in the VistA electronic health record system at the Veterans Affairs Department.
VA just initiated a competition for developers and vendors to come up with tools for veterans to schedule medical appointments, and it is giving preference to an open source solution, according to VA CIO Roger Baker.
The benefit for VA in conducting a contest instead of using federal procurement is that the vendor takes the risk for the software’s performance and not the agency, he said at the Oct. 17 conference of the year-old Open Source Electronic Health Record Agent (OSEHRA), a non-profit organization formed to modernize VistA for open source and to contribute to the VA-Defense Department’s integrated electronic health record (iEHR).
Risk taking by the vendor is a huge change, and it’s critical because VA previously acquired a medical scheduling package through the traditional route and, Baker said, “we lost $127 million.”
“This proves that we can do government acquisition differently with open source. What we will know is that there are multiple scheduling packages that meet our requirements that already work with the product. We will be highly confident that we can run a competition where we buy straight off the shelf. It works. It runs. We can go do it. We’re not risking $127 million here. We will know what we are getting,” Baker told Government Health IT in comments after his presentation.
From the vendor’s point of view, they’re going to do a calculation that they want to win the scheduling software competition: “We know the VA is big, and DOD might be right behind them,” Baker said. “The dollars in the prize will not be inconsequential. They will be substantial enough to get people interested.”
The scheduling tools will be standards-based, modular, extensible and scalable, and certified to work with the production version of VistA in OSEHRA.
As the custodial agent for the open source community, OSEHRA certifies software code for integration into the VistA code base and interoperability of complimentary software. OSEHRA, however, may also approve code for applications that might not become part of VistA but may still be useful for other programs.
Todd Park, the White House chief technology officer, spoke briefly at the conference and said that, like the ecosystem of apps growing around the Blue Button feature, developed originally at VA, so patients can access their health information in a simple format, “OSEHRA is catalyzing another ecosystem for open source software and health IT innovation that no closed system could do," Park said. "This is unbelievably cool."
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VA hopes to build a common platform with OSEHRA and its production version of VistA called the Gold Disc VistA, said Michael O’Neil, senior advisor for the VA Innovation Initiative (VAi2). Many versions of VistA are operating, even customized and variously configured versions at individual VA facilities.
With OSEHRA, the aim is to standardize certain functions on VistA, converge some of the major versions of VistA that are used commercially, and develop applications rapidly. “OSEHRA enables VA to be quick and nimble,” O’Neil said.
Among the most recent contributions to OSEHRA are Document Storage Systems' (DSS) tool to quickly search a patient’s electronic record for free text data that might otherwise be scattered throughout the chart, and Medsphere Systems Corp.’s Fileman database management system.