The Veterans Affairs Department is taking another step—apparently a big one—toward opening its VistA electronic health-record system to a full, two-way, open-source development model.
The VA has published on the Federal Business Opportunities website
a presolicitation for an electronic health-record system open-source custodial agent.
In the 60-page document, the VA lauded its Veterans Health Information Systems and Technology Architecture, or VistA system, which serves 152 VA health hospitals and 928 ambulatory-care and community-based outpatient clinics, as "stable and reliable." Furthermore, according to the presolicitation, VistA is available "99.95% of the time and performs well in both large hospital and small office settings."
But the rate of innovation and improvement of VistA—now more than three decades old—"has slowed substantially, and the code base is unnecessarily isolated from private-sector components, technology and outcome-improving impact," according to the notice. "To address this issue, VA is establishing a mechanism that will open the aperture to broader-based public and private sector contributions."
The bulk of the VA's software code is "public domain" software available to the public free of charge under the Freedom of Information Act. Yet historically, the VA has been reluctant to incorporate open-source software created outside the VA by a growing number of commercial and not-for-profit developers.
Now, according to the presolicitation, the VA intends to "create a structured, deliberate and predictable migration path from our custom and proprietary EHR software to an openly architected, modular and standards-based platform." The notice adds: "We believe that a nongovernmental custodian will achieve all these objectives quickly and efficiently."
The latest VA notice is an apparent follow-up to an official "request for information" the VA published in February on how it could continue development of VistA
as an open-source project.
The VA also is in talks with the Defense Department about possible joint development
of IT systems that could serve both the VA and the Military Health System.