A meaningful hurdle the VA still hasn't crossed

Question: What has a small band of open-source programmers and a handful of health information technology vendors accomplished that the massive U.S. Veterans Affairs Department has not?

Answer: Attained certification for their versions of the VA's VistA electronic health-record system as capable of meeting the meaningful-use requirements under the health IT incentive payment program of the American Recovery and Reinvestment Act of 2009.

The latest VistA version to be certified as a complete, meaningful-use-compliant inpatient system is WorldVistA EHR 2.0, developed by the not-for-profit World VistA organization. Hat tip to Denise LeFevre, the chief information officer at 153-bed Oroville (Calif.) Hospital; to Dr. Matt King; and to programmer George Lilly for helping make it happen.

WorldVistA joins commercial vendor DSS, with its vxVistA and Medsphere Systems and its OpenVistA CareVue, as a developer of VistA cloned EHRs that are MU-certified for hospital use. Kabot Systems offers a certified outpatient version it calls VistA++ EHR Office Edition.

They're accompanied by the Indian Health Service's VistA-derivative Resource and Patient Management System, or RPMS, which is certified for inpatient and outpatient installations. IHS providers receive Medicare and Medicaid reimbursements, so that explains the agency's hustle in getting its EHR system in step with the certification program earlier this year in time for providers to qualify for Stage 1 health IT incentive payments the first year of the federal program.

Still, since the VA is the federal government's most prominent health IT progenitor, one would expect it to—if for no other reason than to lead the nation by good example—get its own VistA system tested and certified.

I've put the question to the VA: Why hasn't it run VistA through the traces? When I hear the answer, I'll let you know.

Open-source health IT maven Roger Maduro has written more and in greater depth on this topic as well as on certification of other open-source EHRs on his blog, as has programmer and blogger Fred Trotter.

Follow Joseph Conn on Twitter: @MHJConn.