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IT Everything

A witness to history in healthcare information technology.
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By Joseph Conn

Documents in hand, still in the dark

To begin, I want to thank Phillip Wood, the Freedom of Information Act officer at the U.S. Veterans Affairs Department Office of Acquisition & Logistics for his quick work—relative to my prior experience with FOIA—turning around my request for documents pertaining to a contract to manage the proposed open-source VistA electronic health-record system development project.

A packet of documents from Wood landed on my desk yesterday. I made an official FOIA request on June 14. Mr. Wood, my beef is not with you.

What I—and you, readers—gained from the FOIA documents delivered, however, was slim pickings.

We learned there were five bidders for the contract to become the "custodial agent" of VistA. The names of the five bidders are here along with other dribs and drabs extractable from the heavily redacted documents the VA chose to release.

(The Informatics Applications Group, a privately held, for-profit company based in Reston, Va., was named in June as the winning bidder, with a bid of nearly $5 million. The company, also known as Tiag, has worked with the U.S. Defense Department.)

Still, the amount of information that was requested by me but denied by the VA greatly outweighs what was supplied. For example:

I didn't get the bid amounts of the four firms that didn't win.

I didn't get the unit prices by the winning bidder for setting up a certification program or running the day-to-day operations of the custodial agent.

I didn't get copies of any of the bid proposals, even the winning proposal. That is, I didn't get to see any variety these contractors may have had in their proposals to create and manage the VistA system as an open source project.

I didn't get insight into why the VA chose one bidder over the other.

An irony about the VA's clandestine behavior is that VistA itself, or most of it at least, is in the public domain. That is, you can obtain a copy of the VistA code—millions of dollars worth of inpatient and outpatient EHR software—for free under FOIA.

Granted, in Mr. Woods' letter to me, he cited two federal laws and one section of federal administrative code by way of explaining what purportedly provides legal cover for the VA to deny my request for release of that information.

But can the legalese, please. What the VA is telling presumably any taxpayer who might ask is, "You don't get to see how we decide to spend your money. Trust us."

No wonder the nation is running a deficit, if that's the opaque environment in which the federal government does its contracting. State and local governments don't handle information this way. It's an open invitation to bid fraud at worst, poor and unresponsive government at best.

We shouldn't be in the business of handing over custody of a treasured public asset like VistA to a private contractor without total transparency.

It's just nuts.

Follow Joseph Conn on Twitter: @MHJConn.

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