Kizer leaving Medsphere after successor found

Physician-executive Kenneth Kizer is stepping down as the chairman of the board and chief executive officer of healthcare information technology developer Medsphere Systems, Aliso Viejo, Calif.

"It really has nothing to do with my enthusiasm for the company," Kizer said. "The company is doing very well. It's kind of a personal and family-related thing."

In addition, Kizer said he plans to retain a seat on the Medsphere board and remains solid in his support for open-source development in healthcare.

Kizer, who has long maintained his residence in the Sacramento, Calif., suburb of Rocklin, commuted between his West Coast home and Washington, D.C., where he served from 1994 to 1999 as the top physician at the Veterans Affairs Department as its undersecretary of health. He left the VA to become the first president and CEO of the National Quality Forum, where he served from 1999 until December 2005. He left the NQF to take over as CEO of Medsphere, where he'd served as chairman since 2002.

"I had always lived in Northern California and commuted to Washington, and what I ended up doing was trading a 2,500-mile commute to a 500-mile commute, so clearly part of the agenda is to start cohabiting with my wife," Kizer said. "That is not an insignificant consideration."

Kizer said his resignation will become effective "when there is a new person to take the helm." An executive search firm has been hired to find his successor, he said. "I'm committed to stay until a new person comes in. It will be a very smooth transition and I'll turn over the reins when that happens."

Kizer said he has no definite future employer at this time. "I think I'd like to get back a little bit more into the healthcare I was doing," he said. "I'm going to be working with a few folks doing some things, but at least in the short term, I am not going to some (specific) place."

Although Kizer's name has been mentioned in industry circles as a possible successor to Dennis O'Leary, outgoing president of the Joint Commission, he scotched the rumor.

"No one has ever talked to me about it," Kizer said. "I can say unequivocally I'm not part of anything there."

During Kizer's first year at the VA, the federal healthcare system's clinical computing system, then called the Decentralized Hospital Computer Program, was renamed the Veterans Health Information System and Technology Architecture, or VistA. Kizer remained a booster and protector of the VistA program throughout his VA tenure. Though not open-source software by strict definition, VistA has long been in the public domain and much of the code is available for downloading without cost under the Freedom of Information Act. In addition, the development model within the VA for the DHCP and VistA largely has been collaborative and distributed across the organization, mirroring an open-source model in that respect.

Medsphere is the largest and thus far most successful of a growing number of companies that have produced software systems based on VistA code for use outside the VA at both private- and public-sector facilities. Medsphere has billed itself as an open-source company since its inception in 2002, although portions of its software code remain proprietary—a point of friction with some members of the VistA community, like WorldVistA, a not-for-profit organization devoted to expanding use of the VistA system outside the VA.

Last August, Medsphere filed a $50 million, 12-count lawsuit against its two co-founders, brothers Steve and Scott Shreeve, accusing them of misappropriation of trade secrets, breach of contract, breach of duty of loyalty, violations of the Racketeer Influenced and Corrupt Organization Act, and other alleged offenses for posting portions of Medsphere code on, a Web site used as an exchange for open-source software development projects.

Fred Trotter is an open-source advocate, the founder of a healthcare software development project, FreeB and a frequent critic in postings on the Hardhats listserv of the Medsphere approach to open source, particularly the company's decision to keep portions of its code proprietary and its lawsuit against the Shreeves. Trotter said in a telephone interview that in recent months Medsphere has shared significant sections of its improved code with developers of open-source versions of VistA.

"The community can be hard to please, in general, but they (Medsphere) have been making some overtures," Trotter said. Licensing issues about the terms of the recent releases have caused some grumbling, but the bigger issue remains, he said.

"You can't sue your own employees for releasing their code as open source," he said.

Joseph Dal Molin is director of business development for WorldVistA, which maintains an open-source version of VistA. Dal Molin said that, on balance, Kizer was good not only for Medsphere, but also for the VistA movement.

"I think he certainly brought credibility to Medsphere," Dal Molin said. Naming Kizer to the board and then as CEO of the young, privately held company, "was a very strategic move on their part."

"Regardless of our differences of opinion regarding (open-source) distributions, they have been successful in the market and I think Ken had a good deal to do with that," Dal Molin said. "Anything that contributes to the success of VistA in the market place is a good thing as far as I'm concerned."

Kizer said that despite his leave from Medsphere, he remains personally committed to open-source software development in the healthcare industry.

"That's where I see the future of healthcare IT," he said. "I don't expect the propriety vendors to ever go away, but I do see open source to be a major part of the healthcare IT landscape, (particularly) in electronic healthcare records."

"If you look at open-source publishing, like the (Public) Library of Science and medical journals being printed, even things like performance measurement and public reporting on healthcare, it's all part of a sea change of public expectation of transparency. Open-source software is one of many manifestations of society's demand for more transparency."

Further, Kizer said, "The basic ethos of open source fits healthcare. And healthcare has this infinite need for customizing and tailoring at the sharp end. Some doc wants a program for this or some doc wants a disease registry for that and you just can't get that with proprietary (software), at least not quickly and cheaply. I see open source as the disruptive technology in healthcare IT."

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