But because proprietary software likely will be part of the mix during re-engineering, VistA 2.0 won't be entirely open-source, predicts Ed Meagher, chairman of the IAC work group that prepared the report.
Still, any commercial off-the-shelf, or COTS, software products that connect with VistA initially via an interface, soon must be reprogrammed to run “native” in the surrounding open-source environment, Meagher said. A proprietary software vendor will still be able to charge the VA license fees, but “three guys in a garage can say, ‘I can do a Red Hat on it,' ” Meagher said, referring to the purveyor of the open-source Linux operating systems, and try and compete with the proprietary system's vendor for the VA's business. “We haven't eliminated anybody from playing,” he said.
Aside from the COTS vendors, Meagher said, major contractors who develop new software to government specifications should be required to hand over intellectual property rights to the VA so that the new software code can be put in the public domain, he said.
That recommendation, if followed, could avoid a recurrence of a situation from the late 1980s and 1990s when giant defense contractor SAIC copied the publicly available VA system, adapted it for the Military Health System, but was allowed to retain ownership of the new software.
The initial SAIC contract price for the work was reported at slightly more than $1 billion. But Meagher said the ultimate cost to taxpayers for the resulting Composite Health Care System, or CHCS I, and its troubled successor system, CHCS II, now called AHLTA, is more in the range of $3 billion to $4 billion.
Meagher said it will be up to the VA to ensure those sections of the new VistA developed under contract will remain in the public domain.
Meagher said the entire job of re-engineering VistA “could be done, soup to nuts, finished in five years.” That would include “decomposing” the current VistA system, writing the specs for a replacement, programming the replacement, rolling it out to all VA facilities and migrating the data from VistA to VistA 2.0.
Last month, the VA held an “industry day” to go over details of a massive IT contracting opportunity called Transformation Twenty-One Total Technology, or T-4. A request for proposals is scheduled to be issued under T-4 by May 31, with contracts to be awarded by the end of September. The total limit of T-4 contracts over five years is $12 billion.
As it works on the VistA replacement, Meagher said the VA should find ways to revitalize the development approach it used to create the VistA system and its precursor, the Decentralized Hospital Computer Program, with one-on-one interaction between VA clinicians and programmers.
Of the 20 alternative development models reviewed by the IAC work group, the VA's own iterative model made it to the final round of six contenders selected by the work group as the most practical, valuable and viable when taking into consideration criteria such as financial and technical risk, time to benefit, governance complexity and estimated return on investment.
According to the work group report, “Since many of the VistA applications were actually built this way, why not do what has proven to work in the past?”