The VA's VistA, developed in the 1980s as a leading-edge health IT effort, has come under fire because it is based on the decades-old MUMPS programming language.
And Baker, while stating that he “may well be the biggest fan of VistA,” told the audience, “We've got modernization to do.” Moreover, that modernization—in particular, migrating to open-source computing to allow physicians to more quickly and easily access patient data—will depend on the private sector, he said.
“For me, it really came together about a year ago when I walked the floor of HIMSS 2010 in Atlanta: There is no way that the government can keep pace with the private sector,” he said. “If I keep trying to use governmental approaches to modernize VistA, we're going to keep falling behind.”
Integrating private companies' products into government systems will be more efficient than taking a traditional public-sector approach of telling companies what the government wants—or thinks it wants, preliminarily—and asking how long it would take to deliver a product that would meet those parameters, according to Baker.
And regardless of the decision about the best way to approach a joint VA-Defense Department EHR system, “I believe we'll end up with a single way forward,” Baker said.
Baker, who was appointed to his post in 2009 by President Barack Obama, also touted the VA's achievements over the past 21 months. The department cut spending $200 million during fiscal 2010 and has become more agile by focusing on six-month delivery schedules for development projects, he said.
“I have found that if you focus an organization on functionality and making the dates, cost control follows,” he said.