Roger Baker, assistant secretary for information technology at the U.S. Veterans Affairs Department, said the VA is committed completely to pursuing an open-source model for modernization of its VistA electronic health-record system.
"There is no half-hearted in this from the VA standpoint," Baker told his audience at a community meeting of World VistA, a not-for-profit organization formed to promote the use of an open-source version of VistA outside the VA. "We either succeed with open source or spend $16 billion" on switching to a commercial EHR system, he said.
A decade ago, according to Baker, the VA had the best EHR system in the world, but since then VistA's rate of improvement has diminished while the pace of progress among private-sector products has accelerated. VistA has "been ignored for a while," he said.
For World VistA members, many of whom are current or former VA programmers, official word of the VA's commitment to open-source VistA was a welcome development. For at least a decade, according to members, the VA had pursued various plans to replace VistA with commercial products. This fear that the VistA code base, which is in the public domain, might be lost to the healthcare community, was one of the driving factors in forming World VistA nine years ago.
One goal of moving VistA development to an open-source model is to keep pace with accelerated changes in healthcare, Baker said. Another is to ensure that taxpayers are getting their money's worth on an EHR system that is central to healthcare operations at VA facilities, he said.
Baker said the VA open-source development scheme also will impact the U.S. Defense Department's Military Health System IT initiatives. The secretaries of the VA and the Defense Department have agreed to create a "single joint electronic health-record system," Baker said. "We're going to build it together and we're going to field the same system in all VA and (Defense Department) hospitals," Baker said.