Group recommends upgrading VA health system with open source

This article was updated at 5:33 pm on Thursday.

A blue-chip information technology industry recommended the Veterans Affairs Department reengineer its decade-old electronic health record system based on open source models and offered as the international standard for hospitals.

The recommendations have implications for the Obama administration's push for a national network for health records, which faces a roadblock of incompatible systems nationwide. Open source theoretically could provide a solution.

In October 2009, VA Chief Information Officer Roger Baker tapped the Industry Advisory Council, a 550-member group of technology companies in the Washington metropolitan area that fosters dialogue with federal agencies about IT solutions and procurement, to recommend how to modernize VA's award-winning Veterans Health Information System and Technology Architecture and determine how it can be leveraged "for the betterment of the country."

The IAC panel recommended the current version of VistA be stabilized while a new open source, open standards VistA was developed with the aid of a federally funded research group. The new Vista 2.0 software system would be managed by a not-for-profit open source foundation.

The implications of using open source are "staggering," an industry source told Nextgov in October 2009 when the task force was formed to look into upgrading the two-decade-old VistA. If VA modernizes the system on an open platform, it could become the model for a national health record network President Obama envisions.

The agreement to use open source was unanimous among the 40-member IAC panel. "Through many hours of debate, compromise and collaboration, we not only produced a viable set of recommendations, but were unanimous in those recommendations," said Ed Meagher, chairman of the IAC VistA Modernization Working Group and a former deputy chief information officer at VA. "That unanimity is a real credit to the cohesiveness of this working group. That we recommended an open source solution is a real game changer from the business-as-usual approach to systems development."

At a press briefing this morning, Meagher said when the IAC task force asked VA clinicians who use VistA in the field what they would like in an upgraded system, it realized a new version of the health records platform "has to look as good as the old one" to gain buy in from the department's front-line doctors.

The report said the upgrade, Vista 2.0, should replicate screen by screen and interface by interface the current system, while still based on a modern open systems architecture. The task force also said the new version should "harvest everything of value" from the old system, including data models and business processes.

VA should tap the expertise of a federally funded research organization to spur development of the software and sponsor an open source community to promote continued development, the group said.

Meagher said in an interview the report provides Baker with a new direction for development of a next-generation electronic health records system that could serve private hospitals nationwide.

VA kicked off a project to modernize its health information systems in 2001, a program called HealtheVet, which the Government Accountability Office estimated would cost $11 billion to field by 2018. VA requested $36.6 million for HealtheVet in its fiscal 2011 budget.

VistA 2.0 would allow VA to field a new system quicker and at far less cost than HealtheVet, said an industry source who declined to be identified because of the financial and political sensitivity of issue.

Baker did not respond to a request for comment on the report.