Arguably the gold standard of electric health records management, the federal Department of Veterans Affairs could be "re-engineered" as an open-source project.
That was the unanimous recommendation of the Industry Advisory Council, which was asked to study and suggest ways to modernize and simplify the VA's VistA (VA Health Information Systems and Technology Architecture), which serves about 8 million veterans through 153 medical centers and 768 outpatient clinics across the U.S.
VistA has been continually developed and upgraded over the past 32 years, but if it's to continue being effective, it needs an overhaul. Updates on top of updates have rendered VistA difficult to maintain. So the VA decided to seek recommendations for an overhaul before it needed fixing.
The IAC committee unanimously agreed on the report's key recommendations:
The idea is to have the system appear to function much as it already does, but with streamlined code and the ability to make updates to it more easily. This would allow greater ability of VA employees, healthcare professionals and others involved in the VA's services, such as large contractors and healthcare software vendors to contribute to the system's improvement.
The council made several suggestions on how to find the right people to launch this re-engineering, such as the "Toucan" (two can) approach, which is how much of VistA was developed in the first place: two people, one highly technical and the other end-user-oriented (possibly a user himself) working as a team; or "Structured Open Source," where the VA would "aggressively participate and even lead the open source community" in developing the new systems, applications and code.
In the end, creating a modular system, where bits and pieces could be added or removed without affecting the overall funcationality, working in tandem with a greater open source community, was pointed to as the best model.
Fact is, right now the VistA system works great and is comprehensive, everyone agreed. But its roots make it too hard to innovate on the system and deliver new functions or integrate new technology in a timely manner. This issue was addressed, somewhat in the VA's open government plan released recently, which got "middle ground" ratings on the audit by OpenTheGovernment.org.
A new VistA system would have a basic kernel that would be well-documented so in future years, no one would have to depend on one or two people to make significant changes to the guts.
If that's not a solid argument for moving to an open source infrastructure, then there just isn't one.
After nearly 20 years as a professional journalist for large and small daily newspapers in Florida, Arizona and New York, Amy was part of the Great Newspaper Culling of 2008. That was a good thing. Now, Amy writes for a variety of websites, including NetworkWorld, Discovery's Parentables and Soshable and consults with a variety of sites on their social media strategy.
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