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1. NextGov.com - VA's health record system cited as model for a national network
TECHNOLOGY AND THE BUSINESS OF GOVERNMENT
VA's health record system cited as model for a national
network
By Bob Brewin 03/27/09
One of the more perplexing problems facing the Obama administration's pursuit of building a nationwide electronic health
records system is the fact that hospitals and doctors can't share medical data seamlessly because the medical networks are
incompatible.
But many health officials say they might have found the solution at the Veterans Affairs Department. Medical information
technology specialists and industry executives told Nextgov that the open-source version of the VA's electronic health record
system called the Veterans Health Information System and Technology Architecture (VistA) could serve as a building block
for e-health networks nationwide and provide a variety of plug-and-play medical applications that can be easily shared among
clinicians.
Open-source systems allow a range of applications that power information sharing to be shared on a large scale, just as users
of Apple Computer's iPhone's open interface can download thousands of various applications off the Internet. The same
model should be the primary approach the Obama administration uses when spending the $19 billion stimulus investment in
health information technology, two doctors wrote in an article in the latest issue of the New England Journal of Medicine,
released on March 25.
Dr. Isaac Kohane, director of informatics at Children's Hospital in Boston, and Dr. Kenneth Mandl, a pediatrician at the
hospital and a professor at Harvard Medical School, wrote that the if the iPhone model were applied to health IT, it would
stimulate a variety of low-cost medical applications that hospitals and doctors could download from the Internet to apply to
the management of health records and patient data.
And the open source version of VistA "is definitely worth looking at" as a platform on which to build similar applications,
Kohane told Nextgov in an interview.
Some health networks have already used VistA to deploy open-source records systems. Community Health Network of West
Virginia, which operates 80 clinics serving 120,000 patients, deployed a version of OpenVistA in 2005, and the state of West
Virginia installed the OpenVistA version in eight hospitals in 2006.
OpenVistA costs a tenth of the price of commercial health IT software, said Jack Shafer, chief information officer of the
nonprofit Community Health Network. For example, the West Virginia University Hospital System spent about $90 million to
install commercial health software from EPIC Systems Corp. in seven hospitals, while the state's Health and Human
Resources Department installed OpenVista in eight hospitals for $9 million.
The West Virginia state hospitals use the inpatient version of OpenVistA while Shafer said Community Health Network uses
an outpatient version based on the Resource and Patient Management System that was developed as an offshoot of the VistA
system used by the Indian Health Service. Both versions of VistA lend themselves to the kind of application development
envisioned by Kohane and Mandl, Shafer said.
When VA began developing VistA in the early 1980s, it called the system the Decentralized Hospital Computer Program, a
name indicating that software programmers at any of the 168 VA medical centers wrote applications and modules that could
be used by other hospitals in the system, Shafer said.
http://www.nextgov.com/site_services/print_article.php?StoryID=ng_20090327_6548[3/30/2009 8:46:31 AM]