VA moves forward on open-source health records

After more than a year of deliberation and consultation, the Veterans Affairs Department is moving on its strategy of developing an open-source electronic health record system.

The Veterans Affairs Department intends to begin migrating its Veterans Integrated System Technology Architecture (VistA) electronic health record (EHR) system to an open-source platform starting this summer after it finds a custodial agent to operate and manage an open-source community for it, the department has announced.

The VA has released a draft request for proposal to hire a company to manage developing an open-source VistA digital record system.


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The VA intends to deploy the open version of VistA to all of its facilities, and will contribute all non-security essential modifications to the product it makes or pays for directly to the open source custodian, the VA said in a news release on April 1.

The VA expects to engage with other public and private sector entities on the open source version of VistA, said Veterans Affairs Secretary Eric Shinseki. “This move towards open source welcomes private sector partners to work with us to improve VistA, and is an important part of our strategy to ensure that VA clinicians have the best tools possible, and that veterans receive the best health care possible," Shinseki said.

VistA is used in 153 VA hospitals and more than 800 clinics, as well as other facilities. The VA consulted with industry, government and academic partners in the last year to forge a modernization strategy for VistA. The system is viewed as difficult to upgrade and maintain.

"Over the past year, we have followed a deliberative process to examine the implications of open source for VistA, and we are convinced that this is the best approach for VA, Veterans, and taxpayers," Roger Baker, the VA's  assistant secretary for information and technology, said in a statement. “Our primary goal is to re-ignite the innovative processes that made VistA such a great EHR system. We also want to ensure that vendors of proprietary products can easily and confidently integrate their products with VistA to make them available for VA to purchase and use in our facilities.“

The American Council for Technology-Industry Advisory Council (ACT-IAC) prepared an advisory report on VistA modernization at Baker’s request in May 2010 that recommended an open-source approach.

ACT-IAC said its report was significant because it was unanimous in providing a strategic plan for modernization. “Although the working group represented a wide diversity of perspectives within the IT and health care communities, its members were able to reach agreement on a strategy that would serve the nation,” it said in a statement.