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 Shaffer, 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.
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