I, along with over 300 others, many new to the world of VistA, attended the
first annual OSEHRA conference and heard the disturbing presentation about
iEHR and the plan to have iEHR virtually supplant VistA leaving VistA as a
complete, open source system mostly in a pile on the cutting room floor.
In the view of the speaker, a few pieces of VistA could potentially used
in this new, largely closed source, system of services that would become
the EHR for the DOD and VA.
It became crystal clear what the plan was for VistA after I asked the
question about the role of VistA in iEHR and it was so clearly answered.
As I sat down to the table after that shocking revelation, I heard someone
say, "Why are we here?"
I think that question could be asked by virtually everyone at the
conference with their various hats. Some were there looking to sell their
services or products for use with VistA, particularly looking for the
potential for government contracts. Some were there because they use
VistA. Some were there because they develop for VistA inside of the VA or
they manage the relationship with OSEHRA. Some were there because they
already implement and support VistA for business reasons and some of us
were there because we know VistA is a great thing and is used to improve
the lives of people around the world. Were the reasons they were there at
the conference now irrelevant? Some were there because they have great
ideas for ways to use their creations to improve and help the users of
VistA. Were their hopes and plans now meaningless and useless? Are they
on the cutting room floor as well? Is the VA going to abandon VistA and
does OSEHRA collapse like a house of cards?
To many at the meeting, VistA may be new to you. OSEHRA made it possible
for you to see what had been right there all along but largely ignored.
For some of us it is the 30 plus year story of the passion of many to do
For some, like me, it is a much shorter story but nonetheless, a no less
You should also know this is not the first chapter in the history of the
attempts to destroy VistA. Attempts go all the way back to its near
beginnings when there was an arson attempt to destroy it. None of these
attempts so far have succeeded and frankly, some of them looked like they
had a lot more probability of succeeding than this iEHR plan.
VistA is not going to go away just because government contracts go away.
It is being adopted around the world and it may become harder to do the
things that need to be done to maintain it and move it forward, but it
will not die.
Whether or not you feel in your view of it you fit into this moving forward
is up to you to decide. If OSEHRA is not swept aside by iEHR or politics,
it may become a major force in seeing that VistA moves forward more quickly
with more support. It would certainly provide a lot easier way to
coordinate efforts to move VistA forward, but it is not the only way
I am sure there are those out there who will benefit from the funds that
will be thrown at iEHR over the next few years, but keep in mind when you
do, that there is VistA and it will still be there and maybe you could have
a role to play in that scenario which would be more likely to be sustained
over the long term than iEHR.
The established VistA Community will be attending its 26th VistA Community
Meeting in January. The VistA Community meetings are actually a relatively
new thing but there have been 25 of them where people meet that have been
contributing to sustaining, modernizing and improving VistA (and VistA
derivatives) for many years. The momentum for the adoption of VistA has
been growing independently of OSEHRA and the VA so even if the VA abandons
VistA and OSEHRA falls by the wayside, VistA will survive.
The education community has also now learned the benefit of open source and
VistA. The momentum to use it in education is growing. Out of that I
expect a wave of young blood with forward looking ideas to join our
Business certainly has a role in all of this and business can help make it
happen faster and better. The users of VistA can tell you the advantages
of open source, just like Robert Wentz did, and they are spreading the
word. The users of VistA worldwide outside of the US can also tell you.
Ask the Jordanians and the three hospital systems in India.
I am hopeful that efforts will continue inside of the VA as well, but we
will be waiting for those inside of the VA to join us if iEHR displaces
them. Personally, I believe iEHR will be an extremely expensive failure and
the sooner that the folly of it is recognized, the better for those of us who
are tax payers and the better for VistA. Those resources could be so much
better utilized to work to improve and modernize VistA to serve military,
veteran, and civilian patient populations worldwide.