This person has been listening to a lot of the old FUD

[Nancy Anthracite]

and comparing apples to oranges.

https://thehill.com/opinion/technology/3975573-the-problems-facing-va-modernization-are-bigger-than-its-software-systems/ 

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Nancy Anthracite

[Matt King]

I wonder if the author knows that EPIC, the most popular commercial system, is Mumps based. It's a terrible thing to lead with "Mumps is old", as every other point suddenly becomes suspect. Also, the author said Cerner was second for Large Hospitals in a survey. Actually, it was second not for large, not for mid-sized, but for small hospitals, I'm actually surprised by that, but I didn't dig any deeper.

[Greg Kreis]

Good points!

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Greg Kreis
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[Kevin Toppenberg]

Is it true that VistA cost the VA $900 million a year?  I wonder what all that pays for?

Kevin

[Mark Dawson]

Re: $900M ... Due to the reliance on contractors for so much VistA Mumps support and development, there are two massive layers that would not exist were that work brought back in-house. First, the layer of management within the VA which exists only to watch over the contractors. Second, the owners of the contracting companies, who get their slice of that ginormous pie.

[Joseph Dal Molin]

That number may include the non-clinical parts of VistA too...which are substantial. Having said that, Jordan's military+veterans+ministry of health system runs VistA at a fraction of that cost, with 9+ million citizens in the system....it's not a one to one comparison, but the scale of the difference in cost should be worth VA looking at the numbers carefully...it can't be swept under the rug "as an apples to potatoes" comparison.

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[mikegi...@aol.com]

Why isn’t there more discussion of Hakeem? Actually, why isn’t there any mention of it by the supposed experts who are critiquing Vista?

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[Nancy Anthracite]

I have been advised that Congress does not care about anything except the
people who vote for them, so not to bring up the subject of Jordan when
speaking to anyone in congressional offices about why VistA is a valuable
resource.. I expect that is why.

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Nancy Anthracite

[Joseph Dal Molin]

I can understand why Congress might not care that VistA is considered a "global good" in the international digital health community. Jordan recognized this back in 2007. Over the past 3-4  years open source solutions have become the defacto standard for digital health adoption in low to middle income countries. USAID, CDC, WHO, UNICEF etc. and pretty well all the donor foundations expect that solutions be open source. But let's set this aside as it really doesn't help the VA and the US taxpayer's pocket.

What will matter, is the 10+ years of "ground truth" evidence from Jordan that VistA can be implemented at a much lower cost and can continue to be improved. The other thing to consider is that EHS has built up a team with the deep experience needed to implement VistA. With some help from the VistA community EHS, for example, was able to adapt and implement VistA Blood Bank.

My guess is that the "experts" are very likely unaware of what Jordan has done. Also, it is very likely that those who are aware would brush off Jordan as a small country with an unsophisticated health system, that couldn't possibly do what the VA hasn't been able to do well after spending Billions trying. BTW Jordan's health system is very much like the VA's and other government funded health systems worldwide....BTW there are for profit hospitals etc. too in Jordan.

Joseph

On 2023-05-04 3:55 p.m., Nancy Anthracite wrote:

Subject: Re: [Hardhats] Re: This person has been listening to a lot of the old FUD

From: Nancy Anthracite <nanth...@earthlink.net>

Date: 2023-05-04, 3:55 p.m.

To: hard...@googlegroups.com

CC: mikeginsburg via Hardhats <hard...@googlegroups.com>

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[David Whitten]

Someone told me that hardware was included in the almost $1 billion a year figure. 

Not just computers to run the VistA software but also PCs and Printers, but also lab equipment to run tests, pill filling machines in the pharmacy, equipment and contractors to run the hospital’s Emergency Departments, as well as Radiology equipment including MRI machines, as well as the contracts  with software vendors like Microsoft. 

Best Wishes

Dave

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