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Rockefeller bill calls for nationwide adoption of open source EHRs

April 27, 2009 | Bernie Monegain, Editor

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WASHINGTON – Sen. John D. Rockefeller IV (D-W.Va.) has introduced legislation aimed at facilitating nationwide adoption of electronic health records, particularly among small, rural providers. 

The Health Information Technology Public Utility Act of 2009 builds upon the successful use of "open source" electronic health records by the Department of Veterans Affairs as well as the "open source exchange model," which was recently expanded among federal agencies through the Nationwide Health Information Network-Connect initiative, Rockefeller said.
 
"We need advancements in health information technology across the board to improve the quality of care Americans receive," said Rockefeller, chairman of the Senate Finance Subcommittee on Health Care, in a statement.  "To make this happen, we need universal access to affordable and interoperable health information technology - from small, rural health clinics to large, urban hospitals."
 
"We commend Senator Rockefeller for his leadership and the creation of this historic legislation," said Michael J. Doyle, president and CEO of Medsphere, a company that sells commercially supported open source software based on the U.S. Department of Veterans Affairs' VistA EHR.

"With the proven success of open source technology used in the Department of Veteran Affairs and at independent hospitals across the country, the time is right for best practice standards to be shared rather than recreated at each hospital in America," Doyle said.
 
"Open source software is a cost-effective, proven way to advance health information technology - particularly among small, rural providers," Rockefeller said. "This legislation does not replace commercial software; instead, it complements the private industry in this field - by making health information technology a realistic option for all providers."
 
The bill proposes to:

  • Create a federal Public Utility Board within the Office of the National Coordinator for Health IT to direct and oversee formation of this HIT Public Utility Model, its implementation and its ongoing operation. 
  • Implement and administer a 21st Century Health IT Grant program for safety-net providers to cover the full cost of open source software implementation and maintenance for up to five years, with the possibility of renewal for up to five years if required benchmarks are met.
  • Facilitate ongoing communication with open source user groups to incorporate improvements and innovations into core programs.
  • Ensure interoperability between the programs, including innovations, and develop mechanisms to integrate open source software with Medicaid and CHIP billing.
  • Create a child-specific Electronic Health Record to be used in Medicaid, CHIP and other federal children's health programs.
  • Develop and integrate quality and performance measurement into open source software modules.
Related Topics:
  • Department of Veterans Affairs
  • information technology
  • John D. Rockefeller IV
  • Washington
  • West Virginia

Reader Comments (2)Login to Post a Comment

dwight says: clarify "open source"
April 28, 2009 | 8:34AM GMT

Perhaps Bernie Monegain could clarify what's meant by "open source" here. I would expect the traditional meaning which is that anyone is allowed to open up the system and look inside to see how it was built and what it does, and to build new services and facilities that improve or extend the system. This does not mean absence of security or privacy protection as Stormn fears, but rather that the security and privacy protection can be reviewed by experts to see how well it works, and if it's lacking that competitive approaches can be built and offered.

The opposite of "open source" is generally understood to be "proprietary" - meaning that the workings of the system are based on trade secrets. In the proprietary approach if you try to find out how your system works in order to assure yourself that your medical records are protected, you are violating the rights of the owner of the secrets and can be liable for damages or worse. Also, you need to trust that the vendor will move in an adequate way to address any vulnerabilities that may come to light because you may not have the right to seek competitive offerings.

The proprietary approach has successfully been used to create most of the major, complex computer systems in history, such as Microsoft Windows and the IBM Mainframe. Its defenders would suggest that it is the most efficient ownership structure in that it allows companies like IBM and Microsoft to invest confident in the knowledge that they alone will own the product. But recently IBM, Microsoft and many other champions of the proprietary approach have been moving towards more open source products as they find them more competitive and a better basis for innovation.

In my belief advocating open source allows for arguably stronger approaches to security and privacy of medical records and clearly does not, as Stormn fears, move towards unprotected medical records.
Dwight Arthur
grantsmiths

1168403 says: Open Source EHR
April 27, 2009 | 3:10PM GMT

Gee one would think that with all the password, encrypted services and gobbly gook that you could not steal records on the net, WRONG... Now here come a Governor no less, that wants to put "OPEN SOURCE" medical records on line. Forgive me for saying this .. But does Gov. Rockefeller have some rocks in his head.
Wasn't the secure records of the VA recently heisted, I don't mean one or two but I think the number was 20,000 and how about Master Card, 100,000 members and wasn't it Google's bright idea to sell 200,000 members names to the insurance companies all from ON LINE RECORDS...
Sorry Charlie, no sale.. Medical records according to HIPAA are the private property of the patient and only that patient can say who sees them.. Not Google or Microsoft, not any Joe the Plumber (yup he is still with us) nor any hacker that wants to create havoc. EMR, EHR, PHR, no matter what you call it should be the private property of the patient and they can carry it with them from a company called SGMS (I think that's the name) and be able to display it to any doctor that they give permission to.

That is my opinion and you are welcome to it..
Thanks..
NM Eisenberg

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