VA sets gold standard for EHR baseline

By Mary Mosquera
08:53 AM

The Department of Veterans Affairs is slated to create a separate repository for its fully open source Gold Disk version of its VistA electronic health record (EHR) system to assure a common software baseline compared with the 133 instances of VistA operating at its hospitals and clinics across the country.

VA also will put in place a software testing platform, standards supporting open source development and documentation of open source community outreach planning, according to a Nov. 27 announcement in Federal Business Opportunities.
The department wants to attract more developers and software code contributions to spur innovations and technology enhancements in the 30-plus-year old acclaimed EHR system that is getting a major makeover through the community managed by the Open Source Electronic Health Record Agent (OSEHRA), a not-for-profit corporation custodial agent created under a previous contract between the VA and The Applications Informatics Group of Reston, Va. The agency will re-up its contract with OSEHRA for another year, the notice said. 
As the custodial agent for the open source community, OSEHRA certifies software code for integration into the VistA code base and interoperability of complimentary software. However, OSEHRA may also approve code for applications that may not become part of VistA but may still be useful for other programs.
VA anticipates that the rate of innovation and improvement in VistA can be increased without raising the current budget by better involving the private sector in VistA governance and development through open source, according to VA CIO Roger Baker in written testimony for a Dec. 4 House Veterans Affairs Committee hearing.
While VistA is still popular with VA clinicians, they also are “unanimous in calling for us to re-invigorate the innovation that made VistA the best EHR system available,” he said.
Estimates of the costs of establishing the custodial agent are less than $10 million per year.  VA opted for using open source also because replacing VistA with an existing commercial package would cost about $16 billion, Baker said. “The size of private sector investment and the rate of innovation in the commercial EHR sector far exceed the government’s ability to produce timely, cost-effective EHR products,” he said.