Having Already Failed Once, DoD Snubs Open Source For Second EMR Try

Posted on August 28, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In theory, the VA now has everything it needs to standardize and upgrade the open source VistA EMR, especially after forming the Open Source Electronic Health Record Agent (OSEHRA) organization.  But when it comes to bringing that expertise to the DoD’s EMR projects, it seems OSEHRA alone can’t do the trick.  Sadly, it’s no surprise to find this out, as the DoD has an abysmal track record on this subject.

OSEHRA, an independent non-profit open source group, was launched about a year ago. The group is working away at improving compatibility between versions of VistA at the 152 VA medical centers.  According to an InformationWeek piece, there’s now about 120 different versions of VistA ticking away within the VA system.  OSEHRA hopes to create a common core — a “minimum baseline standard”  for 20 VistA modules — which will make it easier for the medical centers to deploy enterprise-wide apps.

The DoD, meanwhile, is hacking away at a joint system with the VA, called iEHR, which is due for initial testing in 2014.  A few months ago, DoD told Congress that while open source technology will be part of iEHR, the agency will also include commercial and custom applications, using a service-oriented architecture.

What that means, in practical terms, is that OSEHRA will be cooling its heels waiting for DoD contractor Harris Corp. to build an Enterprise Service Bus and open source APIs to allow for open source development on the project.

Now, that wouldn’t raise my suspicions so much if DoD hadn’t proven to be a collosal failure at developing an EMR.  Did anyone else here catch the major slap GAO delivered to DoD a couple of years ago, noting that its 13-year, $2 billion AHLTA application was a near-complete fizzle?  If anyone at DoD had humility, or if their bosses were held accountable for AHLTA’s staggering losses, nobody would let them drive the technical choices on this project.

Am I the only one who sees a recipe for billions more in DoD losses here?