Report from the 13th Government Health IT Conference & Exhibition

The following are some selected observations and notes reported from the 13th Government Health IT Conference & Exhibition held last week in Washington, D.C.
Notes from Dr. Farzard Mostashari session on "Open Solutions Needed to Prevent Vendor Lock-in for Access to Data Exchange"

  • Dr. Mostashari, National Coordinator for Health IT,  reviewed current directions on standards and interoperability. 
  • He cited a vision that for a U.S. healthcare system where during every patient encounter, patients and providers can have access to all the world’s knowledge.
  • He pointed out that across America's health care system, over 200,000 independent practices and 5,000 hospitals and countless other health care organizations share many common attributes – standards, policies, services and business arrangements. 
  • Dr. Mostashari  highlighted the direction toward 'open knowledge' exchange pointing out that we want to access and share knowledge and we want every person to make useful contributions to the world's knowledge base.
  • With regards to standards, Dr. Mostashari pointed out that we cannot risk long timeframes for agreeing on standards as the cost of giving up innovation.  We also need better testing and certification tools.
  • ONC has launched an implementation and testing platform that will help meaningful use stage 2 succeed. See
  • The patient expects the providers will not do something unacceptable with their data.  Dr. Mostashari  said ONC has decided not to regulate how organizations use information related to privacy and trust.
  • In May ONC issued their governance framework to help guide trusted use of data.  ONC is working on creating a trust umbrella.  Every state is working on developing trust guidance. See
  • Dr. Mostashari  expressed concern that vendor lock-in may be restricting choice regarding which electronic exchanges providers can access. As we move further into the market based approach for electronic health records (EHR), the government has to monitor the market and not exclude innovative options for  accessing services.
  • ONC’s continued leadership is needed in guiding the use of 'open standards' and their use in developing coding for electronic health records and exchange functions in order to support seamless interoperability of trusted patient centered information.

Dr. Mostashari has it right, “don’t incentivize the restriction of patient data sharing, the goal with developing standards for interoperability has been to guide and reward collaboration.”

VA Open Source Moves Forward.
Acting CIO Stephen Warren, U.S. Department of Veterans Affairs (VA), updated the audience on current activities and progress with open source at the VA. He also stated:

  • Harvesting value from sharing open source code, knowledge and data is important. 
  • The open source community has been actively working with the code base of the VA VistA system.  Both the VA and the 'open' VistA community are starting to reap the benefits from the collaboration and sharing activities overseen by the Open Source Electronic Health Record Agent (OSEHRA).
  • Warren also mentioned that many foreign countries are interested in using VistA. 
  • VA is publishing a VistA implementation guide that will support commercial providers in deploying VistA, driving forward VA’s open source policy. 
  • Warren stated that every two weeks VA will put out individual VistA module code builds as they are being developed.
  • Between now and September VA and DoD will use JANUS to interface and access patient information in DoD and VA electronic health record (EHR) systems.

Overall, the Government Health IT Conference delivered a thorough view of steady progress from the top of the nation’s leadership toward fully interoperable health IT solutions.

Some top priorities include - VA and DoD collaboration for creating information access for giving veteran and military providers patient data to enable continuity of care; the game changing predictive and preventive solutions coming from genomics and EHRs that promise personalized health decision making anytime and anywhere; the liquidity of big data, especially as it evolves and become more transparent and interoperable; and the evolution toward an identity ecosystem that can delive  ID matching with security across diverse systems.

Common themes include - the rapid diffusion of knowledge and technology necessary to allow more people to participate which depends on employing the common framework of policies and standards to achieve interoperability; the increased use of innovations from investments in web based tools and applications; open and non-proprietary standards; full patient control of electronic medical information; and strong common policies to protect privacy and maintain security of patient information.