The Rise of Open-Source Electronic Health Records

Paul C Webster | The Lancet | May 14, 2011

Several developing nations are joining the revolution in electronic health records to improve efficiency in their health systems, but at a fraction of the usual cost. Paul C Webster reports.

Luisa Sanchez-Garcia's praise for the electronic medical record system in the neonatal ward at the Centro Médico Nacional la Raza, a massive hospital complex in Mexico City, Mexico, is glowing. Standing in front of an incubator housing a 1-week-old child with a severe cardiac illness, she credits the electronic system with vastly improving his survival chances. “The system provides many elements for efficient work”, explains Sanchez-Garcia, who is a paediatrician. “It helps us create a treatment plan, it helps prevent adverse drug events, it gives us drug dosage information, and much more.”

If Sanchez-Garcia were posing for an advertisement for commercial health-information software, her praise would read like a marketing script. But the system she is praising, which is known as the Veterans Health Information Systems and Technology Architecture (VistA) is non-commercial. Developed by the US Government's Veterans Health Administration and widely credited for remarkable gains in quality of care and cost efficiencies across a health-care system with 1400 facilities serving 7 million patients within the health system for American military veterans, the US Government now distributes VistA software for free. In 2004, the Mexican Government began adopting VistA across 40 large hospitals serving 30 million patients within the health system operated by the Instituto Mexicano del Seguro Social (IMSS), the largest social insurance organisation in Latin America.