Joe Conn-DoD Should Make Right Decision and Adopt VistA

Joe Conn | Modern Healthcare | February 12, 2013

...The military, meanwhile, is still working on multiple iterations of its own EHRs . None of them are comparable to VistA, or fully interoperable with it, in large part because the military has always gone at it the wrong way—top-down instead of bottom up, says programmer Tom Munnecke, who worked on early versions of both the VA's and the military's EHR systems.

VA Secretary Eric Shinseki and outgoing Defense Secretary Leon Panetta went on record last week about plans to shelve building one joint EHR system for both the VA and the DOD. Their aim is to improve each department's EHR while building better interfaces between them. That's a good beginning, killing off an unholy experiment before it took on a life of its own. If former U.S. Senator and former VA official Chuck Hagel is confirmed as Panetta's replacement, then VistA supporters will have an old ally heading a department that has been, alternately, indifferent or hostile to their efforts. So, now what? I think what's needed now remains as obvious as it has for decades, which means Shinseki and Panetta got it only half right, because they were half wrong.

There should be one EHR for the military and the VA, but it shouldn't be the just dispatched Frankenstein's EHR that was to be built out of custom-made and off-the-shelf parts. It should be VistA. The VA has a demonstrably superior EHR system, so the Defense Department brass should swallow their bureaucratic pride and adopt it. As a taxpayer, I've seen too much money squandered on the Defense Department's other failed health IT efforts. The Military Health System should begin immediately implementing a non-proprietary, fully open-source version of VistA in its hospitals and clinics, then modify it as necessary for those areas where military healthcare needs are unique. Shipboard and forward deployments come to mind, but I'm sure there are others...