VistA's open-source extension into West Virginia

David Elyard, a health IT coordinator in West Virginia's bureau of behavior health and health facilities, drove the winding roads of his mountainous state last week to trouble-shoot the launch of the computerized laboratory information module being added onto the predominately open-source VistA electronic health-record system...

The seven communities, home to an acute-care hospital, two psychiatric hospitals, four long-term care hospitals, one nursing home and two ambulatory-care clinics, represent, arguably, the largest state government installation of VistA in the U.S. outside the VA. For the past six years, all of the bureau's hospitals, clinics and nursing homes have used VistA as their main EHR system, connected to a central database in Charleston via T1 lines.

While the VistA software was free, operating it across all seven sites has been far from it, according to Craig Richards, the bureau's deputy commissioner for administration. Working under a state contract, Medsphere Systems Corp. helped West Virginia install what's commonly called FOIA VistA, a version of the EHR that's in the public domain. It can be obtained from the VA without charge under the Freedom of Information Act. The state views VistA as a foundation on which the bureau has built, and will continue to build, a VistA “variation” tailored to its needs. “It's uniquely ours at this point,” he said. “We are definitely one of the states that have reaped the benefits. We're starting to lap other people now and thinking, how far can we take this? We're getting real-time feedback from people saying, 'What if we could do this?'”