VistA EHR Community and OSEHRA Experiences Extraordinary Growth in 2014

The following is a year-end recap on the accomplishments of OSEHRA and the VistA community 2014 by Dr. Seong Ki Mun, President and CEO of OSEHRA.

Dr. Seong K. MunOSEHRA Community Members and Friends,

We have recorded a robust year of growth during 2014 and have laid a solid foundation for market expansion in 2015.

OSEHRA corporate membership doubled during 2014. Corporate Members include large, medium and small corporations, nonprofits, academic institutions and international organizations that are leaders in health information technology.  Our corporate membership consists of solution providers, vendors, implementers, consultants, system integrators, researchers, and more. They provide highly competitive expertise and solutions to end users around the world. In fact, our primary open source electronic health record product, VistA, was rated by a MedScape survey as the most preferred EHR by physician users again in 2014. Further, our corporate members collaborate on policy, marketing, education and software initiatives. We expect the business opportunities for corporate members to grow considerably next year as the marketplace for open source health IT continues to expand.

PopHealth® is open source software that the Office of the National Coordinator developed over the past several years to facilitate the development of Meaningful Use. Upon completion of initial development efforts, the community of PopHealth developers and users decided to make OSEHRA their new community home in the fall of 2014. We have completed the transition of the code into OSEHRA, and the steering committee has developed a code convergence plan that the community is working on. Though PopHealth was initially developed to generate analytics necessary for Meaningful Use certification, it is now seen as a principal tool for tracking care outcomes in multiple settings, including Medicaid service by the states. OSEHRA welcomes these new members to its community.

The third annual OSEHRA Open Source Summit was held September 3-5 in Bethesda, Maryland.  More than 325 academics, clinicians, developers, government officials, industry leaders, and members participated—with representation from the United States, Canada, India, Jordan, Mexico, Romania, South Korea, and the United Kingdom.

For the first time, the VISTA Expertise Network and OSEHRA collaborated on an engaging technical town hall regarding the future of VistA. Plenary sessions featured an overview of open source business models by our corporate members, tutorials on open source applications, and presentations by Jim Whitehurst, CEO of Red Hat, Doug Fridsma, MD, PhD of the Office of National Coordinator, and Dan Morhaim, MD of the Maryland House of Delegates.  Stephen Warren, CIO at the U.S. Department of Veterans Affairs, provided an overview of VA’s open source strategy. The technical sessions included 70 presentations of health IT issues. The Summit concluded with a highly informative panel discussion on VistA Evolution by a group of senior leaders from VA and VHA.

During the Summit, three outstanding individuals were recognized by the OSEHRA community for their leadership and contributions to open source health information technology and innovative healthcare.  The 2014 Innovation Award was presented to Rob Tweed, Director, M/Gateway Developments Ltd., a company in the U.K. that specializes in web technologies and their role in healthcare.  The 2014 Leadership Award was presented to Christine Rhodes, Veterans Health Administration Director for Open Source Management within the Office of Informatics and Analytics at the U.S. Department of Veterans Affairs, Veterans Health Administration.  A Lifetime Achievement Award was presented to George Timson.  He is best known as the author of Fileman and associated medical applications, implemented in the early 1980’s by the U.S. Department of Veterans Affairs.

We bid farewell to John Halamka, PhD, MD, of Harvard University as he completed his three-year term as a founding member of the Board of Directors. Under his stewardship OSEHRA emerged as a global leader in open source health IT. OSEHRA welcomed Patricia Abbott, PhD of the University of Michigan as a new member of the Board of Directors.

The community was grateful for everyone who participated in the Summit as volunteers, speakers, sponsors and exhibitors. OSEHRA would especially like to thank DSS, Inc. for their conference sponsorship.

This year we have seen a number of significant code contributions:

• An updated version of VistA’s core File Manager module, better known as Fileman, was contributed by OSEHRA member Medsphere Systems Corporation in November 2014 under Apache 2.0 license.  Medsphere’s contribution is being integrated into the Fileman Lab Agile Project (FLAP).  This integration, which is being performed by a select team of VistA community experts, will complete in early January 2015. The integrated product will be offered to VA for deployment at VA VistA installations.
• Two widely used comprehensive VistA-based EHRs were added to the OSEHRA repository in May 2014.  The U.S. Indian Health Service (IHS) contributed the FOIA release of its RPMS (Resource and Patient Management System), while OSEHRA member and Summit sponsor Document Storage Systems (DSS), Inc., contributed its vxVista EHR. Visitors to the OSEHRA repository now have access to current versions of three of the strongest open source EHR products -- FOIA VistA, RPMS, and vxVistA -- in the marketplace.
• OSEHRA is working with member Oroville Hospital to make available an open source adapter that will ease the community’s transition to proprietary drug interaction information as VA discontinues distribution of its open-source drug interaction table in 2015.

As can be seen from the above contributions, the OSEHRA community’s strength derives from its members and from their products. The Corporate Members of OSEHRA convened a Code Alignment Workshop in Oakland, California, during November 2014 at which more than a dozen OSEHRA members and groups were represented.  The Workshop created and committed resources to a project that, over a series of stages, will produce an OSEHRA VistA core from which the entire open source community -- from VA enterprises to integrators and developers -- can build and deploy safe, reliable, preferred products based on the world’s most widely deployed EHR.

In 2014 OSEHRA has further clarified the policy and practice of software licensing. The Apache 2.0 license minimizes effort to take up and modify code and, if desired, to re-contribute changes, extensions, and upgrades to the community.  At the same time, contributors and users can be assured of a clear chain of attribution and licensure for all code in the OSEHRA repository.  A simple attribution policy document stating these principles was developed during 2014 and adopted by community consensus.

OSEHRA developed Visualizing VistA And Namespaces (ViViAN), a tool in which VistA products are presented via a variety of tree, circle, and bar graph structures. Technical specialists can drill down to individual module details and even into the source code.  The latter capabilities make ViViAN especially valuable for training new developers.  Later in 2014 we developed and deployed ViViAN views for vxVistA, OSEHRA VistA, and also produced a capability view for the Veterans Health Administration’s Business Function Framework (BFF). ViViAN greatly improves overall transparency of the VistA code base.

OSEHRA community members including Veterans Health Administration have developed many enhancements and extensions to VistA code. Recognizing the value of these improvements, VA developed the VistA Intake Program (VIP) to allow streamlined adoption of  modernized VistA code as well as improvements made available by the community through OSEHRA certification process. Adoption of community innovations will strengthen VA’s VistA, benefiting VA medical centers, OSEHRA community members and all implementers of VistA.

As demonstrated, the year of 2014 has been a period of solid community building and the creation of robust software foundation and tools to make VistA the best electronic health record for the Veterans, Americans and friends around the globe.  The pace of innovation will accelerate the adoption of open source as the most desired health IT solution for all.

The 2015 OSEHRA Open Source Summit will commence July 29-31 at the Bethesda North Marriott Hotel and Conference Center.  Plans are underway, and registration and sponsorship opportunities will be available by February 1, 2015, at summit.osehra.org.  We anticipate another exciting and successful event, and we look forward to seeing you at the Summit!   

Wishing you a Happy and Prosperous New Year.

Seong Ki

Seong K. Mun, PhD
President and CEO
OSEHRA Inc.
Arlington, Virginia
USA