Military won't wait on EMR choice

All this reads like a decision to sunset VistA has been made. Is anyone in Congress willing to get in front of the decision train?

S. Ward Casscells, Assistant Secretary of Defense for Health AffairsThe Military Health Service hopes to make a decision next week on an Electronic Medical Record (EMR) system which could sunset the VA's open source VistA system.

The decision is being taken due to the continued foundering of the military's Armed Forces Health Longitudinal Technology Application (AHLTA), a proprietary system developed by Northrup-Grumman.

A Northrup-Grumman spokesman insisted to Bob Brewin of Government Executive that an upgrade to their system is now in beta test, and the company wants to keep control of AHLTA.

Dr. S. Ward Casscells (above), assistant secretary of Defense for health affairs, and a former cardiologist with the UT Health Science Center in Houston, said the decision follows an online town hall where many users called the present system "intolerable."

A press release from the military issued Monday insists no decision has been made but says the service is being pressed by Congress toward a decision.

The author of that press release, Stephen Jones, apparently responded to the Government Executive article by writing "Using the current form of VistA or AHLTA will not work. Trying to morph the two together will not work."

Despite the failure of the proprietary system and the continuing success of VistA, which spawned an open source project and corporate support group, Medsphere, Casscells called VistA  "antiquated technology."

To some activists this is a hint the military will try to just create another, bigger contract like the one with Northrup-Grumman, only with a commercial vendor like Microsoft or Cerner, folding VistA into it.

Cerner won a contract to take over computing for VA labs last year.

In his response to the Government Executive article, Dr. Casscells also wrote:

Most experts tell us that the risks to patients, and dollar costs, of replacing AHLTA with VISTA would be too high, that there is not yet a plug-and-play commercial system that we could buy. So we may well end up trying to upgrade both VistA and AHLTA in coordination, aiming at convergence but at least assuring increasingly detailed and reliable 2-way exchange of data, to the point of real interoperability. The final product is not likely to be very similar to today's VistA or AHLTA, but most clinicians like the look and ease of the VistA GUI.

All this reads like a decision to sunset VistA has been made. Is anyone in Congress willing to get in front of the decision train?

The article also indicates the military wants to talk to Google about its Personal Health Record (PHR) system before making a final recommendation. If the company really wants to fly the open source flag it will give the military a piece of its mind.

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