ie8 fix

VistA proves its value

By | April 12, 2010, 8:26am PDT

Summary: Would the results have been equivalent had the study been done on the military’s proprietary AHLTA system? Past reports have indicated the answer to that would be no.

The VA’s VistA electronic medical records system saved taxpayers $3 billion over 10 years and greatly improved patient care.

The report was done by the Center for Technology and Innovation Leadership, and it must be made clear they have an organizational bias.

CTIL is part of Partners Healthcare, which has provided the Obama Administration with its health IT leadership and the heart of its reform agenda.

The key takeaway CTIL wants you to understand is that spending money on health IT is good.

“While the VA historically has spent a higher proportion of its budget on health IT, it has achieved a very high level of HIT adoption when compared to industry norms,” said Dr. Colene Byrne, CITL Senior Analyst, and Principal Investigator of the study.

Dr. Byrne added, “The VHA greatly exceeds industry norms in outpatient electronic health record (EHR) adoption and in selected outpatient quality measures that are reflective of the use of automated clinical reminders. The VA’s quality measures for diabetes care averaged around 16 percentile points higher than private sector benchmarks based on the Medicare population.”

Of course not all spending is created equal. The VistA system is open source — it was developed as public record software before open source was a gleam in Eric Raymond’s eye.

This means the people who created these savings were government employees, not just contractors. But Veterans Administration head Eric  Shinseki did not take note of this in his statement:

“VA has seen its investment in health information technology pay off for Veterans and taxpayers for many years, and this study provides positive evidence for this correlation,” said Secretary of Veterans Affairs Eric K. Shinseki. “The benefits have exceeded costs, proving that the implementation of secure, efficient systems of electronic records is a good idea for all our citizens.”

Open source was not the point of the study. The efficacy of health IT was. The VA simply has a longer record of using health IT than others.

But the question should be asked. Would the results have been equivalent had the study been done on the military’s proprietary AHLTA system? Past reports have indicated the answer to that would be no.

So how you spend IT money means as much as whether you spend it. That’s the report I’m waiting to read from Partners and from the Obama Administration.

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Disclosure

Dana Blankenhorn

Dana Blankenhorn has been a journalist, writer and part-time futurist for over 30 years. At the present moment I run only a personal blog in addition to my ZDNet open source blog. DanaBlankenhorn.Com has the subtitle The War Against Oil. In the past I have used it to write about political history, e-commerce, personal matters, some ideas related to open source, and The World of Always On, which is the idea of using sensors, motes and RFID to turn WiFi links into platforms for applications which live in the air. My IRA account at Schwab holds a few tech shares, most notably some Intel and Applied Materials, but there are no open source companies in it. I don’t even own any CBS stock.

Biography

Dana Blankenhorn

Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994.
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It's called competition
DanaBlankenhorn 14th Apr 2010
There will be market competition in the EMR space. Yes. Is that guaranteed to raise health care costs? You may believe it does, and you may be right, but providing a government-endorsed monopoly to open source projects is not in the cards.
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Allscripts political connections.
ivaldes1 12th Apr 2010
With the very proprietary Allscripts company principles having the ear of the president due to large campaign contributions, I wonder if open source EHR systems like VistA will ever get their due. Read Health IT Brewsters Millions: http://linuxmednews.com/1270823025/index_html
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The connection is unproven
DanaBlankenhorn 12th Apr 2010
Politicians have contributors. Contributors may
benefit from government decisions. That does not
always mean a quid pro quo.

The test is whether a level playing field is
created under which many people who were not
contributors benefit equally, whether the
contributor was given unequal treatment in the
development of the regulations.

Your link is to an article by Ignacio Valdes,
who seems to want proprietary technology
excluded from stimulus money.
http://linuxmednews.com/1270823025/index_html
That was never in the cards.
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RE: VistA proves its value
ivaldes1 12th Apr 2010
Possibly but there is such a thing as political calculation, influence, and the appearance of equal playing field but not the reality. The reality of proprietary EHR systems is that they are inherently not a level playing field, inherently not a true capital market, and inherently limit customer choice.

The political reality is that money talks or at least purchases access to politicians. The president has a million reasons to talk to Allscripts.

-- IV
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So you admit your charge is unproven?
DanaBlankenhorn 12th Apr 2010
If anyone is to make a charge against any
politician I would hope they would have more
than the fact that a successful company
contributed money.

There is no evidence that policy has been
impacted. Yes, SaaS outfits like AllScripts
benefit more from the current meaningful use
rules than do those selling hardware and
software. Yes, AllScripts is a SaaS outfit.

But there are many others benefiting in equal
measure. Much of AllScripts' bottom line
improvements are attributable to its e-
prescribing unit, not just its EHR.

AllScripts was well-positioned before 2009,
within its market. Its management is well-
respected beyond their role in supporting the
Administration. Other SaaS outfits also benefit
from the new situation.

The point of this story is that open source
VistA has proven its bottom line value. I think
that's a better way to make the case for open
source than to accuse AllScripts of buying the
government.
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Why a subsidy then?
ivaldes1 12th Apr 2010
Political campaign contributions and paid lobbyists have no influence?

If proprietary EHR companies were doing so well and lots of happy customers then why the enormous ARRA subsidy?

-- IV
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To stimulate the benefits shown here
DanaBlankenhorn 12th Apr 2010
The reason health IT was included in the
stimulus was to get the kinds of results across
the board that the VA got with VistA.

There are many examples in private industry of
hospitals saving big bucks on providing care
from health IT. The hope was that you could get
both economic growth and start getting a handle
on health care costs.

I strongly suspect the health IT industry, like
other industry groups, contributed much larger
sums to the Republican Party in the 2008
election than the Democratic Party.

The fact of political contributions does not
qualify any individual or group from seeking
policies amenable to its growth.

Were that the case, no one would be allowed to
contribute to a political campaign. Because
everyone of us has an interest.
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Invasive species allowed.
ivaldes1 12th Apr 2010
Yet ARRA in its present form does not require open source or follow VA model. It allows invasive proprietary EHR species to proliferate using public funds. Public funds will be allowed to disappear into private property to a large degree.

The few times in history when VA went or tried to go proprietary EHR it has caused serious (and expensive) problems which were sometimes not apparent for many years or decades.

-- IV
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It's called competition
DanaBlankenhorn 14th Apr 2010
There will be market competition in the EMR space. Yes. Is that guaranteed to raise health care costs? You may believe it does, and you may be right, but providing a government-endorsed monopoly to open source projects is not in the cards.
0 Votes
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nt
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Well, yes
DanaBlankenhorn 14th Apr 2010
As the population of veterans increases, thanks to the wars of the last 10 years, then the cost to care for them will increase regardless of any cost controls, and the tax revenue needed to sustain that care will have to increase.

How is President Obama responsible for that? Well, he's drawing down slowly in Iraq aqnd continuing in Afghanistan.

Beyond that, health reform in general will reduce the deficit, and the need for taxes, according to the CBO, which both parties see as an impartial referee on those questions.

Unless we can control general health care costs, no deficit reduction program can succeed. Poor people, old people, military and veterans are all getting their care from the government.

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