What Obama promised open source health IT
He has not guaranteed anything.
George Lauer of iHealthBeat wrote last week that the President "chose" VistA and open source Connect for its military records program.
That is not the case.
Sun's work on the NHIN-CONNECT system was contracted for under the Bush Administration. The President promised to "link" the VA's current VistA system with the military's AHLTA system, and he promised our heroes interoperability, but that is all.
The same is true in the larger health IT stimulus plan, HITECH. CCHIT still controls functional requirements needed for certification, which in turn is needed to get paid. But as Fred Trotter notes, whether CCHIT will actually certify open source solutions remains unclear.
Important questions remain unanswered:
- Will VistA be upgraded or replaced with a proprietary system?
- Will AHLTA be moved to the VistA platform or just connect with it?
- What hoops will open source have to jump through in order to participate in HITECH?
So far, under the Obama Administration, open source has been riding momentum generated during the second Bush Administration.
Its acceptance by the military is based on performance under past contracts. VistA's survival seems to have depended more on Dr. Robert Kolodner, a Bush appointee, than anyone on the Obama team.
What open source seems to be getting from the Obama Administration is a shot, a chance, a foot in the door. But there is a big distance between being allowed to present and being given a contract.
Proprietary vendors, especially in the health care space, are experts at creating Fear, Uncertainty and Doubt (FUD) concerning open source. They will offer government "proven solutions" while open source advocates will offer tools the government might build on.
If this now becomes a standard contracting process, in other words, open source can still be shut out. The other guys have more salesmen. They can schmooze whoever needs schmoozing, and grease whatever palms need greasing to get what they want.
What we need are policy statements favoring a "build" process over a "buy" process, and demanding open standards, preferably royalty-free standards, for government contracts.
We don't have them yet, so the jury is still out on the Obama Administration and open source in health IT.