tag:blogger.com,1999:blog-3503957686158274288.post3785463700104306269..comments2024-03-12T12:32:15.598-05:00Comments on On Health Care Tech & Policy: Should the DoD Buy Epic, or Cerner, or GE, or…?Margalit Gur-Ariehttp://www.blogger.com/profile/08777722834145614546noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-3503957686158274288.post-38593751423489928362013-07-14T13:57:20.441-05:002013-07-14T13:57:20.441-05:00My apologies Joseph, and thanks for the correction...My apologies Joseph, and thanks for the correction. The post has been updated.<br /><br />I would suggest that you guys update the "WorldVistA EHR" page on your website, which seems to be stuck at the 2008 CCHIT certified version, as well as the News page.Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-16787957934102977712013-07-14T13:12:11.656-05:002013-07-14T13:12:11.656-05:00Margalit,
"As to WorldVistA, the last releas...Margalit,<br /><br />"As to WorldVistA, the last release I am able to find is from 2008 (CCHIT certified). Is this considered active development?" <br /><br />Goodness you didn't look in the most obvious places to find the latest version... the WorldVistA homepage and the software download page. Both pages clearly show that WorldVistA V2.0 was recently released and passed full certification for both inpatient and ambulatory settings... the only non-VA VistA version to accomplish this. <br /><br />If you were part of the VistA community you would be aware of the many active projects that WorldVistA's team and extensive network of collaborators are involved in which produce these updates. For example: moving the MOCHA drug database web service to an open source platform; porting, with the help of Jordan's EHS, the EDIS emergency department package to open source, and working to meet MU2 requirements. WorldVistA has 4 to 5 development related conference calls a week related to these efforts and is one of the most active contributors the various activities at OSEHRA. In other words WorldVistA EHR development done primarily via a distributed, collaborative community model. This is how VistA was developed at the VA and is the most robust and sustainable business ecosystem for open source in healthcare. Unfortunately this is something the DoD doesn't seem to get, yet... while other big health systems do.<br /><br />I recommend you do your homework before blogging if you want to be taken seriously. If you aren't certain about a fact email those who can answer it, otherwise, to quote Crunchy your blog reads like “infomercial for an embedded interest”.<br /><br />Joseph Dal Molin<br />Chairman, WorldVistAJoseph Dal Molinhttps://www.blogger.com/profile/10985376317116630422noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-11117672959162294422013-07-14T10:13:37.404-05:002013-07-14T10:13:37.404-05:00Hello Crunchy,
First let me say that I have no dog...Hello Crunchy,<br />First let me say that I have no dog in this fight, other than my taxes, which I would very much like to see put to good use. So hopefully in order, but not necessarily:<br /><br />1) All large EHR products are old technology, and VistA and Epic are probably more similar than any other two. I would say that large software is always going to be old because it takes time to grow large. So I am not too terribly disturbed by the "old" description.<br /><br />2) Salvage is not pejorative. It is what you do to keep old stuff alive and updated. The alternative is to accept that every software reaches a natural end of life, and go buy/build something new. Unfortunately, there is nothing much newer and building will take a decade.<br /><br />3) I don't see how the battle ground is or can be about the source code. Unlike the VA, the DoD is not deciding between built in house or purchased. Both alternatives are going to be purchased for the DoD. One may be significantly cheaper, but both are outsourced. Certainly, from this point onwards the DoD can bring development in house for either one (see the Epic deployment at Kaiser). I actually agree with you that IT departments should be kept in house for large organizations and had this exact conversation the other day on G+.<br /><br />4) The DoD according to Mr. Kendall, has received 3 out of 15 proposals that are VistA based, one from the VA itself, so I guess the DoD just wants to compare its options? If they wanted VistA they could have saved us all tons of wasted money going back many years....<br />As to World VistA, the last release I am able to find is from 2008 (CCHIT certified). Is this considered active development?<br /><br />5) I love open source (I come from the Java world). But open-source is in my opinion for parts, not for complete products. You get some parsers, some loggers, some this and some that, and build your product. I don't know of anything worthwhile for a large enterprise that you download from sourceforge and call it a day. Maybe if the DoD was actually building an EHR in house, shopping for tried and true open source utilities would be great.<br /><br />6) That line about using public fund to build secret software was sarcastic. Of course it should be public, but is it? What publicly funded software is open to the public? PRISM? This is the Pentagon we are discussing... A certain level of realism is I think in order...<br /><br />Thank you for your thoughtful comments.Margalit Gur-Ariehttps://www.blogger.com/profile/08777722834145614546noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-85297399274384889172013-07-14T09:21:36.790-05:002013-07-14T09:21:36.790-05:00It's easy to tell you spent a good bit of time...It's easy to tell you spent a good bit of time putting this together...well done. Since this is an opinion piece, here's my two cents worth...because there are a couple of comments maybe we should all think about...<br />1. The iEHR was never really an effort to work with VistA if you take the gap between form and function into account...it was an inside attempt to get the inconvenience of a working eHR (VistA) out of the IT acquisition path. Agreed on the fantasy detour.<br />2. It's interesting that EPIC is recognized as a potential answer but no one mentions it is the same old technology as EPIC...and by your apparent definition SQL tech would be old as well. From what I have seen, GE and Sieman's are also based in the same technology. I can't speak to Cerner.<br />3. So your comment about a “salvage operation” exposes a fundamental poverty of information on the systems...as well as pejorative intent. When the VA exposed the source code of VistA as public domain...a large percentage of the eHR companies out there simply stood up an instance, put their name on it and started selling their “brand”. It's the American way...apparently.<br />4. Accordingly, your flavors discussion is a fairly accurate description of the “American way” trivialising the skepticism these untested approaches clearly deserve. If this was an easy task it would have been solved. It is a dis-service to infer otherwise.<br />5. Your seem to believe the battle ground is not about the source code...I beg to differ. I don't have space or inclination to debate this fundamental concept...except to say it is ALL about the source code. We have to accept IT departments as a fact of life...oursourcing mission critical capability is a VERY short-sighted plan.<br />6. The DoD has not rejected the option of adopting VistA...this is fiction. Over the last week the House Armed Services Committee and House Veteran's Affairs Committee have jointly met to hear testimony...I refer you those meetings. DoD expects VistA participation...<br />7. It is also clear you don't buy in to the open source concept...but using “hope and pray” is nothing less than mis-characterization of the concept...which is clearly targeted at the uninformed...what is your motive?<br />8. WorldVistA is in active development at all times...I can't decide if you know the truth and are trying to hide it or if you don;t know what you are taking about...either way it is repugnant. There are several other VistA variants AND for that matter convergence between standard coded variants is close to trivial...so your point is moot...except for the motive.<br />9. Could you please explain why an intellectual property 100% built using 100% public funds should NOT be public property...this concept amounts illegal conversion of public funds...IMHO.<br />Finally, my global response to this somewhat preposterous effort leads me to believe you speak in ignorance except for the pejorative tone and question of motive.<br /><br />I just think readers need to know this reads like an infomercial for an embedded interest. I have many problems with much more than I stopped to mention. <br /><br />Look elsewhere for authoritative, accurate and/or unbiased information.Crunchyhttps://www.blogger.com/profile/18047470787681242504noreply@blogger.comtag:blogger.com,1999:blog-3503957686158274288.post-24080306904896022512013-07-13T21:05:43.605-05:002013-07-13T21:05:43.605-05:00Is no surprise DoD is looking into a commercial pr...Is no surprise DoD is looking into a commercial product. That has always been their hidden agenda. And how is it not possible, Epic's owner seats at some of the government HIT committees. Talk about conflict of interest.Anonymousnoreply@blogger.com