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Could Open Source EHRs Expand Beyond Public Sector?

October 8, 2012
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VistA developers band together to work toward MU Stage 2 certification

In a recent blog post, John Halamka, M.D., noted that within the next few years more than 200 hospitals and 1,000 clinics within the federal sector will be managing and maintaining their EHRs using open source software, adding that activities in the open source arena “create a significant market opportunity for both private and public sectors.”

Halamka, CIO of Beth Israel Deaconess Medical Center, has more than a passing interest in open source. He is on the board of directors of Open Source Electronic Health Record Agent (OSHERA), a nonprofit organization set up to facilitate open source EHR work, and he will speak in a panel session at its first annual summit meeting Oct. 17-18 in Washington, D.C.

One question for attendees is how the open source development being done in the Department of Defense, Veterans Administration, and Indian Health Service can spread to impact a broader segment of the healthcare arena. Could the collaborative nature of open source work be attractive to CIOs developing new types of clinical data repositories to measure quality?

Last week I had the chance to interview Seong K. Mun, PhD, president and CEO of OSEHRA, about the upcoming meeting. He told me that the group was established as a nonprofit 15 months ago by a partnership of DoD and VA. Its mission is to promote open source EHR within government agencies and in the private sector.

“We see the pace of open source EHR adoption as considerable, both here and overseas,” Mun said. “One of the largest hospitals in India is implementing the VistA EHR. We are also seeing more interest at the state level, for instance from public health agencies.”

One hindrance to wider adoption of open source has been what Mun calls a “museum” model. “Developers write beautiful code and make it available, but there are no support documents or testing routines, so they are difficult to use and the new users have to work backwards from that,” he added. “We are trying to work toward better documentation so that as third parties reuse it, they will have more success.”

Speaking at the summit meeting will be Robert Wentz, president and CEO of Oroville Hospital in California, which has achieved meaningful use with an open source EHR. Oroville Hospital adopted the VA’s VistA in its153-bed hospital as well as 17 of the 20 clinics the hospital owns.  After customizing the software for its own needs, Oroville will be contributing the software back to the community so that other hospitals can take advantage of the open source product.

OSEHRA is working with its members to create a collaborative work platform and code repository. “One of the exciting things we are working on now is a commitment from VistA organizations, both public and private, to use our facilities to collaborate on working toward meaningful use Stage 2 certification as a group,” Mun said.

Next week’s summit sessions will cover topics such as big data, clinical genomics, molecular medicine and the secondary data use architecture required to support personalized medicine. Experts will discuss topics including open source interoperability, security and testing. Leaders from the open source sector in areas other than healthcare will offer their perspectives.