Industry anticipates MUMPS decision on VA's VistA modernization

As the Veterans Affairs Department considers an open source development program to modernize its Veterans Health Information Systems and Technology Architecture (VistA) medical record system, officials eventually will have to decide whether to retain all or part of the existing computer language of the system, according to industry members involved in the project.

The VA recently issued a Request for Information asking industry members to address concerns related to the proposed adoption of an open source development plan for VistA, including licensing and governance structures.

Though the RFI did not explicitly mention the MUMPS (Massachusetts General Hospital Utility Multi-Programming System) programming language that is the basis of VistA, many industry members believe that it will be necessary to make a decision on whether to quit or retain MUMPS before, or during, an open source modernization program for VistA.

The topic is generating strong opinions among industry members.

Stakeholders include executives with a financial investment in existing open source VistA applications retaining MUMPS. For example, MedSphere Systems Corp.’s OpenVista is currently used in a modified form by the Indian Health Service and a number of public and private hospitals. MUMPS also is used in several other commercial electronic health record systems and in the banking industry.

“For modernization of VistA, we are recommending MUMPS for heavy-duty transaction processing,” said Rick Jung, chief operating officer of MedSphere. “MUMPS’ power to rapidly process transactions is unparalleled.”

MUMPS ought to remain the core of VistA, while other computer languages could be used for developing applications for related processes such as pushing data out to physicians, Jung said.

Ed Meagher, who chaired the American Council for Technology- Industry Advisory Council VistA Modernization Working Group chartered by the VA, said the group recommended that the VA consult with a federal laboratory to determine if MUMPS should be retained for VistA. He said the working group members anticipated controversy if they addressed the MUMPS question, and sought to avoid it.

“Why should we pick that fight? Let the experts decide,” Meagher said in a recent interview with FCW.

However, Meagher added that in his personal opinion, MUMPS should not be retained as part of a VistA modernization because it is outdated and because he claimed few MUMPS programmers are being trained.

“Is MUMPS the right entity? I think the obvious answer is ‘no,’” Meagher said. “It just happens to have a bunch of very committed people who want to stay in that environment.”

“MUMPS is a small community, not state-of-the-art,” Meagher added. “Where are you going to find MUMPS programmers?”

But Jung asserted that MedSphere has had no problems finding MUMPS programmers and the company is working with academia to strengthen training programs.

“There are many misunderstandings about MUMPS,” Jung said. “We have found no lack of development talent for MUMPS.”

Meanwhile, both Jung and Meagher said they were pleased with the RFI and with VA Chief Information Officer Roger Baker’s recent statements about making a decision on whether to proceed with an open source VistA modernization by year’s end. VA officials were not immediately available to comment about retaining MUMPS.

“We look forward to working with Mr. Baker to facilitate the time frame,” Jung said.

“We are dealing with very important issues, and so far, no one has brought up any problems,” Meagher said. “There are challenges and concerns, certainly, but no one has said there are problems.”