VA's Baker says VA, DOD digital record systems will morph into joint system

Roger Baker, the Veterans Affairs Department's assistant secretary for information and technology, offered some details about how the VA and Defense Department are going to meld their digital medical record systems.

“Use of open source is for VA the ‘how’ of getting a joint system. For DOD, open source is the ‘what’ of the system,” said Baker, who also is the VA's CIO.

The Veterans Affairs and Defense departments’ approaches to modernizing their health record systems may be slightly different, but their goals are aligned in developing a joint electronic health record (EHR) system, according to Roger Baker, assistant secretary for information and technology for the VA.

Baker offered several details about the VA's pending development of a joint medical record system with DOD, while speaking in a conference call with reporters April 28. A transcript of the discussion was released afterward by the VA.

Concerning DOD officials’ recent statements that they may be looking at commercial solutions first for the joint record system, while the VA is modernizing its Veterans Health Information System and Technology Architecture (VistA) system with an open-source approach, Baker said there is no conflict between the two approaches. He described the VA’s open-source development as a means of examining commercial products.


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“Open source and ‘looking at commercial first’ go well together,” Baker said. “It [looking at commercial first] is, in fact, what VA intends to accomplish, and has specifically said many times, through open source. While we’re not prepared to talk in detail about our plans, VA and DOD have agreed that VA’s use of open source as the model for development of VistA fits within our mutual plans for the Joint Common Electronic Health Record.”

Whatever joint solution is chosen, it will be the same solution for both departments, and will likely include many proprietary products, which VA currently has in VistA, Baker added.

“The private sector is developing EHR systems faster than government is," Baker said. "The two departments will have the same collection of software, but the standards will be the first and more important part of a joint system. For example, VA might ask vendors to build a patient scheduling package that will accommodate open source."

Asked what steps will taken for both VA and DOD systems to become a single system, Baker said the systems will “morph.”

“VA will evolve from VistA to a new EHR system," he said. "We will have incremental upgrades, using the PMAS [Performance Management and Accountability System]. We will transition from VistA, and DOD will do that with AHLTA [Armed Forces Health Longitudinal Technology Application]. In five to 10 years there may be no more VistA code remaining, but our users will not notice any difference.”

The VA and DOD secretaries will meet May 2 for the next discussion on the issue, he said.

Baker also said the VA hopes to have an open-source development ecosystem of VistA operational by July 1.

The VA recently sought proposals for a custodial agent to operate the open-source development of VistA.

The target date is July 1, Baker said. “That’s an aggressive target, feasible because many people had the opportunity to discuss this with us, and we can expect the selection of a custodial agent to be fairly straightforward.”