Devil is in the open-source details

Although the Veterans Affairs and Defense departments are equally committed to deploying a joint electronic health record system in the next four to six years, the VA is more enthusiastic about the role of open-source development in the process, according to  VA CIO Roger Baker.

“It is clear the VA is wholeheartedly embracing it [open-source development], while the DOD views it as an asset,” Baker told reporters in a conference call on May 27.

The VA currently is seeking a custodial agent to operate an open-source development ecosystem to modernize its longstanding Veterans Health Information Systems and Technology Architecture (VistA) digital medical records system. The custodial agent is expected to be in place in two months, Baker said.

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Meanwhile, the VA and DOD secretaries decided in March to implement a joint records system that uses a single database and a single graphical user interface. The interface is being tested at facilities in North Chicago and in Hawaii and is expected to be available by July, Baker said. The joint system would subsume the VA’s VistA and DOD’s Armed Forces Health Longitudinal Technology Application.

The cabinet secretaries met on May 2 to approve several business rules for the new joint platform, including agreements to use commercial technology when available; to adopt solutions developed by VA or DOD when commercial solutions are not available; to jointly approve new application development; and to use jointly all new applications developed, according to a memo summarizing actions taken at the meeting.

Although the business rules described in the May 2 memo did not specifically mention “open-source” applications and how open-source development fits in the business rules, Baker said he does not anticipate any problems in that area.

“We have spent six months working through open source with the DOD and the Hill answering that question,” Baker said. “We are confident that they [commercial and open source] go together and that open source is a substantial asset to facilitate our ability to work with the private sector.”

Baker said he sees several commercial vendors developing software “wrappers” that will allow their applications to interface with the open-source code of VistA. The wrapper could be proprietary, or it could be contributed to the open-source ecosystem, he added. In the latter case, the vendor would retain some of its code for a proprietary application.

Asked if the VA, under the business rules, would need approval from DOD for any joint applications to be developed through the open-source process, Baker said he did not view it that way.

“I look at it as not, ‘I have to get approval,’ but ‘I want to make sure we are in agreement,'" Baker said. “There has got to be a lot of goodwill in doing this stuff, and there is at this point.”

The VA and DOD secretaries are to meet again on June 23 to discuss the joint digital medical platform.