Questions loom about the future of open source at VA

The CIO for the Department of Veterans' Affairs sought to reassure stakeholders that the agency was committed to open source in the future, but with Congress pressuring the agency to give up the homegrown health record system VistA, the open source community is a bit perplexed. 

"We really had to think about our open source platform…that is where we will be working over the next few years," CIO Laverne Council said at a conference in Maryland on June 28.

The Open Source Electronic Health Record Alliance, which hosted the conference, provides commercial access to the VistA software to hospitals and health care systems. The group is understandably concerned about whether VA intends to support development of VistA beyond the scheduled round of releases under the current modernization program.

Council has told Congress that VA is re-evaluating where VistA stands post-2018. Undersecretary for Health Dr. David Shulkin has noted that the future of VistA might be more cloud-based, rely on commercial off-the-shelf products, or a mixture of both. That leaves the open source community wary of what the future might hold.

"The people who have just arrived into the VA don't know about VistA, whether or not they realize what they've got and why it would be hard to shift from it," Nancy Anthracite, a group leader for OSHERA, told FCW. She said "the users really like it," and noted that newer commercial products might not be compatible with VA's business processes and approach to patient care.

The solution for moving toward more of an open source environment may depend on the VA's digital health platform. Council said that is "really the direction we should go. We believe that VistA….is a viable resource but not the only viable resource. The real question is ... how do you create a platform that others can innovate on?"

"As we were thinking about VistA and the importance of VistA," Council continued,  "the question was really how do we get the biggest motivators to think about it differently. And EHR is a heartbeat to the system."  But it is not the entire system, she said, adding that clinical management, clinical operations are also important aspects that need to be "done well" for a better veteran experience.

The Obama administration is pushing the use of open source in government more broadly. A recent draft policy would create a new set of rules for custom code developed by or for the federal government to be more open, sharable and reusable.