What’s been described as one of the most effective and popular computerized medical records systems traces its roots back 40 years. In Politico, Arthur Allen writes, “Four decades ago, in 1977, a conspiracy began bubbling up from the basements of the vast network of hospitals belonging to the Veterans Administration. Across the country, software geeks and doctors were puzzling out how they could make medical care better with these new devices called personal computers.”
The result is now called VistA (Veterans Information Systems and Technology Architecture). It owes its success, Allen writes, to the fact that doctors were brought into the loop early on to help define how VistA would organize prescriptions, CAT scans, and patient notes, for example.
Allen quotes VA IT veteran Howard Hayes as saying, “We didn’t call it ‘agile development,’ but it was agile,” with “tight relationships between user and programmer, and sometimes they were one and the same.”
Allen adds, “As recently as last August, a Medscape survey of 15,000 physicians found that the VA system…ranked as the most usable and useful medical records system, above hundreds of other commercial versions marketed by hotshot tech companies with powerful Washington lobbyists.”
But the VistA system is showing its age. Budget cuts, reorganizations, and the departures of the system’s developers have taken a toll. And although VistA excels at clinical care applications, Allen says, it lacks commercial hospital systems’ billing-handling capability.
“You’d have to be a very brave VA administrator, and perhaps a foolhardy one, to keep VistA in 2017,” writes Allen. “The system’s homegrown structure creates security and maintenance challenges; a huge amount of talent has fled the agency, and many Congress members are leery of it.”
Consequently, officials are determining whether to scrap VistA and replace it with a commercial system at an estimated cost of $16 billion, Allen reports.
A decision on VistA’s replacement is scheduled for July 1. Read Allen’s complete article here.
