OSEHRA at a crossroads


Signs are that the Open Source Electronic Health Record Agent might not be living up to its promise. It's too early to say so declaratively, but we've reached the point now where a combination of apparent slowness and possibly questionable practices could require the Veterans Affairs Department to rejigger the project.

OSEHRA is meant to be the open source repository for the VA electronic health record, VistA, as well as an active hub whereby the agent initiates open source projects, accepts or rejects other proposed projects, and manages the process of placing code into the codebase.

But (as one open source proponent pointed out to me), the actual VistA code itself hasn't been touched in 4 months.

It could be, the proponent told me, that the ground work necessary for converting VistA into the open source iEHR (the joint VA-Defense Department EHR which VistA is meant to metamorphose into) has required OSEHRA to gather reams of documentation before proceedings, as it appears to be doing.

Nonetheless, "to someone who's never developed VistA before, things are moving pretty slow."

Also, the VA's recent sole-sourcing of two OSEHRA-related contracts to the same Florida-based service-disabled, veteran-owned small business--with each contract reeeeeeaaaal close to the VA's $5 million threshold limit for SDVOSB sole-source contracts--suggests the potential for this open source project to be dominated by a limited set of favored contractors rather than being a truly open effort.

There may be nothing untoward in the award of those two sole-source contracts--made within 2 months of each other and for related work--but sole-source contracts by their nature often spring up from the opaque world of connections and mutual comfort. The company, Ray Group International, now has a contract to refactor VistA code, and it received it without VA officials comparing its proposal against others'.

The suspicion of many is that the Ray Group will now go off on its own "and drop a code bomb on OSEHRA in six months' time" without community input.

That the VA set up OSEHRA in the first place is laudable. But it seems we're at a point where the VA must now ensure that its original intentions are truly realized, rather than submerged in murk. - Dave