VA-DoD joint EHR to be commercial, not necessarily proprietary

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The future Veterans Affairs and Defense Department joint electronic health record system will not necessarily be built on proprietary software, said VA Chief Information Officer Roger Baker--despite a leaked memo that emphasizes "commercial solutions" for the project.  

"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," Baker said in a statement to FierceGovernmentIT.

Leaked minutes (.pdf) from a March 17 meeting of DoD and VA officials said the agencies are looking to purchase commercially available solutions for joint use and "adopt a Department-developed application if a modular commercial solution is not available and one Department has a solution."

"People often use 'commercial' and 'proprietary' interchangeably," said Gunnar Hellekson, chief technology strategist for Red Hat's U.S. Public Sector group, making it difficult to determine what type of solution is sought by DoD and VA. Agencies should treat open source software as a type of commercial software, following guidance in a 2004 Office of Management and Budget memo (.pdf) and a 2009 DoD memo (.pdf) on the subject.

"Open source is, especially in the government marketplace, something you need to explain a lot about," conceded Baker in a March 28 press call.

Baker would not say whether DoD officials feel the "commercial" solutions mentioned in the memo should be proprietary, but he did say DoD and VA will have "the same solution, a common electronic health record system."

He also said that it will "incorporate a lot of proprietary products, but VistA today incorporates a lot of proprietary products."

"Open source is the how, from a VA perspective, and the joint electronic health record system is the what, from a VA-DoD perspective," Baker said.

The secretaries of both departments are set to meet May 2 to discuss a transition plan from the installed legacy base to the new joint EHR.

"What's important here is the common standards piece. What we also want is maximum availability of commercial software and maximum ease of plugging that commercial software into the joint EHR," said Baker.

An industry source with close knowledge of the DoD-VA joint EHR discussions said DoD is "trying to go down a path of buying a COTS product despite the fact that VA is moving forward with an open source custodial agent RFP." Baker said the VA would like to have the custodial agent up and running by July 1.

The industry source said the ambiguity of the term "commercial" and the leaked memo are "face-saving gestures on the part of DoD," because it doesn't like that VA is pushing strongly for open source solutions.

"VA is not going to say 'I can't move forward unless DoD cooperates.' That's a way of giving DoD a veto," he said. "DoD has spent several billion dollars over the last 20 years [on building an EHR] and it's come up with crap. Eventually DoD will have to come to the table and work with VA."

For more:
- listen to the press call
- see the leaked memo 

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