- The Open Source EHR Alliance (OSEHRA) is creating a new version of its Veterans Health Information Systems and Technology Architecture (VistA) EHR system designed for international implementation.
VA established OSEHRA in 2010. VistA comprises more than 100 integrated applications and currently supports patient care delivery at 152 VA care sites and 928 ambulatory care and community-based outpatient clinics around the world.
In 2017, VA announced its decision to replace VistA with a commercial Cerner EHR system similar to the Department of Defense’s (DoD’s) MHS GENESIS system.
The EHR implementation will go live at initial operating capability (IOC) sites in the Pacific Northwest in March 2020. The federal department will continue to maintain VistA at all VA care sites until the Cerner EHR implementation project is complete.
As VA moves to abandon VistA, OSEHRA is launching a new initiative — Plan VI — to develop an international version of the EHR system.
VA will not be involved in the initiative, but VistA will still be periodically released to the public through the Freedom of Information Act (FOIA).
OSEHRA VistA is an open source resource available for use by the EHR community. Plan VI will serve as a way to extend VistA to other countries by ensuring the system is capable of storing and displaying health data in a variety of different languages.
As part of Plan VI, OSEHRA will also develop an international reference implementation guide.
“We are seeing substantial interest in open source EHR solutions from the international community, for both technical and economic reasons” said OSEHRA President and CEO Seong K. Mun, PhD.
“Technically, the ability to take true ownership of the system and create customized solutions is very attractive, and the possibility of cloud-based collaboration and even cloud-based production is spiking international interest,” continued Mun. “Economically, leveraging high quality open source code and community collaboration can dramatically reduce both implementation and maintenance costs.”
So far, institutions and health IT developers from South Korea, China, and the Kingdom of Jordan have signed on to join the initiative. The ultimate goal of Plan VI is to leverage Unicode to create a version of VistA capable of storing and displaying data in any language.
Project participants are working to include glyph-based languages such as Chinese, German, and Arabic in the project, as well as European languages. Plan VI will also integrate right-to-left written languages in the initiative.
The initiative includes three developmental stages. Participants will first work to optimize the system’s computerized patient record system (CPRS) interface, followed by VistA’s internal Fileman/Roll-and-Scroll interface. Finally, developers will implement the HL7 data transfer standard.
OSEHRA is a nonprofit organization part of several industry associations including the American National Standards Institute (ANSI), HIMSS, HL7, the Open Source Initiative (OSI), and others.
Members of OSEHRA include InterSystems, Microsoft, the MITRE Corporation, and 27 others.
VA developed and maintained VistA for years before swapping the system for a commercial, off-the-shelf EHR system offering.
“I said recently to Congress that I was committed to getting VA out of the software business, that I didn’t see remaining in that business as benefitting Veterans,” said former VA Secretary David Shulkin. “And, because of that, we’re making a decision to move towards a commercial off-the-shelf product.”
The decision to replace VistA with a Cerner system was fueled by the federal department’s need to streamline interoperability between VA and DoD.
The VA Cerner EHR implementation will geographically follow DoD’s MHS GENESIS implementation to allow the departments to share resources and cut costs.