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May 25, 2010 News 27 Comments


From The PACS Designer: “Re: Microsoft’s CDSA. The Clinical Documentation Solution Accelerator (CDSA) for Microsoft Office helps you create clinical document workflow by using Microsoft Office SharePoint Server 2010. CDSA is good for linking EMRs to other systems and also populating PHRs and CCRs.”

From Alan: “Re: Vermont Information Technology Leaders. It announces four more preferred partners.” They are athenahealth for revenue cycle, Concordant for consulting, MBA HealthGroup for implementation, and the University of Vermont’s Technical Services Partnership for services.

From LeBron Kydis: “Re: stats. I was charting the number of HIStalk visitors from day to day (I know, it’s a little neurotic) and realized the number of subscribers could be more interesting to watch as it climbs. Any chance you might include that number with the number of visitors?” Wow, that is compulsive. Bad news on the subscriber list, though: unlike the visitor count, there’s no widget to display it automatically. This will get you started: the confirmed count as of this minute is 5,565.


From FLgal: “Re: Epic. Tampa General (affiliated with USF) is implementing Epic. Shands (affiliated with UF) is also implementing Epic. Supposedly those two are collaborating with University of Alabama (not sure of the hospital name) to create a southeastern arc of Epic hospitals. Combine that with all the hospitals in Atlanta that are implementing (or thinking of doing so) Epic, and you’re got quite a nice chunk of the US covered by Epic.”

From A Family Affair: “Re: UPMC. A highly wired hospital with a highly connected leadership family.” UPMC paid $10 million last year to companies with ties to its directors and executive management. Relatives of the CEO, who himself made $5.16 million in 2009, received more than $3 million in payments, including his $265K daughter who was a contractor and is now executive director of UPMC’s technology development center. The CEO’s former son-in-law made $260K (until his wife divorced him and thus went his job) and his brother raked in $2.48 million for advertising. They didn’t ‘fess up until hearings convened by my hero, Senator Chuck Grassley.

Fletcher Allen Health Care lays off 23 transcriptionists who were rendered obsolete by technology such as EMRs and speech recognition. I feel bad for them, but that’s a nice plug for the cost saving potential of Nuance’s eScription, which I believe FAHC uses.


It was just over a year ago when Compuware inexplicably hired disgraced former Detroit mayor Kwame Kilpatrick to sell healthcare software, giving him a cushy six-figure job barely a week out of prison (what the hell were they thinking?) Well, today they got to fire him: he’s going back to the slammer for violating the terms of his probation. He tried the sorrowful apology route yet again, but the judge wasn’t buying it this time: he’s going away for at least 18 months and possibly up to five years. You can read up on his checkered background, but get comfy first because it will take awhile. Please hold for a job offer on Line 2, Mr. Blagojevich.

Michael from Bitwork offered an explanation of the article I mentioned that said a Hawaii clinic was saving 55 hours a month through some unspecified change. They were manually assembling quality measure information using standard reports offered by their EMR, he says. The change was to implement Bitwork’s solution, which collects the information in the background and presents it as a scorecard.

Stung by the defection of HIMSS and other conferences because of absurd costs, the governor of Illinois is considering signing a bill that would limit union shenanigans at McCormick Place. Naturally being Illinois there’s all kinds of dirty politics, union wheeling and dealing, and favoritism involved, not to mention that attendees will get stuck with newly increased bus and taxi fees to generate funds for marketing the convention center.

Weird News Andy labels this story as, “I’ve heard of dropping a transmission in a car before, but not a baby.” A Minnesota woman who is feeling labor pains drives off for the hospital, stopping to pick up the baby’s father, who can’t drive because he has epilepsy. Her water breaks while driving, she yells for him to take the wheel, and she shucks off her pants and delivers an eight-pound baby boy right in the driver’s seat. She summarizes, “I was just sitting on the seat and he just slid out.”

Some Epic youth filmed a video of the famous on-campus treehouse. I’m beginning to think I need one of those for philosophical reflection or something like that since I’ve always wanted one.

Inga and I have jumped on the Facebook bandwagon because so many of HIStalk’s readers are active there. I’ve made a site change that puts a little blue Facebook icon at the top right of every post. Click it and you can easily and quickly publish the article link with your comment to your Facebook feed.

Connecticut Attorney General and US Senate candidate Richard Blumenthal apologizes for not being “clear and precise” in claiming Marines service in Vietnam that he really spent stateside. That’s newsworthy here only because he’s the brother of national coordinator David Blumenthal, which I happened to see in one of the newspaper articles after thinking they sure look alike. You would think serving honorably in the Marines in any location would be enough without having to embellish, which hopefully he’s realizing.

Speaking of David Blumenthal, he was the commencement speaker at the University of Florida College of Medicine’s graduation this past Saturday. He told them most of what they had learned would be obsolete shortly, a sad but true fact and another reason to use technology to support pushing current best practices to the bedside.


The Raleigh, NC newspaper takes heat from UNC Health System employees after publishing the organization’s salary database online, including employee names and ages.

Tri-City Medical Center (CA) looks into alleged privacy disclosures involving employees and Facebook, denying a rumor that 26 employees have been disciplined. One conclusion is that hospitals need a social networking policy. Policies don’t usually work, of course, but at least you have grounds to fire violators.

Federal CTO Aneesh Chopra, speaking at the American Telemedicine Association conference, calls for great healthcare technology ideas and recites some examples: Voxiva’s Text4Baby (I interviewed head guy Paul Meyer in November), a Case Western Reserve telehealth project, American Well (which I just mentioned), and Project Echo (I interviewed Director Sanjeev Arora in October).

Speaking of innovation, I’ve had some conversations about scouting out more of those in HIStalk (I’m non-disclosed to say who those conversations were with, but you would probably be impressed) It could be as simple as doing interviews like those above, or it could be evaluating products with potential to benefit the healthcare system as a whole (not necessarily for their business potential, which others are doing already). If you have ideas of how to do this or want to help in some way, let me know. I was thinking of offering companies or developers the chance to pitch their wares and have them evaluated by a panel of expert HIStalk readers, but I always have high-falutin’ ideas that I don’t have time to execute properly because I’m working two full-time jobs already. In any case, if you know of cool, innovative technology that’s delivering results but not getting much attention (preferably as a user and not a company pitch person), let me know.

Monday is Memorial Day, set aside to honor men and women who have lost their lives in military service involving conflicts both popular and not. Flags are cheap, easy to find, and fun to hang (and I’m reminding you way ahead of time). And unfortunately, they stand out nicely in most neighborhoods since everybody’s too wrapped up in picnics and car races to think about dead service members and their families on the one day per year set aside to pay those respects. So if you’d like to be a rebellious contrarian like me, hoist Old Glory on Monday. End of good-natured soapboxing. 

The VA’s VistA Modernization Report

A reader sent over a copy of “VistA Modernization Report”, the work product of a committee that was convened to advise the VA about modernizing VistA. Its recommendations:

  • Stabilize VistA by freezing the code to some degree, releasing only enhancements needed for patient safety or mandates.
  • Contract with a research group to develop tech specs for a new open source VistA replacement.
  • Contract creation of a prototype.
  • Contract development of a foundation to manage the new, open source VistA.
  • Get more widespread VistA deployment outside of the VA by creating an easier delivery model.
  • Replace VistA’s functionality screen by screen.
  • “Harvest everything of value” from VistA.
  • Use commercial software where needed to complement VistA’s core functionality.

My reaction: big government contractors are wetting themselves at the prospect of getting a chunk of what is sure to be a massive cost. Remember VistA’s history: it was mostly developed by skunkworks programmers defying management orders and working directly with end users. It was not developed under an open source model and wasn’t cheap to build – it just happens to be free because taxpayers paid for it, which makes it available under the Freedom of Information act.

Software rewrites have ruined even nimble organizations who didn’t have to deal with bureaucrats and fat cat contractors. And let us not forget the $450 million taxpayer-raping by BearingPoint’s CoreFLS ERP system, overseen by an apparently napping VA IT management and mercy-killed during its beta testing when it nearly shut down Bay Pines Hospital in Florida.

All of this sounds like the usual feel-good consultantese, soothing and logical in a perfect world, dangerous when you’re dealing with the federal government and its cadre of trough-lappers. And who cares if VistA adoption is minimal outside of the VA? That wasn’t the point of writing it.

Software rewrites are usually a really, really bad idea, advocated by techies and mid-level managers who see the fun of working on something new instead of the gaping black strategic hole beneath them. The VA was lucky that VistA turned out as well as it did, but it’s a one-trick pony not likely to be repeated.

Open source or not, wanna bet this will be a billion-dollar project if it gets approved? Heck, HP got $784 million back in 2004 just to support VistA going for ten years, so imagine a stimulus-happy administration getting to announce this grand vision in front of veterans and former civil servants turned contractor lobbyists. Most vendors (including the ones that would provide commercial systems to the VA where needed) are selling systems that are just as clunky and outdated as VistA. Most of the time, they work just fine, especially if the whole package was built by the same company instead of being acquired from failing vendors anxious to sell out.

Maybe the VA should just do what everybody else seems to be doing if they really think VistA is on its last legs — buy Epic and install it using the Kaiser model. I wouldn’t want VistA replaced for the wrong reasons, but if it’s really necessary, then I’d rather see them writing Judy a huge check for a known quantity instead of a series of never-ending ones to the usual government contractors who have stars (and stripes) in their eyes.

That’s my uninformed opinion. What’s yours?

HERtalk by Inga

Baptist Health System (AL) selects Compuware’s EHR Service Delivery Solution to monitor performance and availability of its EHR.

All Children’s Hospital (FL) expands its relationship with Mediware, adding BloodSafe Tx for patient and blood verification.


The 107-bed Pioneers Memorial Healthcare District (CA) will replace its QuadraMed Affinity Clinicals with QuadraMedCPR.

Walmart cuts the price of the iPhone to $97, AT&T raises its early termination fee from $175 to $325, and rumors swirl that Verizon will soon offer service for the iPhone. Must be almost time for Apple’s Worldwide Developers Conference. June 7th is the date we’ll likely hear more about Apple’s 4G version (with video-chat, perhaps?)  plus maybe news of a Verizon deal.

Maybe one of our marketing genius readers could explain why a company would even bother to create and distribute a press release like this? Mr. H puts it on the short list for stupidest press release ever written. The company is obviously trying to raise money for programmers and designers. If they are successful, I suggest they put a few dollars aside for marketing.


If you are an HIT purist, mosey on to the next news item. A woman is denied entrance to Yankee Stadium because she is carrying an iPad. Seems the Yankees have a “no laptop” policy and a security guard placed the iPad in that category. Not be deterred, the woman put the iPad under her jacket and went in another gate. I gotta say I like this lady because she likes her technology, likes her baseball, and is willing to be a bit sneaky to get her way. Anyone who has ever scored a baseball game has to love the the idea of using an iPad to run the cool-looking iScore app.

A former University of Washington Medical Center patient complains to the local press when a hospital representative called his unlisted number to solicit donations. Turns out that HIPAA specifically allows medical centers to use patient information for fundraising activities. UWMC offers an opt-out alternative, but it requires patients write a letter to the hospital’s privacy office. I’m all for fundraising, but shame on any hospital using such tactics. At least make it easier to opt out on the front end.


Forty private equity firms form the non-profit Healthcare Private Equity Association to support the healthcare PE community. The association’s members represent about 500 healthcare portfolio companies and combined revenues of $200 billion.

Speaking of private equity investments, Phreesia announces the close of $16 million in Series D funding, led by Ascension Health Ventures. Phreesia’s technology platform automates patient check-in in physician offices and urgent care centers.

Coming soon to HIStalk Practice: a new question in our HIT Vendor Executive series (sign up for e-mail updates so you don’t miss it!) This month’s question is, “If you could give David Blumenthal one piece of advice, what would it be?”

A few quick updates:

  • MEDecision names Eric Demers as SVP of life sciences.
  • Three new hospitals select McKesson’s Practice Partner EHR and PM for their employed and affiliated physicians.
  • Wolters Kluwer Health promotes Susan Driscoll from EVP to president and CEO of the company’s Health’s Professional & Education Business Unit. She takes over for Gordon Macomber.
  • Pomona Valley Hospital Medical Center (CA) implements the Access e-Forms Repository, providing direct access to users from its Siemens Soarian portal.
  • The Johns Hopkins Hospital goes live with iMDsoft’s  MetaVision AIMS in 39 operating rooms.
  • St. Elizabeth Regional Health (IN) contracts with TeleHealth Services for interactive patient education systems.
  • Healthcare Management Systems names F. Bradley Meyers its director of integration and Interoperability and Neal Reizer as chief architect.
  • MEDSEEK awards Spectrum Health (MI) its 2010 eHealth Excellence Award for its use of eHealth technology.
  • Halfpenny Technologies’ ITF-GoDoc solution now includes a new critical value alerting feature that allows hospitals or labs to send  results to physicians’ smartphones.
  • Integrating the Healthcare Enterprise International names the College of American Pathologists as the primary sponsoring organization of the IHE Laboratory Domain.


E-mail Inga.

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Currently there are "27 comments" on this Article:

  1. I’m sure you know that the government has already decided to buy Epic, but due to way our government operates they will first pay out tons of money to political favorites to follow Plan A (creating a brand new project)… probably spend billions of dollars… then eventually spend hundred of millions or billions buying Epic to replace the eventual failure that the first project will become.

  2. Wish UW Medical Center could get out a correct bill, to the correct address, for the correct services. And even better, schedule a clinic and not cancel it the day of…after patients arrive…very common occurence. They need to focus on the patient experience…as in improving it. Perhaps then, the patients would feel a bit more generous towards donations. Even better…wish we had an alternative care center to escape the consistently poor experience. Docs are great, but everyone surrounding them needs to learn something about service with a smile…or just a little follow through would be a nice surprise.

  3. Instead of spending millions to re-engineer VistA, they should just have a competition among the smaller EHR companies. Some probably have good technology but just don’t have the marketing power. There would be an expert assessment of their software architecture; the winner of the grand prize gets $X million, their technology becomes open source, and they get another $Y to fund improvements. I would think there would be some takers.

  4. What’s even more interesting than jailed Mayor Kilpatrick losing his Covisint/Compuware job? The CEO of Compuware with some other Detroit businessmen loaned him $240K.

  5. My opinion on VISTA: it’s the product on the market that scales an IHDS 25 miilion people wide accross hundreds of geographical locations. The product was developed for it’s purpose– healthcare delivery which is why it works. Therein lies the dificulty; define “work” in it’s proper context. This is a bigger problem isn’t it? Have we defined the context yet? Throttle back for a moment and consider the idea of heathcare. Is this a basic right or something people purchase?
    Back to VISTA for the moment: it seems like the issue of the right to healthcare for Vets has been answered. A standard user interface is accessible– clinicians see the same screens everywhere and this from a training persective makes it truy the most valuable product on the nar
    market. Why not continue the conversion of VISTA programming code to an object oriented language like C## and or languages that are dedicated for well defined purposes like healthcare once we have answered the basic questions.

  6. Speaking of Illinois dirty politics, brothers Richard and David Blumenthal, and hearings convened by your hero and mine, Senator Chuck Grassley, there is an interesting comment posted in the WSJ article, “Blumenthal Apologizes for Vietnam Remarks”

    A former HIMSS employee, who is also a Vietnam Combat Veteran, has blown the whistle to Senator Grassley and other government agencies regarding the wrongful taking and disclosure of his Veteran’s medical record from a private physicians office as being unlawful and not an authorized military operation. The post contains the USDOL complaint number that is on file.

    Senator Grassley’s office is also aware of the HHS HIPAA complaints filed against HIMSS by several former HIMSS employees (complaint numbers provided also on the Federal Register), and that HIMSS self-insures. The former HIMSS employees have asked Senator Grassley’s office to investigate the Federal grants HIMSS has received from HHS for CCHIT, CCHIT’s bogus laboratory and the absence of certification records, and have also invited Senator Grassley to take a tour of CCHIT’s vapor-ware laboratory located at 200 S. Wacker Drive in Chicago.

    The media giants—such as the WSJ, Washington Post, Time, CNN—have lifted the bar to posting the truth about the current state of EHR industry control over healthcare, physicians who deliver the care, and the patients who are going to be on the receiving end of every imaginable mistake possible that a clinician can make.

    We appreciate the opportunity that HIStalk provides, and the lifting of the bar to publish the truth.

  7. RE: VA and Epic – There’s no doubt our Cheesehead friends are good at what they do. But let’s not forget this is a company that charges healthcare organizations hundreds of millions, even billions, for software, at a time when we as a Nation are impelled to reduce our multi-trillion-dollar healthcare spend. Epic is also the least interoperable vendor on the market and has a vested interest ($$$!) in seeing that NHIN and interoperability never happens. It’s time to say sayonara to big One System vendors who insist on “My Way or the Highway.” We have to make vendors connect to other vendors, or pull the plug.

  8. Re: Kwame Kilpatrick and Compuware.

    What they were thinking: This guy’s mom is a US Congresswoman and we can ingratiate ourselves to her by hiring her son.

  9. I enjoyed reading the report and the words of wisdom from Dr. Blumenthal to the new grads at Gainesville:

    “Dr. David Blumenthal was the commencement speaker. He was appointed by President Barack Obama to move the nation toward electronic medical records under the federal health care reform law, with a target date of 2014. Blumenthal told the new doctors that much of what they’d just learned in medical school will be obsolete before they finish their practice. “You must relearn the art of medicine over and over again,” he said.”

    Funny he should say that. The art of medicine ceases to exist under the influence of EMRs and CPOEs. Creativity is stifled and will not not have to be relearned because it is eliminated in the first place, actually. All patients are vanilla according to Blumenthal’s standardization of care ideas. The new patient is the terminal and physician competence will become irrelvant.

    Good medicine and good medical care does not change. The problem is that it is no longer being taught. Mediocrity is tolerated as witnessed by the failure of any safety vetting for the HIT he is promoting.

    I know my ideas are not popular with some of the supermarket minds and commenters who post on this blog, a natural resource for HIT through out the world.

  10. Wow, who knew that the Epic campus was like Disneyworld? I swear it looks just like the Swiss Family Robinson treehouse at Magic Kingdom!

    As for the baseball game, that’s the conundrum we’re all having to face this decade: what, exactly, is a computer? Today’s smartphones are Supermen compared to my mom’s 1980s Tandy laptop, but one people would instantly recognize as a computer and one people would see as a phone. Tablets are really bringing to fruition the genre-bending the smartphone started. Here’s a question: can kids bring in a PSP or NDS? Those “toys” are also lightyears ahead of older laptops in terms of processing power, and with a little hackery could be converted into “laptops.”

  11. Suzy, can you explain how EMRs and CPOE stifle medical creativity? That makes no sense.

  12. Marketing Genius Reader Here:
    Companies put out these type of releases primarily for search engine pickup and mention in on news release aggregator sites. They are writing more for Google than an actual reader. But along the way, they might get picked up in a popular, online healthcare executive blog, like yours. Crazy but true.

  13. Re: World’s Stupidest Press Release, my guess is they’re desperate for money and either the boss or an investor demanded they do something to get their name out their with *something* in hopes *somebody* will save them.

  14. RE:Blago, McCormick Place, Quinn et al., you won’t need to kick them around much longer. Finance professor on Chicago Tonight talked about the unfunded state budget hole being somewhere between $16,000 and $54,000 per household depending on how you look at the math and the spectacularly optimistic projections on rate of return for state investments at 8% per year….In short, IL is already in bankruptcy but will become “realized” in about 2018 when no one will buy IL bonds. (Or maybe sooner, the lameduck IL legislature just voted to borrow another $4B to keep things floating along rather than take any decisions on raising taxes or cutting spending heading into Fall elections. Note to vendors or providers doing business in the state of IL, you might want to start throttling back on all contracts with them about 2015…) So in the larger picture, whether or not Quinn signs the bill for reforming how McK Place “operates” is just a footnote on the tsunami already in motion. Curious note, the President will be “home” for the first time in over a year to speak at the Abraham Lincoln National Cemetery for Memorial Day. It would be interesting to hear the not-for-public conversations with Quinn, Madigan, and Daley while he is home. Here’s an idea, annex the southern third of Wisconsin onto IL, put a special tax on EPIC sales, and IL can pick up an extra year of solvency if sales keep going at their eye popping numbers. C’mon Judy, we need you now more than ever…how about a nice treehouse in Millennium Park’s Lurie Gardens? Just sayin, anything you want, anything at all.

  15. Violations of Compliance at UPMC is emblemmed by your excellent report. Questions of relevance , here: Do the relatives of the kingpin have the credentials to perform the tasks for which they are being paid at the expense of taxpayers? Is Attorney General, Mr. Thomas Corbett, too busy running for governor to investigate or might he not because of the campaign contributions from the million dollar men and women and BOD? Have the close “friends” of the current governor attneded baseball games with the wired family?

    Your blog is excellent and I love reading it.

  16. “buy Epic and install it using the Kaiser model.”
    I’m a pretty regular reader, but you left me in the dust on this one. What, exactly, is the Kaiser model for EHR installation?

  17. Re: VistA modernization. What’s the goal? To re-write the front-end so that it looks more modern? If so, then just move to Epic – they already have Hyperspace and it looks very pretty.

    If the goal is to move off of MUMPS because MUMPS is old, then moving to Epic does not make sense. Epic runs on Cache and much of it’s code follows the MUMPS standard. So you’d be trading one MUMPS system for another.

    CPRS is not VistA just like Hyperspace is not Epic. The CPRS GUI looks old and it needs to be re-written. I am also of the opinion that Hyperspace needs to be re-written, not because of the way it looks, but because of the massive size of it’s local install and the challenges in deploying it. Both of these systems should have web front-ends. Moving the underlying code and DB from M to say, a C derivative and Oracle/SQL, would be pointless.

    The fact that one of the committees bullet points is “Replace VistA’s functionality screen by screen.” makes me think that they are really talking about the CPRS/terminal GUI and not the VistA M code. Can anyone clear this up for me?

  18. Re: John Adams and Epic

    I think you are wrong about Epic being the least interoperable, and I think and integrated Epic solution is very affordable if you consider the success rate and what is provided, versus other companies underbidding but just going way over in budget and under-delivering on functionality.

    I think as it related to VistA, the fact that Epic is written in M-like Cache ObjectScript is a huge bonus… without knowing this for sure, I would assume the VA employs a large group of talented M programmers. Those people can be retasked to assist in data conversion to Epic and future customizations of the Epic code.

    Just my $.02

    We all know the vendors want to hack VISTA apart like they did Britney. We know how they hunger to attack beautiful things and turn them into mediocre effluence.

    Lets face it. The vendors are plagued with epidemic OCD, jealousy and rage. The best they have is EPIC. Seems like Justin called that one a few years ago. Maybe EPIC and HIMSS can merge and move to Las Vegas to create a slot machine healthcare system that uses ONC Bucks bearing the motto in HIMSS-ONC we trust. David Blumenthal can be the new Pit Boss. Lieber can do the floor show.

    You had better hang on to your body parts if they do.

  20. Dear Bar Code who asks: “I’m a pretty regular reader, but you left me in the dust on this one. What, exactly, is the Kaiser model for EHR installation?”

    Justen Deal, featured on this blog in 2008, will explain the Kaiser model for EHR installation and what Kaiser does to those who tell the truth.

    As for Epic, Cerner, Eclipse, Centricity, and others, who know which is better?? They all are being sold without assessment and approval for safety and efficacy yet they all make claims to be make care safer? Where is the proof?

  21. @not tired of suzy rn

    I worked at Kaiser and helped roll out Epic at hundreds of clinics in Northern California. Although Kaiser certainly has its share of problems (hence why I am not working there anymore…) they DO have an incredible model for designing a rock-solid implementation and rolling it out very rapidly and successfully. They did make some systemic mistakes, but mostly with staffing and management of implementation resources, not with the design of the system or the overall rollout strategy. Having worked at several other Epic clients, I can say I am more in awe of their master plan and standardized Epic implementation than I ever was when I worked there. Their method means rapid rollout and minimal support needed, and once you support one specialty within the system you immediately know how to support it in the future. Bravo to them for getting at least that right.

  22. The IAC recommendations describe an open-source VistA modernization effort that already exists in the private sector. Beyond MUMPS, there are new ways to open up the core code set to other programmers. For example, Medsphere recently announced accelerated modernization with the OpenVista Interface Domain (OVID), broadening access to the source code to the entire Java development community so hospitals can benefit from increased open-source contributions. In addition, a GUI front-end called CareVue has already replaced CPRS and has been in use at the Indian Health Service for many years.

    Given the collaborative roots of VistA and all the VistA-derived EHR systems in use in hospitals across the nation, the modernization of VistA should include a broad global community of programmers and developers in building the best possible system for both VA and non-VA hospitals. Efforts such as these save taxpayer dollars.

  23. Re; Memorial Day Celebration

    Here’s a thought, don’t just fly Old Glory only on Memorial Day or July 4th. Fly it all the time as a constant reminder of the ultimate sacrifice many service people have given to keep this country safe and free.

  24. You do make some good points about federal waste, Mr. HISTalk, but since you invited other opinions, let me respectfully weigh in on something I am getting more familiar with these days: the viability of an open-source model for VistA modernization. The open-source model is already a proven solution. My hospital, a county hospital in Central California, is a committed member of the Medsphere-sponsored ecosystem, which supports collaboration around OpenVista, a VistA-based open-source EHR solution. As such, we are helping to re-engineer VistA/OpenVista with significant upgrades and enhancements. Although this is our first venture into the world of open-source, we are already seeing the benefits and look forward to writing our own apps (using Medsphere’s new Java layer, OVID) so we can delve into the VistA databases and extract meaningful information for use in custom reports. Our team here at Kern Medical Center is especially excited about OpenVista’s potential to help us use data to drive significant improvements in quality, safety and efficiency. Consider just this one example of what we can do: easily query our database, then compare medical interventions and ascertain which methodology is best. One way clinical breakthroughs are born is when we begin to analyze the data, discover significant differences and identify best practices.
    In closing, I’d like to say how impressed I’ve been by how excited some of the VA people still are about VistA and their desire to continue making this a live, open system to serve healthcare needs in years to come.

  25. There is no southeastern arc of EPIC.
    UAB (Univ of Alabama MC) is a solid Cerner client. As is Emory, despite unfounded rumors to contrary.

  26. Sir,
    I am the chair of the ACT IAC Committee that produced the VistA Report. I recently retired after 24 years in government and almost 7 years as Deputy CIO and CTO of the Department of Veterans Affairs. I am at a bit of a loss as to how respond to your analysis of the report. The level of cynicism is almost toxic. I can tell you that the personnel who participated in the report did so as IT industry experts, veterans, and citizens and not as representatives of their companies.
    We believe we did what was right for the veterans, the VA, and the larger healthcare community. Please feel free to criticize the report or to suggest improvements to it but to criticize the motives of people you don’t even know is not only unfair but is bound to be wrong on the face of it.
    Best Regards,
    Ed Meagher

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