OSSDC 2012: Innovation in Government

Open Source Software and Electronic Health Records. Presented by Mike O’Neill, Senior Advisor to the Director, VA Innovation Initiative (VAi2), U.S. Department of Veterans Affairs

1. Innova&on  in  Government:   Open  Source  So4ware   and   Electronic  Health  Records   Mike  O’Neill   Senior  Advisor  to  the  Director,  VA  Innova&on  Ini&a&ve  (VAi2)   U.S.  Department  of  Veterans  Affairs       June  21,  2012        
2. The  Need  for  A  New  Approach   2   •  VistA  EHR  is  the  cornerstone   of  the  care  and  benefits  VA   delivers  to  Veterans   •  Rapidly  evolving  models  of   care  drive  EHR  changes   •  At  a  &me  when  a  higher  rate   of  innova+on  is  required,  how   do  we  keep  up?   Establish  an  Open  Source  Community  to  Increase  the   Rate  of  Innova&on  
3. Why  A  New  Open  Source  Model?   You  Can  Already  Get  the  Code…   3  
4. Why  A  New  Open  Source  Model?   Many  Organiza&ons  Have  It…   4   DSS   Indian  Health   Service   Military  Health   Service   Medsphere   WorldVistA   Veterans  Affairs  
5. Why  A  New  Open  Source  Model?   They’ve  Invested  In  Development…     5   DSS:  vxVistA   Indian  Health   Service:  RPMS   Military  Health   Service:  CHCS   Medsphere:  Open  Vista   WorldVistA     Veterans  Affairs  
6. Why  A  New  Open  Source  Model?   Customers  Have  Been  Supported…   6   DSS:  vxVistA   Indian  Health   Service:  RPMS   Military  Health   Service:  CHCS   Medsphere:  Open  Vista   Midland  Memorial,  Kern  Medical   Center,  Silver  Hill  Hospital,  …   World  VistA     Oroville  Hospital,   Jordan,  …   Nigeria,  Finland,   Mexico,  West   Virginia…   Veterans  Affairs  
7. Why  A  New  Open  Source  Model?   But  the  Picture  Is  Fragmented.   7   DSS:  vxVistA   Indian  Health   Service:  RPMS   Military  Health   Service:  CHCS   Medsphere:  Open  Vista   Midland  Memorial,  Kern  Medical   Center,  Silver  Hill  Hospital,  …   WorldVistA     Oroville  Hospital,   Jordan,  …   Nigeria,  Finland,   Mexico,  West   Virginia…   Veterans  Affairs  
8. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   8  
9. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   9  
10. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   •  Allow  enhancements  to  be  contributed  and   widely  shared   10  
11. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   •  Allow  enhancements  to  be  contributed  and   widely  shared   •  Collaborate  whenever  possible   11  
12. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   •  Allow  enhancements  to  be  contributed  and   widely  shared   •  Collaborate  whenever  possible   •  But  compete  when  it  makes  sense   12  
13. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   •  Allow  enhancements  to  be  contributed  and   widely  shared   •  Collaborate  whenever  possible   •  But  compete  when  it  makes  sense   •  Support  users  who  are  not  IT  experts   13  
14. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   •  Allow  enhancements  to  be  contributed  and   widely  shared   •  Collaborate  whenever  possible   •  But  compete  when  it  makes  sense   •  Support  users  who  are  not  IT  experts   •  Support  users  who  are  IT  experts   14  
15. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   •  Allow  enhancements  to  be  contributed  and   widely  shared   •  Collaborate  whenever  possible   •  But  compete  when  it  makes  sense   •  Support  users  who  are  not  IT  experts   •  Support  users  who  are  IT  experts   •  Allow  companies  to  make  money   15  
16. What  Should  the  Model  Look  Like?   •  Share  code  that  should  be  shared   •  Allow  fixes  to  be  widely  shared   •  Allow  enhancements  to  be  contributed  and   widely  shared   •  Collaborate  whenever  possible   •  But  compete  when  it  makes  sense   •  Support  users  who  are  not  IT  experts   •  Support  users  who  are  IT  experts   •  Allow  companies  to  make  money   •  Promote  the  growth  of  the  market   16  
17. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     17  
18. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     Other  EHRs,  including  AHLTA  &  CHCS   18  
19. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     Other  EHRs,  including  AHLTA  &  CHCS   Joint  VA/DoD  health  record:  iEHR   19  
20. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     Other  EHRs,  including  AHLTA  &  CHCS   Joint  VA/DoD  health  record:  iEHR   PHRs   20  
21. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     Other  EHRs,  including  AHLTA  &  CHCS   Joint  VA/DoD  health  record:  iEHR   PHRs   Informa&on  Exchange   21  
22. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     Other  EHRs,  including  AHLTA  &  CHCS   Joint  VA/DoD  health  record:  iEHR   PHRs   Informa&on  Exchange   Analy&cs   22  
23. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     Other  EHRs,  including  AHLTA  &  CHCS   Joint  VA/DoD  health  record:  iEHR   PHRs   Informa&on  Exchange   Analy&cs   Tools     23  
24. What  Should  the  Model  Look  Like?        This  is  not  just  a  VA/VistA  story…     Other  EHRs,  including  AHLTA  &  CHCS   Joint  VA/DoD  health  record:  iEHR   PHRs   Informa&on  Exchange   Analy&cs   Tools     Fully  Enable  Providers,  Pa&ents,  and  Researchers   24  
25. What  Should  the  Model  Look  Like?            Different  People…   25  
26. What  Should  the  Model  Look  Like?            Different  People…   Different  Organiza&ons…   26  
27. What  Should  the  Model  Look  Like?            Different  People…   Different  Organiza&ons…   Different  Roles…   27  
28. What  Should  the  Model  Look  Like?            Different  People…   Different  Organiza&ons…   Different  Roles…   One  Community   28  
29. What  Should  the  Model  Look  Like?            Different  People…   Different  Organiza&ons…   Different  Roles…   One  Community       29  
30. Government  Contrac&ng  Market   VA   DoD   IHS   Contractor   Product   Services:   Design,  Development,  Support   Code   Requirements  
31. OSEHRA  Makes  It  More  Open   And  More  Efficient   31   VA   DoD   IHS   Contractor   OSEHRA   Code   Requirements   Cer&fied   Code   Common  Codebase   APIs   Tes&ng   Collabora&on   Creates  more  opportunity   for  engagement  
32. Commercial  Product  Market   •  Mul&-­‐billion  dollar  market   •  Fewer  than  1/3  of  private  physicians  have  an   EHR  that  meets  minimum  requirements   •  Dominated  by  proprietary  solu&ons   Adopter   Product   Company   Sales  of  Products   and  Services  
33. Growing  the  Open  Source  EHR  Market   33   OSEHRA   System   Integrator   Adopter   Common  Codebase   Version  Management   APIs   Tes&ng   Collabora&on     Services:   Installa&on,   Maintenance,   Support     Bundled   So4ware   (Linux  Founda&on)   (Red  Hat,  Canonical,  etc.)   (Customers)   Choice   Flexibility   Great  Service    
34. New  Open  Source  Collabora&on   34   Government   Open  Source   EHR   New  market  for  the   open  source   community   New  business  models   for  EHR  community   New  openness  model   for  government  
35. www.osehra.org   35