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

Transcript

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  
    
    
    
   

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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  
   

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3. Why  A  New  Open  Source  Model?  
   You  Can  Already  Get  the  Code…  
   3  
   

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4. Why  A  New  Open  Source  Model?  
   Many  Organiza&ons  Have  It…  
   4  
   DSS  
   Indian  Health  
   Service  
   Military  Health  
   Service  
   Medsphere  
   WorldVistA  
   Veterans  Affairs  
   

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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  
   

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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  
   

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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  
   

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8. What  Should  the  Model  Look  Like?  
   •  Share  code  that  should  be  shared  
   8  
   

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9. What  Should  the  Model  Look  Like?  
   •  Share  code  that  should  be  shared  
   •  Allow  fixes  to  be  widely  shared  
   9  
   

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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  
    

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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  
    

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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  
    

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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  
    

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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  
    

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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  
    

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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  
    

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17. What  Should  the  Model  Look  Like?  
         This  is  not  just  a  VA/VistA  story…  
     
    17  
    

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18. What  Should  the  Model  Look  Like?  
         This  is  not  just  a  VA/VistA  story…  
     
    Other  EHRs,  including  AHLTA  &  CHCS  
    18  
    

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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  
    

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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  
    

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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  
    

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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  
    

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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  
    

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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  
    

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25. What  Should  the  Model  Look  Like?  
         
     
     Different  People…  
    25  
    

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26. What  Should  the  Model  Look  Like?  
         
     
     Different  People…  
    Different  Organiza&ons…  
    26  
    

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27. What  Should  the  Model  Look  Like?  
         
     
     Different  People…  
    Different  Organiza&ons…  
    Different  Roles…  
    27  
    

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28. What  Should  the  Model  Look  Like?  
         
     
     Different  People…  
    Different  Organiza&ons…  
    Different  Roles…  
    One  Community  
    28  
    

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29. What  Should  the  Model  Look  Like?  
         
     
     Different  People…  
    Different  Organiza&ons…  
    Different  Roles…  
    One  Community  
     
      29  
    

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30. Government  Contrac&ng  Market  
    VA  
    DoD  
    IHS  
    Contractor  
    Product  
    Services:  
    Design,  Development,  Support  
    Code  
    Requirements  
    

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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  
    

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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  
    

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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  
     
    

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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  
    

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35. www.osehra.org  
    35  
    

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