Robert Wentz, President and CEO of Oroville Hospital, will be addressing the Plenary Session of the 2nd Open Source Electronic Health Record Agent (OSEHRA) conference in Bethesda, MD, on September 5th. Wentz will discuss the key factors behind the hospital's successful self-implementation of the open source VistA EHR for less than $13 million in total and less than $7 million for the EHR component. This compares to proprietary EHR implementations in regional hospitals that currently average $25 to $30 million per hospital on the low end just for the EHR component. In addition, Oroville Hospital went a step further and implemented computerized physician order entry (CPOE) into VistA.
Wentz, who spoke during the keynote panel at last year's OSEHRA conference, helped organize this year's conference as Co-Chair of the Organizing Committee together with Lt. Gen. (Ret.) Bruce Green, M.D. This year's conference is substantially larger than last year's conference, a reflection of the exponential growth of the VistA community. This year's conference has more than 120 speakers and three full days of panels and presentations.
Wentz will be sharing the podium during the plenary session with some of the best known advocates of health IT transformation in the U.S., including:
John Halamka, M.D., Member of the Board of Directors, OSEHRA, Professor of Medicine at Harvard Medical School; CIO of Beth Israel Deaconess Medical Center; Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the National HIT Standards Committee, and a practicing Emergency Physician.
Kenneth W. Kizer, M.D., MPH, University of CA, Davis, Former Under Secretary of Veterans Affairs, Chairman, Medsphere Systems Corporation.
Stephen Warren, VA Liaison to the Board of Directors of OSEHRA, Acting Chief Information Officer and the first Principal Deputy Assistant Secretary in the Office of Information and Technology (PDAS/IT) at the US Department of Veterans Affairs (VA).
Howard Hays, M.D., MSPH, Chief Information Officer (acting), IHS Office of Information Technology.
James Peake, M.D., Chairman of the Board of Directors OSEHRA. Lieutenant General, USA (Ret); Secretary of Veterans Affairs, December 2007 through January 2009; Senior Vice-President for the Health Industry at CGI.
Peter Groen, Co-Founder and Senior Editor, Open Health News. Mr. Groen served in numerous senior health IT management positions during his 30 years of service at the VA.
In addition, the conference will also be addressed by Dr. Tony Shannon, Chief Medical Information Officer, National Health System (NHS) Leeds, England. Shannon has been one of the strongest advocates of open source health IT solutions in the United Kingdom. The UK's NHS, which runs the countries hospital systems, spent nearly $20 billion in a failed attempt to implement a national EHR using Commercial Off-the-Shelf (COTS) technologies. At the same time that this program, as well as a large number of proprietary EHR implementations failed, many hospitals in the UK successfully developed open source solutions. As a result of all these open source successes, the Secretary of State for Health and Professor Sir Bruce Keogh, Medical Director of NHS England, launched a £260 million Technology Fund on May 17, designed to fund innovative, open source health IT solutions.
One of the key questions to be answered by this effort is whether VistA can be used as an EHR core for the UK. The pros and cons of this approach are addressed in detail in an article titled Overview of Open Source and VistA in the UK's NHS. Shannon will be providing an update on all the momentous events in the UK.
This year's OSEHRA conference is divided into three days of presentations, each day having a separate focus.
The first day focuses on a set of in-depth tutorials on open source and agile development. These tutorials will address the core concepts of behind open source software. The first half-day session will explore the technical aspects of open source including: licensing, intellectual property, as well as social norms and mechanics of contribution to open source projects. The second session will focus on the historical background of the open source movement and practical looks at existing open source projects and communities.
While the second day of the conference is focused on the Plenary Sessions, the third day is focused on workshops and technical presentations. The main tracks include:
Open Source Technologies – Clinicians and Users
Open Source Technologies – Developers
Open Source Business Models
Open Source Enterprise EHR
One of the more interesting aspects of the conference is that in addition to Stephen Warren, Acting CIO of the VA, there will be more than 20 key personnel from the VA speaking during the third day of the conference and participating in panels and workshops. This emphasizes the VA's concept of OSEHRA as a “bridge” to the private sector in its drive to collaborate with private sector companies in the continuing development and enhancement of VistA. This is a two-way street as the VA continues to spend over $3 billion a year improving VistA and is looking to leverage some of the extraordinary improvements being made to VistA in the private sector. It also reiterates Warren's commitment as Acting CIO that the VA's software development will be focused on an open, collaborative, and transparent development process.
The growing collaborative relationship between the VA and the private sector VistA Community assumes a much greater importance in view of the bleak future faced by hospitals that have implemented proprietary EHRs.
In a report released on July 16, Black Book Market Research warns that “the crowded environment of nearly a thousand [proprietary EHR vendors] will shrink down to less than half by 2017, or by Meaningful Use 3, whichever comes first.” According to the Black Book survey's findings, “90 percent of insiders expect the majority of existing vendors will have merged, been acquired or ceased operations within five years.” In addition “88 percent of insiders ascertain that most of these [proprietary EHR] vendors will falter because they pushed usability issues to the back burner in order to capitalize on the incentive spoils of meaningful use achievement.”
This size and scope of this year's OSEHRA conference demonstrates that hospitals that implement VistA don't have to worry about this massive “vendor die-off.” The VA is clearly demonstrating that it will continue to develop VistA and to share and collaborate with the VistA community. The sheer growth of the members of OSEHRA and the number of solution providers speaking at the conference shows that there is a large, growing and robust ecosystem of companies in the private sector that are going to support VistA.
This is precisely one of the reasons Oroville Hospital chose to implement VistA. Oroville Hospital is in complete control of its EHR system and does not have to rely on any vendor to continue to support and enhance VistA. Oroville Hospital has actually gone one step beyond and created its own code development office. Oroville's staff has been able to take advantage of the inherent flexibility of VistA to customize it to its needs. The office will continue the hospital's efforts to enhance VistA and adapt it to its own uses.
In addition, Oroville Hospital is contributing code it is developing to the open source community and it is looking to help build a bigger base of VistA contributors in the form of developers and consumers in hospitals and health systems. Oroville Hospital wants to continue collaboration on best practices for use and development of electronic health records and help other hospitals in the US that are looking to implement VistA in the same organic way that Oroville has done.