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| DATE | 2005-08-05 |
| FROM | Ruben Safir
|
| SUBJECT | Subject: [NYLXS - HANGOUT] Free Software on the Healthcare Front
|
Friday, August 5, 2005
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HHS to offer private
physicians 'free'
software
Open-source software
could cost doctors $500
a month
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RELATED LINKS
VA drives open-source health records
initiative [Federal Computer Week,
Nov. 21, 2004]
VA wants money for records
[Government Health IT, Feb. 15,
2005]
VA gets fit with tech [Government
Health IT, Feb. 20, 2005]
Open-source EHR suite gets upgrade
[Government Health IT, June 21,
2005]
More than a view in a vista
[Government Health IT, July 25,
2005]
CMS VistA-Office May, 2005 Briefing
CMS VistA Office FAQ
CMS VistA-Office 1.0 Requirements
Chronic care
Besides serving as an electronic
health record, VistA-Office also
includes tools that help clinicians
monitor and manage chronic
conditions, such as diabetes and
heart disease.
Managing patients with chronic
illnesses can help improve their
health, which is what West Virginia
Primary Care Network accomplished in
its beta test of VistA-Office
earlier this year.
David Campbell, chief executive
officer of the network, which
operates 50 clinics, said
VistA-Office can be used to ensure
that every diabetic has an annual
foot and eye exam. The system also
helps ensure that people with
diabetes eat appropriately and that
patients with hypertension maintain
control of their blood pressure, he
said.
The Department of Veterans Affairs
has long used its version of the
Veterans Health Information Systems
and Technology Architecture (VistA)
for such patient monitoring and has
achieved impressive results. The
software allows the VA to maintain a
diabetes registry and generate
patient reminders with 80 percent or
more resulting in office visits, far
better than commercial health care
providers, according to an article
in the August 2004 Annals of
Internal Medicine.
Campbell said his organization wants
to follow the trail the VA blazed
and use VistA- Office to help
improve health outcomes through the
use of information technology.
— Bob Brewin
BY Bob Brewin
Published on Aug. 1, 2005
More Related Links
The Centers for Medicare & Medicaid Services (CMS) plans to offer open
source electronic health record (EHR) software designed for use in
physician offices this week, but vendors consultants and health care
industry leaders warn that just as there no are no a free lunches there
is no free software.
CMS officials want to use VistA-Office to accelerate the adoption of
EHRs in private physician practices. It is based on the Veterans Health
Information Systems and Technology Architecture software used in the
Department of Veterans Affairs' hospitals and clinics.
The Department of Health and Human Services estimates that only 30
percent of the nation's 650,000 doctors use EHR software. CMS officials
have said that doctors have been slow to install EHR systems because
commercial versions are costly, ranging from $10,000 to $20,000.
Physicians will not be charged for the VistA-Office software, but it
will come with support costs, said Dr. Ismet Kursunoglu, director of the
Alaska Clinic in Wasilla, north of Anchorage. Earlier this year, he
installed the open-source version of the VA's software at his clinic.
Kursunoglu said the computer skills he picked up when he started
dabbling with Linux in 1994 allowed him to install the VistA software on
his own. But, "an average doc is going to need support for installation
and training," he said.
Donald Meehan, VistA-Office project manager at Document Storage Systems,
which has developed VistA modules for the VA, agreed. Meehan was chief
information officer for VA facilities in Arizona before joining DSS. He
said physicians will save money by paying someone else to handle
software installation and support rather than trying to do it
themselves.
DSS plans to support VistA-Office with an application service provider
model for small practices and a client/server model for larger ones. He
said DSS will charge about $500 a month for the ASP version. Dr. Ignacio
Valdes, a psychiatrist, computer scientist and editor of the
LinuxMedNews Web site, called the fee reasonable.
Dr. Kenneth Kizer, president and chief executive officer of the National
Quality Forum, a nonprofit group focused on improving health care in the
United States through standards and performance measurement, said
VistA-Office will need a lot of support to succeed, even in the hands of
sophisticated users. Kizer, who served as undersecretary for health at
the VA from 1994 to 1999, said he worries that without vendor support,
"a good product would get tarnished."
Kenneth Strier, senior health industry manager at Deloitte Consulting,
said physicians who adopt VistA-Office or commercial EHR systems face
challenges that have nothing to do with the software's cost. The systems
require changes in business processes and workflows, and clinicians will
endure those disruptions only if they see improvements in efficiency and
patient care, he said.
Besides the support costs for VistA-Office, physicians might have to buy
a Microsoft Windows operating system to run the software and pay a
license fee to use VistA-Office's underlying database and programming
language, based on MUMPS, from long-term VA software supplier
InterSystems Corp.
Open-source alternatives to Windows for VistA-Office could be available
in the fall. MetaStar, a nonprofit CMS-funded, health care quality
improvement organization in Wisconsin, plans to develop a Linux version
of VistA-Office and make it available for distribution by September,
said Karl Stebbins, MetaStar's vice president of information
technologies.
A CMS spokesman refused to comment or make program managers available
for interviews until the software's release this week.
Kursunoglu said he runs VistA on Linux with an open-source version of
MUMPS and has experienced no problems with the combination. He views all
forms of VistA as the building blocks of a national medical information
infrastructure.
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