In this slideshow, Micheal ONeill, Senior Advisor to the Director, VA Innovation Initiative (VAi2), US Department of Veterans Affairs, outlines the need for a new approach to electronic health record systems and the benefits of establishing a new, open source community worldwide, in order to drive innovation. Michael ONeill presented at the Nuffield Trust seminar: Sharing international experience: Is implementing the VA's electronic health record system an option for the NHS? in July 2012.

1. Making VistA More Accessible
Mike O’Neill
Senior Advisor to the Director, VA Innovation Initiative (VAi2)
U.S. Department of Veterans Affairs
July 5, 2012

2. The Need for A New Approach
• VistA EHR is the cornerstone
of the care and benefits VA
delivers to Veterans
• Rapidly evolving models of
care drive EHR changes
• At a time when a higher rate
of innovation is required, how
do we keep up?
Establish an Open Source Community to Increase the
Rate of Innovation
Enable Maximum Benefit to Public and Private Sector
2

3. Why A New Open Source Model?
The Current Picture Is Fragmented.
Medsphere: Open Vista
Midland Memorial, Kern Medical
DSS: vxVistA Center, Silver Hill Hospital, …
WorldVistA
Indian Health Veterans Affairs
Service: RPMS Oroville Hospital,
Jordan, …
Military Health Nigeria, Finland,
Service: CHCS Mexico, West
Virginia…
3

4. 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
4

5. What Should the Model Look Like?
This is not just a VistA story…
Other EHRs, including AHLTA & CHCS
Joint VA/DoD health record: iEHR
PHRs
Information Exchange
Analytics
Tools
Fully Enable Providers, Patients, and Researchers
5

6. What Should the Model Look Like?
Different People…
Different Organizations…
Different Roles…
One Community
6

7. Government Contracting Market
Requirements
VA
DoD Contractor
Code
IHS
Services:
Product Design, Development, Support

8. OSEHRA Makes It More Open
And More Efficient
Common Codebase
APIs Creates more opportunity
Testing
Collaboration
for engagement
OSEHRA
Certified
Code
Code
VA
DoD Contractor
IHS Requirements
8

9. Commercial Product Market
• Multi-billion dollar market
• Fewer than 1/3 of private physicians have an
EHR that meets minimum requirements
• Dominated by proprietary solutions
Product
Adopter
Company
Sales of Products
and Services

10. Growing the Open Source EHR Market
(Linux Foundation) (Red Hat, Canonical, etc.) (Customers)
System
OSEHRA Integrator
Adopter
Common Codebase Services: Choice
Version Management Installation, Flexibility
APIs Maintenance, Great Service
Testing Support
Collaboration
Bundled
Software
10

11. OSEHRA Provides Foundation for Long-
Term Collaboration and Growth
New market for the
Government Open Source open source
community
New business models
for EHR community
New openness model
EHR
for government
11

12. www.osehra.org
12