Where vendor organizations, legislation and open source collide – Healthcare Information Systems

I thought I’d include this as a reference since I’ve brought up this discussion elsewhere. If you’re looking for drama, plot twists and a wide assortment of characters look no further than the current impetus toward Electronic Health Record (EHR) adoption – A potentially Shakespearean Drama.

The players and scenario:

The battle brewing over EHR adoption has brought a number of interests out of the woodwork. Not surprising, considering the stakes involved and the profit potentials assisted by ARRA. The Healthcare Information Management Systems Society (HIMSS) Electronic Health Record Association (EHRA) appears to be not in favor of open source solutions for electronic healthcare records. If you read their background (first) paragraph, you’ll see the emphasis on developing proprietary vendor solutions. In addition they have raised objections to the Stark (D-Calif) bill as written, that would : “require the development of an open-source health IT system that could be used by providers as a low-cost investment to the often costlier systems already on the market. Such an option could mimic the electronic health-record system currently used by the Veterans Affairs Department.”

Their argument appears to be that offering a [well-tested, widely deployed, interoperable, freely available – my comments] EHR such as that developed by the VHA will somehow undermine the “competitive market” and “The development, routine updating, and provision of an open source healthcare information system is not the role of the federal government and such product development should remain in the private sector.” Do I hear a metaphorical face-slapping sound? Wouldn’t the entrance of a competitor with muscle such as VistA/CPRS enhance the level of competition, rather than diminish it? Methinks current precedent of overriding “market forces” with bailouts hath thusly weakend many freemarket philosophies.

Meanwhile, the Community Health Network of West Virginia(CHNWV) has successfully implemented an open source EHR (RPMS – a variant on the VHA’s VistA CPRS, used by the Indian Health Service (IHS). If you cast your eyes to the right side of the CHNWV link, you will notice one of their Senators has now introduced legislation favoring the use of Open Source software in healthcare.

The plot yet thickens more: RPMS has become CCHIT certified, and ironically the CCHIT/HIMSS connection has been criticized as being too cozy.

I don’t think I could write a soap opera with this many twists and turns. As the well-funded lobbyists converge to gain favor for proprietary systems, we can but wonder how all this will turn out?

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