VA electronic health records system could be low-cost option for non-VA hospitals

The Veterans Health Administration's open-source electronic health records system could be an effective and low-cost option for non-Veterans Affairs hospitals that are seeking to implement such a system but have been held back by the cost, the Wall Street Journal reports.

A recent survey in the New England Journal of Medicine found that fewer than 2% of the 5,000 non-VA hospitals in the U.S. have a full-fledged EHR system. Many facilities have said they cannot afford such a system, which can cost between $20 million and $100 million to implement, according to the Journal.

However, because the Veteran's Health Information Systems and Technology Architecture, or VistA, was developed over a 20-year period with several billions in taxpayer dollars, its source code is now part of the public domain. That means software developers can use the code at no cost and introduce additional features without restrictions. As a result, although the software still costs money to install and maintain, it frequently costs less than other options from private companies.

In addition, VistA, which is now used at more than 1,400 VA medical facilities, offers a standardized program that facilitates seamless transfer of patients' records between different hospitals and facilities, a benefit that private commercial vendors of EHR systems do not provide. The standardized software also reduces implementation costs and potential errors for users, according to the Journal. Furthermore, VistA provides the same benefits of most other EHR systems, which advocates say will reduce medical costs, medical and prescription errors, and increase efficiency and quality of care.

Kenneth Kizer -- chair of Medsphere and former undersecretary for health at VA, who oversaw the development of VistA -- said his company can implement its OpenVistA system "in one-third the time and for about one-third the cost" of other private companies that offer proprietary systems. Medsphere is one of several startups that has begun using VistA's open-source platform. However, Dan Garrett, a PricewaterhouseCoopers consultant, said that while VistA could be beneficial for some hospitals, the system's advantages have not been widely proven commercially like those offered by private companies.

The Journal profiled one hospital in Texas that has been using VistA, which cost the hospital $7 million to implement (Landro, Wall Street Journal, 4/30).