December 4th, 2008
First test arrives of Obama promise to transform health IT
The first test of the Obama Administration’s promise to transform health care through technology is coming fast, as the U.S. military and Veterans Administration move toward contracting a unified system for health IT.
The VA has long used a public record system, VistA, which is the basis of the open source project WorldVista. The military runs AHLTA through a contractor, Northrup-Grumman.
Users hate AHLTA, and love VistA, but customers don’t seem to have many advocates as the military moves toward giving VistA over to a closed-source commercial contract.
That effort took a big step forward this week.
A study by Booz Allen said the military and VA systems are functionally similar and recommended a single contract be awarded, suggesting Epic Systems or Cerner for the work. Booz Allen was bought by the Carlyle Group this year.
At Booz Allen’s suggestion, both the Department of Defense and VA are moving toward a Service Oriented Architecture, but that doesn’t specify contractors or standards the way a contract does.
UPDATE: Booz Allen says its work is being misinterpreted. Here is what a spokesman wrote today:
Booz Allen did not recommend a single contract be awarded, nor did we suggest Epic Systems or Cerner for the work. Booz Allen recommended that the two departments collaborate to create a service oriented
architecture with a time-sequenced service implementation plan.
Why does this matter to you? Between them the military and veterans control one of the biggest pieces of IT infrastructure in the nation. Their choice could easily define the direction of health IT for everyone else.
Unfortunately open source and open, royalty-free standards look to be outgunned in this fight. Defense Secretary Bob Gates is staying on, as is the business structure favoring proprietary solutions.
The industry, through the Healthcare Information and Management Systems Society (HIMSS), also favors a “commercial” (read proprietary) approach to the problem. Only VA advocates show any support for open source.
Ironically this is one area where Microsoft can do great work for the cause of open source. Its Amalga unit does not seem to even be under consideration for this work.
If Microsoft made open standards a rallying cry its lobbying muscle could slow the contracting train down enough for open source efforts to climb on and stop it.
Another actor who might want in to this drama is Tom Daschle, recently selected as Secretary of Health and Human Services. A unified health IT strategy can start with this contract, but only if the new HHS secretary demands it and has the President behind him.
If a closed system is chosen for this contract it could prove disastrous for efforts to open up health IT standards. If the largest piece of the health IT puzzle is held by a proprietary, closed source company, how can open standards get in the door?
On the other hand this contracting process could easily prove an enormous opportunity. Regardless of who is contracted to do the work, that contract should specify use of open, royalty-free standards. It’s our money.
Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.
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| 12/06/08
