On Fri, 15 Oct 2004, Bill Walton wrote:

This is GREAT news! And the Health IT Strategist article, together with the
 VistA Office release, are "shots heard 'round the world" signaling VistA's
long term viability.

Or are they?

Before you "pop the cork" I think you should consider another, very probable
(based on my 16 years of experience IT products and services) possibility.

The "we're there" case is really only viable to the extent that VistA Office
 will be the only "industrial strength" Open Source (i.e., free) EHR software
 available to community-based physicians.  What happens when that changes?

As with any other informatics product this is not a "Make-a-Sale" game any health information architecture will evolve and it must evolve with the support, in this case, with te involvement of the health Professional specialty disciplines. Clear capability targets are needed stated in implementing technology-independent language so that the VistA Open Source community can manage its evolution and the proprietary product vendors can manage theirs. Acquirers must understand that there is not "Free Lunch" and it is "what do you pay for what you get". Acquirers must procure compoenents and build their individual information architecture to serve their enterprise and they must have the knowledge and skills to do that effectively. Thye can utilize open and closed sources.

How does VistA fare in head-to-head competition with, say, "Open Logician"?

With an appropriate strategy.

  My background says VistA loses, big time.  On every single front that matter
 from a market viability perspective.

Your opinions are yours but I do not agree as an acquirer.

I won't rain on your parade anymore here except to say that unless the VistA
community addresses the marketability issues that have, more than once, been
pointed out here, the recent HHS initiatives regarding VistA are not
"21 gun salutes."

No one says they are. They are just the beginning of addressing the problem by both Suppliers and Acquirers.

They're shots to the head.

Both Users and Suppliers are in an immature market and we all need to learn.

I think you need to begin a serious discussion of survival strategy.

And you too! in my view.

Best regards, Bill ----- Original Message ----- From: Michael Ginsburg To: [EMAIL PROTECTED] Sent: Friday, October 15, 2004 8:04 AM Subject: [Hardhats-members] Fwd: Text of Article from Modern Physician


This is from Modern Physician:


IT vendors invited to show interest in new vistas By Joseph Conn / October 13, 2004







 Next week, the CMS will hold a meeting with information technology vendors interested 
in using a proposed version of the Department of Veterans Affairs' comprehensive 
computerized electronic record and IT system -- the Veterans Health Information 
Systems Technology Architecture, or Vista -- modified for use in physician offices.

 The CMS/VA effort aims to bring the Vista Office Electronic Health Record, a proven, 
affordable version of an electronic medical records system, to the small-group office 
practice, where EMR penetration rates are lowest due to system costs.

 The vendors meeting on the Vista-Electronic Health Records project is scheduled for 
Oct. 20 in Washington, D.C.

 At the meeting, CMS and VA officials will gauge the level of vendor interest in the 
project as well as raise awareness of the initiative, according to Capt. Cynthia Wark, 
an officer in the Public Health Service and deputy director of the information systems 
group in the CMS' Office of Clinical Standards and Quality.

 "We just want to figure out if we put this out on the street, are any of the vendors going to pick 
up on it," said Wark. "We're trying to gauge the interest. The other thing is to let people know 
what we're doing."

 Wark is a registered nurse with certification in medical informatics from the 
American Nurses Association. She comes to the job from the Indian Health Service, 
which uses a modified version of the VA clinical IT system.

 Under CMS' Physician Focused Quality Initiative, the federal agency has joined with 
the VA in a plan to scale the massive Vista program to office size.

 "One of our goals is to help physician offices get over the impediment of an investment in 
a software product -- and why not do it (with Vista) since the government has invested a lot of 
money in a product that without too much modification physicians can use in their office," 
Wark said.

 Vista, which comprises about 100 program modules -- including programs to run 
activities as far-ranging as an inpatient pharmacy or an out-patient mental health 
service -- also includes a module called Computerized Patient Record System, or CPRS, 
which is an electronic medical record system. The Vista CPRS has already been adapted 
to the office practices by several private consultants working independently of CMS. 
(See the current Health IT Strategist.)

 Copies of the Vista software are available free under the Freedom of Information Act, 
but the VA provides no support for installation and maintenance of Vista by outside 
users. License fees also are required for the Cache database and computer language on 
which the system runs on the server side, and for Windows for some applications that 
have a graphical user interface on the provider side.

 The Pacific Telehealth and Technology Hui, based in Hawaii, a joint venture of the VA 
and the Defense Department, has ported Vista to the open-source Linux operating system 
and GT.M database. Their aim was make the system more broadly available by reducing 
licensing fees. The software can be downloaded for free on the Internet at the Web 
site of WorldVista, a not-for-profit organization of Vista supporters.

 CMS' Vista Office EHR will run on the Cache database and the Windows operating 
system, according to Dennis Stricker, CMS' director of the information systems group 
in CMS' Office of Clinical Standards and Quality.

 Vista is the IT backbone of the VA's vast healthcare system that provides care to 
more than 7 million people at 1,300 care sites, including more than 800 out-patient 
clinics and more than 150 hospitals.



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