It is significant to note that these process characteristics are the basis of the evidence based medical model and open source development model.
The kudos VistA and the VA have received of late are a result of VistA's DNA.... DNA that was shaped in the early days and improved during the era when the management model tolerated and worked with the distributed, user driven model. This is the ONLY model that will work effectively in health systems...health systems are complex adaptive systems and it is from this "new" perspective that we need to solve IT problems in health care.
The irony of the current discussion etc. is that the VA got it right...my guess is that it was the interval between developing VistA to the point where it had a critical mass of capability and experiencing its impact in terms of health outcomes (VistA has been recieving significant praise for only the last few years) that made the management strategy vulnerable to criticism. The peddlars of the "latest fad" or software product were able to captilaize on whatever "inferiority complex" or criticism there was of the VA and knock them off the right strategic direction. Time lag is often a killer of excellent strategy....imagine if the VA and VistA were receiving the recognition it has recently, say 8 years ago...what would the HealtheVet strategy look like? How could the HealtheVet strategic goals be met by re-adopting what the VA was doing right?
Joseph
Greg Woodhouse wrote:
There is much truth in the old adage that if we keep asking the same questions we'll keep getting the same answers.
One hundrd years ago in 1905, Einstein asked a different questions, and the results were both the birth of quantum mechanics and the theory of special relativity.
What questions should we be asking?
A practical man is a man who practices the errors of his forefathers. --Benjamin Disraeli
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Greg Woodhouse [EMAIL PROTECTED] [EMAIL PROTECTED]
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