Is this the good news or the bad news? VistA needs a few elements to make it complete. That is a recommendation for VistA not an objection. There's no other open source project out there that can make that claim...that can even remotely make that claim.

Dave makes a very important point...VistA needs to be able to, and can,
integrate with other systems...and while a fully integrated system as
Ignacio points out is much easier to work with the reality is that in
most cases migration requires several steps. Secondly VistA doesn't have
all the bases covered...e.g. obstetrics and pediatrics are not in VistA
but are in its derivatives in the Indian Health Service and in the DoD
system. It also does not have financials that would be up to what is
necessary in most hospitals.

Joseph




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