"The software itself is free, but as Siegel noted it still costs millions to install and maintain"
"Few hospitals go paperless using free VA software; Electronic record system helps W. Va." by Lisa Wangsness, Globe Staff | May 4, 2009
WASHINGTON - In a country where just 1.5 percent of US hospitals have fully computerized records, one of the poorest and least technologically advanced states has created a paperless records system for its state-run hospitals and nursing homes serving the indigent elderly and mentally ill.
West Virginia did it on the cheap by using an electronic medical records system built by the Veterans Administration with taxpayer dollars, saving millions in software licensing fees charged by commercial software vendors. The VA software, known as VistA, is open-source software - its code is freely available to the public and is constantly being improved by users - and it includes important features, such as a bar-coding system to track drug dispensations, to help improve patient safety.
You sure that is the best system?
"Patients at Veterans Affairs health centers around the country were given incorrect doses of drugs, had needed treatments delayed, and may have been exposed to other medical errors due to software glitches that showed faulty displays of their electronic health records"
Also see: What the VA Really Cares About
But very few US hospitals have taken advantage of it. Wealthier hospitals have opted to buy more expensive, custom systems from private vendors, while smaller and more rural hospitals often stick with paper records....
Phillip Longman, a fellow at the New America Foundation and author of "Best Care Anywhere," a book about the Veterans Administration's quality-of-care revolution, said VistA is an unrecognized national resource.
"It's really insane that we have a fully developed health information technology system that is bought and paid for and free to anybody who wants it and used widely around the world by other governments running their healthcare systems . . . and yet we don't have any take-up in the US, or not much to speak of," he said....
Michael Siegel, a professor at MIT's Sloan School of Management, said he thought small rural hospitals in western Massachusetts "could very much benefit from an open-source system, but they're not."
Technology experts cite a number of reasons why: The software itself is free, but as Siegel noted it still costs millions to install and maintain, so money remains a barrier.
My town can't afford that; we in deficit as it is!
There is also another problem - installing and running VistA requires skilled technology workers, a resource lacking in many hospitals, particularly smaller and more rural institutions.
I knew there were catches!
Edmund Billings, Medsphere's chief medical officer, said it can be difficult to persuade hospital executives to buy into a system that does not have a large sales force to promote it. The private vendors, he added, have deployed a significant lobbying force in Washington, and the Bush administration's pro-private sector leanings put the focus on developing standards to try to get different brands of commercial software to communicate - not on promoting a government-sponsored alternative.
"The business software alliance lobbies against any open-source provisions," he said. "And that's a hard thing to beat when they have more capital."
--more--"Which is why we come nowhere near single-payer, universal coverage!
