Medsphere | Hospital EMR and EHR

W. VA. Rolls Out Enhancements To VistA

Officials with the West Virginia bureau of behavior health and health facilities are putting some finishing touches on VistA installations cutting across the state, adding computerized laboratory information to a six-year-old implementation.

West Virginia officials have implemented Vista in seven communities, Modern Healthcare reports. Facilities include an acute-care hospital, two psychiatric hospitals, four long-term care hospitals, a nursing home and two ambulatory care clinics. The facilities are all connected to a central database in Charleston via T1 lines.

The state has been working on contract with Medsphere Systems Corp. to install a VistA version known as FOIA VistA, a version in the public domain that can be obtained freely from the VA under the Freedom of Information Act, Modern Healthcare notes.

Though VistA itself is free, the state has spent heavily on installing it across the seven sites. Since FY 2005, West Virginia has paid Medsphere $8.4 million for system implementation, development and support, and is contracted to pay the vendor $939,800 this year for support.

In addition to paying Medsphere a monthly fee for systems support, the state pays licensing fees to InterSystems, developer of Cache, a version of the MUMPS database and programming language. It also licenses Keane’s financial system, which interfaces with VistA.

West Virginia began looking at a common infrastructure for all of its facilities when HIPAA passed back in 1996, noting that the idea behind it was portability and accountability. Now state officials are glad they moved ahead. “It’s expensive,” but “in terms of satisfaction, I think we’d all agree it was well worth it,” deputy commissioner for administration Craig Richards told the magazine.

Study: VistA Is Doctors’ Favorite EMR, Beating Epic

Despite more than a decade to work things out, discussions about open source vs. commercial enterprise software always seem to devolve into “religious wars” over the inherent goodness of one business model over the other. EMR software seems to be no exception to this rule, a state of affairs which has done little to advance the industry as a whole.

Well, maybe the following will help move the discussion into more positive channels. According to a new survey by Medscape, physicians prefer VistA over Epic, as well as Cerner, Meditech and McKesson, on characteristics which included ease of learning, reliability, value for the money, physician overall satisfaction and staff overall satisfaction.

According to the study, VistA came in at 3.89 out of 5 (five being “like most”), while Epic followed at 3.51, Cerner at 3.15, Meditech at 2.94 and McKesson at 2.91. (The pack was actually led by Amazing Charts (4.22) and Practice Fusion (4.04), both systems aimed at physician practices directly.)

Lest this seem like a flash in the pan, consider the results of a similar study done by the American Academy of Family Physicians in 2011. The AAFP, which asked physicians to compare 30 EMRs on 15 criteria. Of enterprise EMRs included in the study, Epic and VistA were neck at 5th and 6th, with McKesson 19th and Cerner 25th in line.

Now, in all fairness, it should be noted that the author of the blog item I mined for this piece is Edmund Billing, MD, CMO and EVP of Medsphere, whose product is OpenVista. But the stats outlined by Dr. Billing are worth considering nonetheless.

Perhaps we’re not ready for the religious wars to end, but throwing some relevant stats into the conversation couldn’t possibly hurt. After all, there’s never a bad time to take physician perceptions seriously.

Sometimes Epic Doesn’t Win: Public Hospital Goes Open Source

Most of the hospitals I write about go with big, expensive commercial EMR packages and suffer through upgrades and code fix schedules imposed by the vendor. The process seems pretty miserable, and rather inefficient, but IT departments are stuck with it.

That being said, at least some hospitals take advantage of the open source paradigm, including the following midwestern facility.

Oklahoma-based Stilwell Memorial Hospital, a 50-bed public facility, has decided to install Medsphere Systems Corp.’s OpenVista EHR. The Medsphere product is an open source derivative of the Department of Defense’s widely praised VistA system. Rather than millions of upfront bucks, Medsphere charges a subscription fee for OpenVista use.

As part of choosing OpenVista, Stilwell Memorial becomes part of Medsphere’s “Healthcare Open Source Ecosystem,” in which various users share code, system upgrades and tips for managing the system.

The question that pops into my head, as I read the background on this install, is why we’re hearing about a 50-bed hospital making this selection, but few if any medium-sized or large community hospitals.

After all, given its history as a massive DoD implementation, I don’t think there’s any question that VistA scales up well. And we are all over the taint open source once had as too casual a community for hard-core enterprise use, right? By at least a decade?

The truth, however, is that we probably all know the answer. The reason open source EMR installations are still in the minority is that CEOs and board members like the sound of having a giant, sprawling corporate partner better than working with a community. Meditech, Epic, Cerner and Siemens are more or less automatically shortlisted.

Sigh. Wouldn’t it be nice if hospital C-suite folks and boards were more flexible? Great things could happen.

Medsphere Makes Varied Pitch for Open Source EMRs

Historically, most of the arguments for using open source software of any kind revolve around cost and stability (e.g. free software is as cheap as it comes, and you can’t find a bigger dev team than the entire open source community). But at a recent conference backed by an open source EMR vendor, some hospital IT folks argued that open source tech can offer much more.

At Brooklyn-based Lutheran Medical Center, a 476-bed teaching hospital, execs plan to attest to meeting Meaningful Use Standards in early 2012. They’re doing so using Medsphere’s OpenVista, which as most readers would know is the daughter of the Veterans Affairs’ VistA platform.

According to LMC CEO Wendy Goldstein, using OpenVista has been critical in preparing for MU attestation. As with other enterprise-level open source users, Goldstein likes having access to the source code, she told the audience at Medsphere-backed Meaningful Use NOW conference. ( That certainly makes sense, given the pace at which regulatory demands on hospitals are shifting.)

We already know about open source software’s pricing and development advantages, but is that OpenVista’s only advantages? Perhaps not.

Medsphere claims that open source EMRs are better for taking on huge tasks such as transforming workflow and business processes, an intriguing if as-yet-unproven claim. Does having access to the source code really make a big difference in how effectively hospitals can customize their EMR? I’d argue that the jury is still out on that one.

And Meaningful Use NOW speaker Bill Petasnick of Wisconsin’s Froedtert Health System argued that the best way to unify health IT platforms across various organizations might be to use an open source, open-architecture solution. That may not be realistic from a market perspective, but it’s worth considering. Wouldn’t it be nice if some of the silos fell down?

– P.S. Want to follow up and check some platforms out? Check out this list of open source health IT options.

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W. VA. Rolls Out Enhancements To VistA

Study: VistA Is Doctors’ Favorite EMR, Beating Epic

Sometimes Epic Doesn’t Win: Public Hospital Goes Open Source

Medsphere Makes Varied Pitch for Open Source EMRs

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