points by trimbo 5 years ago

It's worth noting that the VA's most critical software -- its EHR system, VistA -- is public domain with the source code available.

However, despite being a critical, successful piece of open source software that had massive investment over decades, it's being abandoned for a commercial system, Cerner, in a $16bn project.

https://ehrintelligence.com/news/va-cerner-implementation-co...

rjzzleep 5 years ago

That thing is actually mostly designed by HP and RedHat, had really weird design choices and wasn't cheap either.

In my opinion none of them were capable of designing a user facing application. It was also built as a client/server desktop application. Not really a good choice in my opinion. Sure there were no offline PWA at the time, but by contrast if your SAP backend dies all the local applications in a hospital e.g. writing the release report also dies.

Needless to say given it's immense complexity it was also impossible to use this monstrosity elsewhere.

But replacing it with Cerner in a $16bn project is just sad.

rattray 5 years ago

Why is that happening? How successful was the open source software?

  • trimbo 5 years ago

    As far as software success goes, all healthcare providers at the VA have used VistA daily for a couple of decades (actually CPRS -- it's like an MFC app or something on top of VistA). A relative who works at the VA likes it, and is not excited about moving to Cerner.

    Why Cerner? I don't know.

  • dmm10 5 years ago

    VistA has been a very successful open source project and is being continued in OpenVistA [1]. Originating as a software project in the Veterans Administration (named VA MUMPS) in 1977 it only took on the name VistA in 1994[2]. Internationally it has been used freely in hospitals in the U.S., Mexico, India, various countries in Africa, ...[3].

    It was a truly open source project within the VA with programmers customizing this national patient record software in cooperation with doctors (to meet their needs) locally and sharing the modifications nationally. Perhaps its greatest technical challenge (besides complexity arising from decades of evolution) was finding programmers to work with the MUMPS language that it was written in. FYI MUMPS is a language with an integral db -a concept which was out of vogue for some time.

    Political challenges are another story[4].

    [1] https://sourceforge.net/projects/worldvista/ [2] https://www.hardhats.org/history/hardhats.html [3] https://worldvista.org/AboutVistA [4] https://www.politico.com/agenda/story/2017/03/vista-computer...