VA Secretary Articulates Open Source Strategy as the Core of VA’s Transformation During OSEHRA Conference

Robert A. McDonald, Secretary of the US Department of Veterans AffairsRobert A. McDonald, Secretary of the US Department of Veterans Affairs (VA), articulated a clear strategy for the VA’s technology efforts based on open source, crowdsourcing and agile development during a speech at the 2015 OSEHRA Open Source Summit in Bethesda, MD yesterday. McDonald, who was the keynote speaker of the conference, gave an overview of the crisis that the VA was facing a year ago and the steps taken to address the crisis. McDonald said that his primary step was to change the focus of the discussion from problems within the VA bureaucracy to a focus of putting the customers, America's veterans and military personnel, at the center of things.

McDonald began his presentation by calling himself a computer geek, pointing out that he learned programming as a teenager on an IBM 360. He cited Malcolm Gladwell’s book, “The Tipping Point: How Little Things Can Make a Big Difference” as a great guide for solving problems. He said that the approach for digital technologies at the VA will be based on open source, crowdsourced innovation, open standards, and collaboration. He said that he had spent eight months recruiting the incoming CIO, Laverne Council, former CIO of Johnson & Johnson, to drive this strategy.

McDonald talked about the importance of being able to exchange medical records with the Department of Defense (DoD). He said that Federal government agencies should be sharing open source EHR software, adding that this included not only the VA and DoD, but also the Indian Health Service (IHS). He emphasized that he wants to partner with the military health system in building an interoperable health system, saying that such a systems is critical to the health and well being of America’s military personnel and veterans.

McDonald did not address the obstacles that his partnering approach is going to face as the Department of Defense explicitly rejected an open source collaborative strategy and just picked a pre-Internet, mainframe-based EHR developed in the 1990’s, as their future EHR system. This issue hung heavily during the conference as the DoD announced it had awarded the EHR contract to proprietary EHR vendor Cerner during the conference. Many conference participants noticed that the Department of Defense did not send a single representative of the conference, which was attended by hundreds of participants from the public and private sectors as well as foreign countries. Marc Wine, a health IT strategist who led a panel at the conference on the Blue Button technology commented “how can we believe that DoD is serious about interoperability with the VA when they don’t even show up at the key VistA and EHR collaboration conference?” Wine added that DoD personnel “should have been actively participating in the panels discussing interoperability and information access.”

Given McDonald’s stance on open source, it was clear to the audience, which included many key VA IT personnel, that he fully backs the VA’s Open Source Policy Memorandum. The implications of the memorandum were detailed by Richard Avila during a session at the OSEHRA conference. Avila, one of the key leaders of the open health community, spent a year at the VA helping draft and implement the VA’s open source strategy. McDonald also talked about his trips to Silicon Valley to recruit young developers to come to the VA to develop software and communicate the principles of agile development.

Dr. Seong K. Mun, President and CEO of OSEHRA told Open Health News that the fact that the Secretary of a Federal government agency would come to address an IT conference, “underscores the importance that he places on IT, transparency and community involvement in the development of the code and operations of the organization.” Dr. Mun said that McDonald came across as a “visionary” who is “fully committed to the care of America’s veterans and military personnel.” Dr. Mun added that “open source software is clear example of public, private sector cooperation in IT.”