VistA Expo 2011: Conference Report

Roger A. MaduroI have been in In Redmond, Washington for the past two days attending the VistAEXPO 2011 conference. We are midway through the conference and it's time to write some comments. First and foremost I should note that this has been the most productive meeting of the VsitA community that I have attended.

The conference, organized by the VistA Expertise Network, has featured a whole range of presentations and discussions from high-level briefings on the work of the Open Source Electronic Health Record Agent (OSEHRA) to technical presentations on breakthrough enhancements for VistA such as the Enterprise Web Developer (EWD) and the ePrescribing package.

Some of the most awaited presentations were those from OSEHRA. The organization chartered by the Department of Veterans Affairs (VA) to become the Custodial Agent of VistA. The OSEHRA team was represented by Matthew McCall and Luis Ibañez.

McCall provided background on OSEHRA as well as details of the organization's accomplishments so far. Ibañez led a series of lively technical discussions on the infrastructure and toolkit that OSEHRA has created to manage the development of the open source code.

As background McCall reviewed the mission of OSEHRA. Some of the salient tasks are:

• To provide a path to rapid EHR innovation through the use of open-source tools and practices.
• To engage all VistA community participants (e.g. Developers, Contractors, Providers, Nurses, Patients, Academia, etc.).
• To support the integrity of open-source solutions by providing an OSEHRA certification function.
• To facilitate and support open-source projects contributed across platforms and communities. 

According to McCall, OSEHRA has met all milestones and deliverables set by the VA for the gestational period of the organization. OSEHRA is now entering what it calls the "Nascent Phase" of initial growth. The goals of this phase are:

• Develop a robust community around VA EHR and aligned Health IT initiatives.
• Integrate aligned initiatives into OSEHRA framework.
• Continue to enhance and refine development tools provided to the community.
• Further, refine and enhance certification services.
• Further, develop and maintain product definition and architectural documentation.
• Enhance community participation and educational offerings.

McCall had a very lively discussion with the audience on how to expand the community. As of Nov. 5, OSEHRA has 478 registered users as well as more than 70 institutional members including 60 businesses and 12 academic institutions.

The major news item from McCall's presentation was the announcement by VA CIO Roger Baker that from this point on all continuing development of VistA is going to be done through OSEHRA. Baker made this unexpected announcement during a meeting between OSEHRA and key VA personnel. 

According to McCall, the VA has made the following commitments to OSEHRA:

• The VA will use the OSEHRA EHR product as its EHR.
• All VA software development will be focused on the OSEHRA product.
• VA staff will contribute code to OSEHRA on a frequent release schedule using the VA Contribution Agreement.
• VA employees and contractors may choose to contribute code on their own time and do so using an Individual Contribution Agreement.
• VA will establish a governance process with OSEHRA to determine what parts of the contributed software constitute the “gold” release.
• VA will develop a test/release process to accept the OSEHRA product into the VA production environment.

These are clearly huge steps for the VA in its course towards an open source strategy. The announcement was very well received by the VistA community. We will have additional updates on the conference over the next few days.