VistA 'Custodial Agent' Site Goes Live

After a long and suspenseful wait for the VistA community, the web site for VistA's 'Custodial Agent' effort went live this morning. Little information has been released by the VA or the 'Custodial Agent' team since the contract award was made so this is the first time the community gets a chance to see what the 'Custodial Agent' team has been working on.

A quick review of the site indicates that the team has done an impressive job in gathering all the information about VistA and  open source methodologies. Named “Open Source Electronic Health Record Agent (OSEHRA),” the organization has delivered a code repository for VistA, a suite of tools for online collaboration, and a an extensive set of documentation and educational resources. The site allows for multiple ways for the VistA community to work with both the code base, and all associated documentation. Hopefully, the first contribution from the community will be a new name for the organization.

Given the substantial amount of content already in the site, in this article we will focus on the plans for the organization. These can be found in the Plans and White Papers section of the site. As stated in the site, OSEHRA created “a series of draft plans that define what OSEHRA will be doing (with your help) to bring the open-source community around VistA to a new level.” These draft documents describe OSEHRA's 'proposed approach in key areas such as the code repository, software quality certification, and community enablement.”

Before going into detail, however, we would like to quote an excellent summary of the 'Custodial Agent' effort we found in the white papers for those who are not familiar with the subject. In summary:

“Open Source Electronic Health Record Agent (OSEHRA) is a not-for-profit corporation established under the sponsorship of the Department of Veterans Affairs of the United States. The Office of Information and Technology of VA is responsible for the development and maintenance of the Veterans Health Information Systems and Technology Architecture (VistA), VA’s Electronic Health Record (EHR). The OSEHRA’s responsibility is to facilitate the rapid rate of innovation and improvements of VistA that have been isolated from private sector components, technology, and outcome-improving impacts. This responsibility is to be executed by adopting the open source business model built within incipient VistA code base and migrate it to Open Source EHR, which is an openly architected, modular, and standard-based platform suitable for deployments in a variety of healthcare settings, such as government, private, and international.”

OSEHRA Plans and White Papers

OSEHRA provides short “white paper” versions of the plans in order to allow members of the VistA community to “quickly review the highlights.” More detailed and extensive draft plans are also readily available. As stated on the website, the OSEHRA team knows that they “did not get everything right in these documents” and are specifically asking the community for feedback. OSEHRA has provided multiple ways for community members to provide their comments and suggestions. At the same time, the VA has mandated a very aggressive timeline for OSEHRA so that feedback for these plans must be provided by September 16. That leaves a little over two weeks for the community's input.  This is clearly where the community's focus must be at the present time.

We have reviewed some of these plans and our initial thoughts are below.

The draft white paper we would like to review is the Software Licensing Terms white draft white paper. This is a very well written and thought-out white paper on open source licensing. The OSEHRA teams makes a very clear and cogent argument in this paper for the adoption of a 'commercially friendly' open source license. This has been a subject of major disagreement in the VistA community for the past decade, leading to severe fragmentation and duplicate work. OSERCA specifically recommends the Apache 2.0 license. The white paper goes into great detail as to why this is the best open source license for VistA. The paper addresses the legal framework of open source software, including copyright, trademark, and patent laws, and then examines all the major open source licensing options in great details. Apache 2.0 is a good open source license for VistA, and this choice will hopefully finally settle the bitter licensing arguments that have caused such grievous harm to the community.

The next set of plans is for the Code Repository. OSEHRA's plans are summarized in the Repository White Paper. The full plan is laid out in the draft Repository Design and Plan. According to OSEHRA, the purpose of the code repository is “to host the code base of VistA and to make this resource readily, publicly, and continuously available to all.” The expectation is that the code repository “and its associated procedures” will facilitate “the maintenance of the code base by streamlining the process of detecting and fixing defects in the code in coordination with the certification procedures.” In addition, the code repository will be a central  mechanism used “to bring innovation into the code base by facilitating the process of moving contributions from the periphery of the ecosystem toward the official code base as the code is improved through the process of software quality certification.”

OSEHRA has decided to use a set of tools based on the Gerrit Code Review server. The code repository plan will be completed in two phases. Phase I will provide a read-only code repository containing a FOIA VistA release provided by the VA. Phase II, scheduled to start on October 18,  will fully open the code repository to the community, allowing all community members to make contributions to the codebase.

The next set of plans is for Software Quality Certification. These plans can be found in summary form as well as in a full draft plan document. The initial objectives of the certification are “the attestation and ultimately the verification that all executable artifacts managed by the OSEHRA meet the following criteria:

• Safe: Individual code units do not cause errors in other components of the system and the code is robust to all code paths and conditions.
• Compliant: Code meets agreed upon interface specifications and is adherent to all applicable laws and regulations.
• Functional: Code has a defined set of requirements that are met when the code executes.”

The plain outlines that the VA “has developed an extensive set of processes and procedures that are currently used to certify” VistA. However, much of this certification infrastructure and information “is not currently shared with potential members of an open source development community external to VA.” The plan states that it is not the purpose of OSHERA to replace what the VA does now, or to become a testing body. Instead, it will “establish a framework of tools, procedures, and educational materials to enable and actively engage a vibrant open source community and evolve a robust, community-based software quality certification process.” OSEHRA's intent is “act as a unifying body for the purpose of innovating toward an Open Source EHR.” Its software quality certification process will “certify that all developed code adheres to the parameters of the open source community and will help the community develop code and applications that will be compatible with and easily integrated into the codebase and software quality certification process.”

Last, but not least are OSEHRA's plans for “Community Enablement” which is a fancy label for building an open source community around OSEHRA. These plans are laid out in summary form here and as part of a detailed draft plan here. The plan calls for a full-fledged outreach effort to the community as well as the development of web-based tools and resources that will allow the community to collaborate with the project as well as with each other.

Over the next few days, Open Health News will be analyzing in more detail all of these plans in more detail as well as the rest of the materials already in the OSEHRA site.