Sharing international experience: Is implementing the VA's electronic health record system an option for the NHS?

^{Nuffield Trust's Geraint Lewis - currently working on sabbatical at Walgreens in Chicago - outlines why VistA, an open source electronic medical record system, would be a viable option for the NHS.}

This roundtable focused on sharing international experiences of using the VistA system and considered whether or not VistA might be an effective option for the NHS.

In the 1990s, the Veterans' Health Administration (VHA), part of the U.S. Department of Veterans Affairs (VA), was transformed into one of the world's highest performing health care systems. Along with strong leadership and a focus on primary and preventive care, this transformation was helped by the use of a comprehensive electronic health record system, VistA.

VistA, an information system with several million users, was developed by doctors working for the VHA, and it spans primary care, secondary care and social care. Since the VHA doctors were employees of the Federal Government, all of their work is in the public domain and the system has become open-source.

This means that the entire VistA system can be downloaded, used and adapted by other health care systems entirely free of charge. For example, the National Health System of Jordan is currently implementing VistA in all hospitals and GP practices across the country.

At the seminar delegates had the opportunity to:

• Increase their understanding of VistA and its potential challenges and benefits;
• Learn from international experience of implementing VistA, including a case study from Jordan;
• Consider whether they think it is feasible and/ or desirable to encourage the use of VistA in the NHS.

Speakers included:

• Joseph Dal Molin, President, E-cology Corporation and Chairman, WorldVistA who discussed implementing VistA in Jordan;
• Dr Geraint Lewis, Senior Fellow, Nuffield Trust, who joined us via video link, on understanding the VistA electronic health record system;  
• Mike O'Neill, Department of Veteran Affairs, who joined us via video link to discuss making VistA more accessible;
• Dr Tony Shannon, Consultant in Emergency Medicine, Leeds Teaching Hospitals NHS Trust who raised practical considerations for implementing VistA in the NHS.

The seminar will be chaired by Dr Jennifer Dixon, Chief Executive, Nuffield Trust.