The potential value to the NHS of learning from the international experience of the electronic medical record (EMR) system, VistA, was identified in the January 2002 NHS Information Authority White Paper:Open Source Software and the NHS.
Ten years on, and several billion pounds of investment later, the NHS is still without a satisfactory comprehensive electronic medical record system.
Open-source software has gone from strength to strength and is now standard for much of the technology industry and is increasingly used by the Government.
The open-source Veterans Health Administration’s VistA system continues to receive international investment and to deliver on usability, usefulness, flexibility and cost-effectiveness where other systems have failed.
Making better use of information and achieving more value for money in NHS IT procurement are major challenges for the NHS
The strategic competitive advantage of open-source software is enormous; lock-in can be avoided, there is greater flexibility, costs are reduced, and basic enlightenment scientific principles such as methodological openness and peer review are respected.
Health care is an information rich business. Making better use of information and achieving more value for money in NHS IT procurement are major challenges for the NHS, and must principally be met locally.
At the recent Nuffield Trust roundtable on VistA, Joseph Dal Molin of WorldVistA discussed his experience of a large-scale successful implementation of VistA in Jordan and Mike O'Neill from the Department of Veterans affairs discussed the significant ongoing US investment in VistA and the related OSEHRA project.
Dr Ross Fletcher, Chief of Staff at the Department of Veteran Affairs in Washington gave a live demonstration of the functionality of VistA on his iPad. Dr Tony Shannon also told of how he had recently successfully delivered a local open-source clinical portal and why open-source is necessary for the NHS.
Several senior NHS figures present were very impressed with the value of VistA and its potential in the NHS. Discussion moved to the practical steps required for implementation at a demonstrator site.
In summing up Dr Jennifer Dixon of the Nuffield Trust commented that on the strength of the evidence presented NHS VistA seems a “no brainer”.
With the support of the international VistA community, the pressing need to make better use of information with less money, and the energy of those involved, an NHS VistA is now looking more likely than ever.
Dr Carl Reynolds is National Clinical Fellow at the Department of Health and the National Patient Safety Agency. Please note that the views expressed in guest blogs on the Nuffield Trust website are the authors' own.
Reynolds C (2012) ‘NHS VistA: The enlightened choice?’. Nuffield Trust comment, 12 July 2012. https://www.nuffieldtrust.org.uk/news-item/nhs-vista-the-enlightened-choice