Edmund Billings

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EHRs: Buy vs. Build, or the Best of Both

In the electronic health record (EHR) market, even though an enterprise solution is not an operating system, the parallels are clear. Healthcare organizations use expensive and complex proprietary systems that are difficult to maintain.  The leading systems have prohibitive total costs of ownership. Ownership is undermined by vendor lock. The most important and valuable enhancements are held back for the next chargeable upgrade.  Lack of interoperability is a business model.

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First cut of VistA for NHS developed

Rebecca Todd | E-Health Insider | December 11, 2013

Two US companies have worked with UK open source experts to create a ‘first cut’ of an anglicised version of the VistA electronic patient record system. Read More »

For Hospitals on the Edge, Health IT is the Tipping Point

Without question, massive health IT expense and the predominant proprietary IT model are threats to a hospital or health system’s financial viability, to its solvency. We’re seeing some examples even now. Michigan’s Henry Ford Health System recently reported a 15 percent decrease in net income as a result of uncompensated care and $36 million spent on a proprietary EHR system. According to health system CEO Nancy Schlichting, “We knew that 2012 and 2013 would not be easy years for the system because of the Epic costs.” Read More »

Go-live gone wrong

Bernie Monegain | HealthcareITNews | July 31, 2013

Much anticipated, and sometimes hyped, electronic health record system rollouts cost millions of dollars and often end up causing chaos, frustration, even firings at hospitals across the country. Case in point: Maine Medical Center in Portland, Maine, a 600-bed hospital that is home to the celebrated Barbara Bush Children’s Hospital, and a part of the MaineHealth network. Read More »

Google Joins VistA Team Proposing Open Source EHR for the Department of Defense

Google has thrown its hat into the EHR ring by joining the team led by PwC which is proposing that the Department of Defense (DoD) upgrade their current EHR to Defense Operational Readiness Health System (DORHS), a customized application built for the DoD and based on VistA, the open source EHR developed by the U.S. Department of Veterans Affairs (VA)...Google’s participation has enormous implications for both the DoD’s EHR and to the healthcare industry as a whole. By choosing the open source EHR team, Google...has sent a clear message to the world that VistA is the best option for the DoD.

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Health IT Innovation? Not Without Open Platforms

The issue here is closed platforms, which enable most EHR vendors to position themselves as the single source of innovation. They also create dependent customers and glacial progress in two parallel areas of innovation—evidence-based medicine and information technology.  No one company can keep up with the natural pace of advancement in either realm, let alone both. Read More »

House Republicans and Democrats Find Rare Bipartisan Agreement on Open Source IT Procurement

In these politically polarized times, Americans expect Republicans and Democrats to disagree on every detail right down to what day of the week it is...So it’s remarkable and unexpected when any legislation exits a House committee with unanimous bipartisan support. It’s even more surprising when the legislation potentially threatens the status quo for established corporate interests—in this case information technology companies. The Federal Information Technology Acquisition Reform Act (FITAR) —sponsored by California Republican Darrell Issa along with Virginia Democrat Gerry Connolly, and supported by every member of the House Oversight and Government Reform Committee—threatens to put open-source software on par with proprietary by labeling it a “commercial item” in federal procurement policies. Read More »

How Closed EHR Records Cause Paralysis

Take a step back from the challenges that surround health information technology (HIT) interoperability and you will recognize that market forces and a desperately fragmented health care system make hospitals and vendors act the way we do...The predominant proprietary HIT vendors know about the interoperability gap yet engage in prolonged foot-dragging on even basic data interfacing. Read More »

Is an EHR backlash brewing?

Tom Sullivan | Government Health IT | February 19, 2013

#EHRbacklash was born as EHRs, vendors, and the meaningful use incentive program are under perhaps as much fire as they’ve faced yet. On Tuesday, in fact, Black Book Rankings managing partner Doug Brown essentially struck at all three by saying that “meaningful use incentives created an artificial market for dozens of immature EHR products,” a scenario that may trigger “the year of the great EHR switch,” in 2013. Read More »

It’s About Time: Open APIs Finally Burst Onto Healthcare’s Sluggish Scene

Sue Montgomery | Nuviun | June 9, 2014

In the midst of the struggles that we face with interoperability, efforts that support open API use may well hold the keys to the HIT Kingdom...

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MaineHealth Facing Financial Debacle due to Proprietary EHR Install

The scenario: A sophisticated medical center health system begins to roll out an expensive proprietary EHR and shortly thereafter sustains an operating loss, leaving no choice but to put the implementation on hold. The operating loss is attributed to “unintended financial consequences” directly related to buying a very expensive EHR system. This is exactly the situation at MaineHealth, who selected Epic. Read More »

Medsphere Makes Key Code Contribution to OSEHRA VistA EHR Core

Press Release | OSEHRA, Medsphere Systems Corporation, VistA Expertise Network | November 21, 2014

Medsphere Systems Corporation (MSC) has contributed its latest version of FILEMAN to the Open Source Electronic Health Record Alliance (OSEHRA) code repository.  FILEMAN 22.2 is arguably the single most important component of the Veterans Health Information Systems and Technology Architecture (VistA), and is one of the largest open source contributions to date. Read More »

Obama and Biden Blast EHR Vendors for Data Blocking

As they are winding their terms in office, President Barack Obama and Vice President Joe Biden dropped a stink bomb on the health IT industry. Speaking at different events on Friday, January 9th, the President and Vice President both criticized proprietary electronic health record (EHR) vendors as the primary obstacle to the success of their administration’s health care strategy. This is the highest level acknowledgment so far of the serious impact that “lock-in” EHR software vendors are having on America’s medical infrastructure and the ability of physicians to provide medical care.

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ONC Must End Opposition to Behavioral Health EHRs

Because our policy makers in Washington, DC, wield words as weapons, the Office of the National Coordinator (ONC) for Health IT has categorized behavioral health providers as “post-acute care,” thus excluding them from MU funding that has driven EHR adoption elsewhere. While the ONC has created one reality by lobbing definitions, behavioral health advocates are promoting THE reality of mental illness as acute and costly; as debilitating as any disease or condition, if not more so; and as a major co-morbidity factor exacerbating acute illnesses and driving up health care costs. Read More »

Open Health Round-Up For 2014: Notable Articles, Reports, And Events

Even the hidebound field of health care can undergo a lot of change over the course of one year. Key health IT trends that I saw throughout 2014 are summarized in another article. Here I'll list some of the most notable articles and reports related to open source, standards, and transparency in health. Read More »