OSEHRA 2014 Summit to Rock EHR World

Roger A. MaduroThe world of electronic health records (EHRs) is going to be rocked next month as the Open Source Electronic Health Record Alliance (OSEHRA) holds its third annual summit in Bethesda, Maryland. After four years of quietly building a organization to promote VistA and open source in healthcare, as well as a central host for the core VistA code, OSEHRA is now emerging as a major force in the world of EHRs. The conference has become a gathering place for not just the VistA community but for major health IT players in the federal government, including the US Department of Veterans Affairs (VA), and Indian Health Service (IHS), and major forces in the open health field. The three-day conference will feature more than 120 speakers addressing 90 separate sessions.

The conference has expanded from last year's conference with joint sessions with the VistA Expertise Network (VEN), and a half-day session where senior people from the VA will discuss their VistA Evolution plans.

The VistA Expertise Network (VEN) hosts the annual VISTAExpo in Seattle in October has decided to join forces this year with OSEHRA as detailed here, and lead a special half-day "Town Hall" on “The Future of VistA” instead of hosting their regular conference.

The US Department of Veterans Affairs (VA) will be playing a major role at the conference with more than 20 speakers, including its top IT leadership, addressing multiple sessions. On the third day of the conference, the VA will hold a full half-day session on the VA's plan for the next generation of VistA, VistA Evolution with a substantial amount of time allotted to discussion and interaction with the audience.
Last, but not least, a large amount of solution providers have stepped up to the plate to sponsor the conference and hold exhibits. This is critical as one of the major factors holding back VistA adoption in the private sector in the US is the perceived lack of VistA vendors. The OSEHRA conference will show a thriving and growing solution provider community.

The OSEHRA Summit is is the most extensive conference on the role of open source in electronic health records systems, and health IT in general, held to date. It is a powerful counterpoint to the annual HIMSS conference which focuses on proprietary/lock-in EHRs and lock-in health IT technologies. We believe this event is going to represent a watershed moment in the transition from closed technologies in healthcare to open and innovative solutions in health IT as well as interoperability, collaboration, and transparency.

Conference Details

The OSEHRA Open Source Summit on Global Collaboration in Healthcare IT will be take place on September 3 – 5, 2014, at the Bethesda North Marriott Hotel and Conference Center outside Washington D.C. Conference organizer, the Open Source Electronic Health Record Alliance (OSEHRA), was created by the VA to serve as a intermediary between the VA and the open source VistA community. It's key role is to help both the VA and the VistA community to work together in the rapid innovation of VistA, widely considered the world's best hospital-based EHR. In its short existence, OSEHRA has emerged as a leader in the advancement of open source electronic health record (EHR) software and related health information technology. OSEHRA is using the conference to bring together the best and brightest from healthcare and various major open source initiatives including the VistA and RPMS EHRs.

Below we will review some of the key elements of the conference.

Keynote Speakers

Keynote speakers this include:

• Stephen W. Warren-Executive in Charge, Office of Information and Technology and Chief Information Officer, U.S. Department of Veterans Affairs
• Doug Fridsma, M.D., Ph.D.-Chief Science Officer and Director of the Office of Science and Technology in the Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services
• Jim Whitehurst-President and Chief Executive Officer of Red Hat
• Dan Morhaim, M.D.-Maryland House of Delegates, District 11. Note that Dr. Morhaim wrote a very sobering piece in the Washington Post last September where he outlined the problems with proprietary EHRs and singled out VistA as an alternative.

Conference Agenda

The conference agenda is divided into three days and addresses the following themes:

• Open Source Principles and Practices
• The Power of Open Source Collaboration
• VistA Evolution: Blueprint for Innovation

Day 1: Open Source Principles and Practices

The first day of the conference is going to be a busy day and will focus primarily on open source principles, practices, business models, and collaboration models. At the same time, as noted above, Rick Marshall from the VistA Expertise Network will be leading a Town Hall meeting on "The Future of VistA." The open source sections will be a "nuts and bolts" set of sessions on how open source works. The early afternoon sessions address Imaging, Open Source Usability, Open Source Business, and VistA Tools and Technologies.

The late afternoon sessions promises to be really interesting. The "Industry Activities" track will address open source business models as well as success stories of hospitals that have implemented VistA.

The first session will feature iCare talking about VistA as a Software as a Service solution (SaaS). For the past couple of years iCare has been working on reverse engineering VistA's GUI, called CPRS, to migrate it to HTML5 from its current Delphi code. They have been successful and now they have a version of VistA that can be hosted in the cloud. Oroville Hospital, which successfully self-implemented VistA for less than $8 million and has been adding extraordinary enhancements to the EHR, will be presenting the user case. North Carolina's Central Regional Hospital will be giving a presentation on their VistA implementation, detailed in this article, which resulted in a fully functional EHR, customized for their needs, for less than one million dollars. That compares rather well with other health systems in North Carolina that are spending hundreds of millions of dollars in Epic Systems implementations and encountering all kinds of problems. There will also be a presentation on Brooklyn's Lutheran Medical Center VistA implementation,

DSS, Inc., and Medsphere Systems Corporation, both solution providers with a great depth of VistA implementation experiences will be presenting the Direct/Integrator approach. DSS is currently playing a key role in the implementation of VistA across all mental health facilities in the State of New York. As detailed in this article, at 23 hospitals and more than 300 medical facilities, this is one of the largest and most complex EHR implementations in the world today. Edmund Billings will be giving a presentation on Medsphere's OpenVistA deployments. Billings, Medsphere's Chief Medical Officer (CMO), has become a thought leader in the health IT field and regularly posts articles in Open Health News.

Day 2 - The Power of Open Source Collaboration

The morning session for Thursday, September 4th will focus on the role of open source as an engine of innovation in health IT. The session has an unusual format.

It starts with the "Welcome and Introduction" by Seong Ki Mun, Ph.D., President & CEO, of OSEHRA and LT. General (ret.) James B. Peake, M.D., Chairman of the Board of Directors of OSEHRA, and former Secretary of the VA from 2007 to 2009.
That will be followed by the keynote speaker section chaired by Andrew Aitken from Black Duck Software/the Olliance Group and best known as the organizer of the Open Source Think Tank conferences. Keynote speakers, as noted above, will be Jim Whitehurst from Red Hat, Doug Fridsma, from ONC, Maryland State Delegate, Dan Morhaim, and VA CIO Stephen W. Warren.

The formal presentation will be followed by Mike O'Neill and will be an open panel discussion with the audience. That open discussion will last until lunch where several tables will be set aside so that participants can discuss topics of interest. This special part of the program requires registration through Desereé Johnston, the 2014 OSEHRA Open Source Summit Coordinator. This highly-unusual arrangements will allow for extensive discussion and direct personal interaction with the keynote speakers and OSEHRA board members.

The afternoon session on Thursday, as well as the morning session on Friday, will be breakout sessions. These were a very successful part of the last year's 2013 OSEHRA Open Source Summit, where there were more than 100 presentations during the breakout session, covering topics in policy, technology, clinical applications, business models, and others.

As part of the program on the second day, the winners of OSEHRA's new Academic Abstract Competition will give their presentation. Through this competition, OSEHRA offered college students the opportunity to win a trip to the Summit, all expenses paid, and present their winning abstract at the Summit. The winners were Nadege Willis and Sandhya Singh from the State University of New York at Albany. The topic of their presentation will be "The Verve Project: Open Source Vitals Monitoring." Note that SUNY Albany has created a VistA EHR Studies Program, the first in the nation to provide their students with a comprehensive education in the open source EHR. The course is taught by the well-known writer and open health expert, Luis Ibáñez.

Day 3 - VistA Evolution: Blueprint for Innovation

Friday morning is packed with presentations. Too many to discuss here, but I would like to point to the panel on "User Experience." This panel is chaired by Aaron Drew, Ph.D., Chief Engineer & Technical Director of the VistA Evolution Program. Usability is one of VistA's greatest strengths. While proprietary EHRs are severely deficient when it comes to usability and interoperability, the VistA EHR is repeatedly ranked as #1. This is not a minor issue as discussed in this article. The panel will include Chris Goranson, from the Parsons Institute for Information Mapping, as well as several usability experts.

The Friday afternoon session is dedicated to a presentation of VistA Evolution - the program to modernize VistA to enhance its interoperability, usability, and functionality. This will be followed by a panel discussion. VA leaders will discus their strategy, progress, and plans, especially involving the open source community. The purpose of the panel is "to provide an update on the status of VistA Evolution, the program that focuses on the modernization of the U.S. Department of Veterans Affair’s health information system, and the direction it is going."

The VistA modernization program is a top priority for the US Congress, which wants to solve the huge backlog of veterans wounded in the wars in Iraq and Afghanistan, a total of nearly two million US combat casualties. These wounded vets have been discharged from the US military and currently have to wait months, in some cases years, to enter the VA medical system. The key to solving this problem is ensure the electronic health record systems (EHRs) of the Department of Defense (DoD) and the VA are interoperable. That way wounded soldiers will no longer have to carry boxes of printed medical and service records produced by DoD to the VA where staff have to spend months reviewing these paper records before they can qualify wounded veterans for admission into the VA medical system.

Speakers and panel members include:

• Theresa Cullen, M.D., CMIO / Director, Health Informatics, VHA
• Alan Constantian, Ph.D., Senior Advisor, Customer Advocate for Health at U.S. Department of Veterans Affairs, OIT
• Paul Tibbits, M.D., Deputy CIO for Architecture, Strategy, and Design; U.S. Department of Veterans Affairs
• David Waltman, Senior Advisor to the Under Secretary for Health, VA
• Aaron Drew, Ph.D., Chief Engineer & Technical Director, VistA Evolution Program, VA

VistA Solution Providers Sponsor Conference

A remarkable development for this conference is that several VistA EHR solution providers stepped up to the plate to sponsor the conference. One of the great challenges faced by those in the private sector who want to implement VistA is to find those companies that can implement the system and support it. The VistA EHR community has suffered from a fairly common open source misconception..."build it and they will come." Well, that idea does not work in the healthcare system. People's lives are on the line when it comes to EHRs, so hospitals seeking to implement VistA want to know who they can contract with. By sponsoring the conference, leading VistA EHR solution providers are thus stepping forward in a public way. This press release from OSEHRA lists the sponsors and their background. The list includes:

Sponsors

• Conference, Document Storage Systems, Inc. (DSS, Inc.)
• Gold, InterSystems Corporation
• Silver, the MITRE Corporation
• Silver, Oroville Hospital and Tenzing Medical, LLC
• Silver, PricewaterhouseCoopers
• WiFi, FIS GT.M

Exhibitors

• Kitware
• KRM Associates, Inc.
• Carl Zeiss Meditec
• Medstreaming
• iCare

According to OSEHRA VP Don Hewitt, there are a few sponsorship slots available. He said that for information on sponsorship and exhibits, one can review the Sponsor / Exhibitor Prospectus or contact: <[email protected]>.

Speakers

Below is a complete list of speakers at the conference as of 8/13/2014. We will continue to update this speaker list as the agenda for the conference is finalized.

• Aaron Drew, Ph.D., Chief Engineer & Technical Director, VistA Evolution Program, VA
• Abhijit A. Gurjarpadhye, Ph.D., Virginia Polytechnic Institute and State University
• Afsin Ustundag, PwC
• Alan Constantian, Ph.D., Senior Advisor, Customer Advocate for Health at U.S. Department of Veterans Affairs, OIT
• Andrew Aitken, OSEHRA Board of Directors
• Andrew Casertano, S.A.N. Business Consultant
• Andy Gregorawicz, The MITRE Corporation
• Aneel Advani, M.D., Assoc Prof (Adjunct) Johns Hopkins University
• Ashish Sharma, Ph.D., Emory University
• Becky Monroe, U.S. Department of Veterans Affairs, VHA
• Bennett Lauber, Ph.D., The Usability People, LLC
• Betty Levine, Georgetown University
• Bill Hoffman, Kitware, Inc
• Brandt Welker, MedicaSoft
• Brian Olinger, U.S. Department of Veterans Affairs, VHA
• Catalin Branea, InfoWorld
• Chris Goranson, The Parsons Institute for Information Mapping, The New School
• Christine Rhodes, U.S. Department of Veterans Affairs, VHA
• Christopher Edwards, KRM Associates
• Chuck Hume, U.S. Department of Veterans Affairs, VHA
• Dan Morhaim, M.D.: Maryland House of Delegates, District 11
• Dave Hill, The MITRE Corporation
• David Waltman, Senior Advisor to the Under Secretary for Health, VA
• Deanne Clark, DSS, Inc.
• Dennis Murphey, Enterprise Business Solutions, Inc.
• Dezso Csipo, ISI Group, LLC
• Doug Fridsma, M.D., Ph.D.: Chief Science Officer and Director of the Office of Science and Technology in the Office of the National Coordinator for Health Information Technology, U.S. Department of Health and Human Services
• Doug Martin, M.D., Regenstrief Center for Biomedical Informatics
• Edmund Billings M.D., Medsphere
• Eduardo Brito, DSS, Inc.
• Eric Whitley, Northwestern University
• Erik Pupo, Deloitte
• Fabian Lopez, DSS Inc.
• Fleming Y. M. Lure, Ph.D., MS Technologies Corporation
• Frank Font, S.A.N. Business Consultant
• Fred Prior, Ph.D., Washington University
• Gail Graham, U.S. Department of Veterans Affairs, VHA
• George Hou, Intersystems Corporation
• George Lilly, WorldVistA
• Guy Esten, U.S. Department of Veterans Affairs, OIT
• Harish Kapoor, Dr. I-Net's Quantum Therapeutics
• Hon Pak, M.D., LongView International Technology Solutions
• Howard Hays, M.D., Indian Health Service
• Jack Shaffer, KRM Associates
• Jack Taylor, M.D., Business Information Technology Solutions, Inc. (BITS)
• James B. Peake, M.D., Chairman of the Board of Directors, OSEHRA
• James Campbell, U.S. Department of Veterans Affairs, OIT
• Jay Goodman, DSS, Inc.
• Jihoon Kang, Parsons Institute for Information Mapping, The New School
• Jim Tyrrell, Red Hat
• Jim Whitehurst, President and Chief Executive Officer, Red Hat, Inc.
• John McKim, Knowledge Analytics Incorporated
• John Rancourt, U.S. Department of Health and Human Services
• John Wolf, Harris Government Healthcare Solutions
• Jonathan Nebeker, M.D., U.S. Department of Veterans Affairs, VHA
• K.S. Bhaskar, FIS GT.M
• Kathleen Decker, M.D., Hampton VAMC/ Eastern Virginia Medical School
• Kensaku Kawamoto, M.D., Ph.D., University of Utah
• Kevin Guiles, DSS, Inc.
• Linda Fischetti, The MITRE Corporation
• Luis Ibanez, OSEHRA
• Marc Wine, The Spectrum Group
• Marcia Pickard,  U.S. Department of Veterans Affairs, VHA
• Marcus Streips, U.S. Army Medical Research
• Marine Koshkakaryan, Parsons Institute for Information Mapping, The New School
• Mario Hyland, AEGIS.net, Inc.
• Melissa Livingston, U.S. Department of Veterans Affairs, VHA
• Michael Ackerman, Ph.D., U.S. National Library of Medicine
• Michael Suralik, HLN Consulting, LLC
• Mike Henderson, OSEHRA
• Mike Webb, The MITRE Corporation
• Nadege Willis, University at Albany, State University of New York
• Nancy Anthracite, WorldVistA
• Neil Evans, M.D., U.S. Department of Veterans Affairs, VHA
• Nicholas F. Polys, Ph.D.
• Noah Pedrini, Parsons Institute for Information Mapping, The New School
• Noam Artz, Ph.D., HLN Consulting, LLC
• Odysseas Pentakalos, SYSNET International, Inc.
• Patrick Redington, U.S. Department of Veterans Affairs
• Paul Bradley, PWC
• Paul Tibbits, M.D., Deputy CIO for Architecture, Strategy, and Design; U.S. Department of Veterans Affairs
• Peter Koutsovitis, U.S. Department of Veterans Affairs, VHA
• Philip H. Newcomb, Software Revolution, Inc
• Rex Ballinger, O.D., VA Maryland Health Care System
• Rick Avila, U.S. Department of Veterans Affairs, OIT
• Rick Marshall, VistA Expertise Network
• Rob Tweed, Ph.D., M/Gateway Developments Ltd.
• Robert Silverman, U.S. Department of Veterans Affairs, VHA
• Sandhya Singh, University at Albany, State University of New York
• Scott Gould, GovernmentCIO     
• Seong Ki Mun, Ph.D., President & CEO, OSEHRA
• Shahid Shah, Netspective Communications
• Shawn Hardenbrook, U.S. Department of Veterans Affairs, VHA
• Sidney Tarason, Astute Semantics
• Stephen Burrows, Sacred Heart University
• Stephen Moore, Washington University School of Medicine
• Stephen W. Warren, Executive in Charge, Office of Information and Technology and Chief Information Officer, U.S. Department of Veterans Affairs
• Terry LeBlanc, Global eSolutions
• Terry Yoo, Ph.D., U.S. National Library of Medicine
• Theresa Cullen, M.D., CMIO / Director, Health Informatics, VHA
• Thomas Woteki, Ph.D., Acentia
• Wei Qian, Ph.D., University of Texas
• Wes Crum, U.S. Department of Veterans Affairs
• Wes Turner, Ph.D., Kitware, Inc.
• Will Locke, Vecna
• William K. Smith, M.D., MedRed
• Yong Chang, Ph.D., Samsung Electronics

[Last updated 9/16/2014] Added two sponsors and several additional speakers.