The VA has considered a variety of options to replace its VistA electronic health records system, and the draft RFP indicates it feels the best approach is to migrate from a "custom and proprietary EHR software to an openly architected, modular and standards-based platform."
The draft RFP, with a response date of April 11, notes that VistA's rate of innovation and improvement "has slowed substantially, and the codebase is unnecessarily isolated from private sector components, technology and outcome-improving impact. To address this issue, VA is establishing a mechanism that will open the aperture to broader-based public and private sector contributions."
What that means is that VA wants to hire a Custodial Agent to set up and manage an EHR Open Source ecosystem that will guide the relationships between developers, users, vendors and service providers.
"In the fully mature ecosystem any member of the community--an individual or an organization--may participate as a developer to improve the codebase and contribute innovations," according to the draft RFP. "Users can incorporate EHR Open Source software into their health care delivery operations and may combine custom applications with other open source and proprietary components. Vendors can offer EHR products that incorporate software from the codebase and may offer complementary products (either open source or proprietary) that interact with the Open Source EHR. Service providers will find opportunities to assist innovators, operators and clinicians in the development, on-site implementation and use of the EHR Open Source code."
The draft RFP is available here.