Open Source Medical Records

Last week, I had lunch with the CEO of MedSphere, Mike Doyle, to learn about the company's plans for OpenVista. The idea is simple - take the the publicly available code from the Veterans Administration clinical information system, add new modules such as revenue cycle interfaces that are needed in practices outside the VA system and include support/implementation services. In effect, you'll have the "Red Hat Linux" of the electronic health record world.

Medsphere has chosen to package Vista in two forms - Enterprise for large hospitals/integrated delivery systems needing departmental system and Clinic for small offices/multi-specialty clinics needing strong outpatient functionality.

Enterprise includes

* Patient Information Management System
* Health Information Management System
* Clinical Information System
* Laboratory
* Pharmacy
* Radiology
* Nutrition and Food Service
* Interface Suite

Clinic includes

* Patient Information Management System
* Health Information Management System
* Clinical Information System
* Laboratory
* Pharmacy
* Radiology

Medsphere has several live deployments in the US and internationally.

The VA's Vista system is well known for its integration, functionality and sophisticated decision support. I spoke with several for profit vendors about their opinion of an Open Source EHR based on Vista. They had a very reasonable response - the real cost of providing a comprehensive clinical IT solution is not really the code (since most vendor products development costs have already been recouped). The cost is in the service.

Implementation, practice transformation, workflow support, and interfaces are the really resource intensive aspects of implementing EHRs and hospital information systems.

Medsphere's true measure of success will be its ability to deliver high touch support in a scalable way as its market expands. Mike shared the Medsphere core values, vision, value proposition with me (the picture above). You'll see that their ideology is very noble - reduce costs, improve quality, and make a difference in healthcare. Decoding the slide, BHAG means Big Hairy Audacious Goals from the Jim Collins article Building Your Company's Vision. The Hedgehog Concept refers to the understanding of the one thing you can be best at. Jim Collins discusses it in Good to Great based on Isaiah Berlin's essay “The Hedgehog and the Fox".

In addition to Jim Collins work, Mike Doyle has great respect for the books "The Blue Ocean Strategy" and "The Culture Code" .

I believe Medsphere is a valuable stakeholder in the eHealth marketplace. As a strong advocate for open source, I wish them the best in their quest to redefine healthcare.