"An Affordable Fix For Modernizing Medical Records"

...from the Veterans Health Administration and Midland (TX) Memorial Hospital.

I know enough about my own strengths and weaknesses to know that I'm no IT expert. But I am acutely interested in examples of people and teams thinking differently to solve long-standing, intractable problems and, for better or worse, there are lots of those to be found in the IT realm.

Yesterday, it was a story about a team adding iPhone portability to MEDITECH functionality, delivering to harried physicians better access to clinical data and more productive hours in every work day. (Wow. Apple in the boardroom AND the physician lounge. Has to be an IT traditionalist's worst nightmare. But I digress...)

Today, the Wall Street Journal features a story about Midland (TX) Memorial Hospital finding an affordable, open-source alternative to proprietary EMR systems:

"In the push to digitize America's hospitals, Midland Memorial faced an all-too-common dilemma: a crying need for information technology to replace archaic paper records, but a shortage of funds to pay for it. Midland Chief Executive Russell Meyers found an unexpected freebie of sorts: the software used to power the electronic medical-record system of the Veterans Health Administration.

"Created with several billion dollars in taxpayer funds over two decades and used in more than 1,400 VA facilities, the source code is in the public domain, meaning software developers around the world can freely build features into it. Add the cost of hardware and the services of a company that has adapted the VA software for commercial use, and Midland paid less than $7 million for a full electronic medical-record system.

"Medsphere Chairman Kenneth Kizer, the former undersecretary for health at the VA who oversaw the development of VistA before joining the company, says its enhanced version of the software, called OpenVistA, "can be installed in one-third the time and for about one-third the cost of the big-name proprietary systems."

I'm partial to open source for reasons that I freely admit are more philosophical than technical. And as counter-argument, the major IT vendors offer the usual litany of benefits of buying from one company - reliability, stability, connectivity with financial systems, etc. Who knows? They may be right, at least for the wealthy and risk-adverse.

But if they're asking you to spend $21 million to buy their system instead of $7 million for VistA they better be REALLY right. And be able to prove it...which I doubt they can.

The Takeaway: Nobody has all the money they need to do everything they want. But isn't a difficulty really just a problem waiting for a solution? Maybe it's time to stop saying things like "It's unaffordable! We don't have enough money!" And time to start asking "...what of our thinking and preconceived ideas must we change to do this with less money?" Models and options, surprises and alternatives are out there everywhere, sometimes in unexpected places, sometimes hiding in plain sight.

Here's a link to the Meditech/iPhone story from yesterday.