By Cindy Atoji

August 12, 2008 | Responding to an upcoming deadline set by Congress, the Military Health System announced last week that the Department of Defense (DoD) is looking at both VistA, used by the Department of Veteran’s Affairs, and its own AHLTA (Armed Forces Health Longitudinal Technology Application), developed by Northrop Grumman, in an effort to link the two and make them interoperable. “The Department of Defense and the MHS still believe in the power of harnessing our existing financial and intellectual investment without pulling the plug on either system,” said Stephen Jones, principal deputy assistant secretary of defense for health affairs, in an MHS press release.

But among analysts, the growing consensus is that the military plans to dismantle VistA. “It would be a grave mistake to do so,” says Michael Doyle, president and CEO of Medsphere, a Carlsbad, Calif.,-based company that has taken VistA to the private sector. “Dismantling and throwing VistA out doesn’t make any sense to me whatsoever. The VistA system works. The AHLTA system does not work. So why throw the VistA away?”

Doyle spoke to Digital HealthCare & Productivity about the looming VistA decision and its implications for Medsphere.

DHP: What are your concerns about the DoD’s possible decision to dismangle VistA?

Doyle: I think it would be a grave disservice to tax payers. The federal government has spent billions and billions of dollars creating VistA. It is the defacto standard of quality in EMR software. Open source is now finally taking hold in the U.S. health care, and the federal government, through the Department of Defense, is talking about going to a proprietary system, which makes no sense whatsoever. And frankly there are fiduciary issues associated with this that in my estimation, are almost criminal. To actually go and spend billions of dollars trying to create a different system when the VistA system works—and it’s been working for many years—is foolish. To refresh and update it is all that it really needs.

DHP: What solution would you propose?

Doyle: I think the Department of Defense should look at using VistA or a derivative of VistA. If you look at medicine in the United States, between 70 to 80 percent of doctors have actually trained at a VA hospital. So these physicians who are out there practicing already have exposure to VistA. They’re used to it; they like the look and feel of it. Why build something else on a proprietary basis that is going to probably [have similar challenges as] the AHLTA system? It failed, and they spend hundreds of millions of dollars building that system. If it ain’t broke, don’t fix it.

DHP: If it’s a no-brainer to keep VistA, why would DoD be considering dropping it?

Doyle: I think there’s a bunch of other agendas that get baked into this—things that don’t always equate to rationale business decisions. There’s some face-saving that’s taking place at the cost of tax payers, and there are lobbying efforts.

DHP: If the military does discard VistA, what does that mean for Medsphere? The company is built around this system.

Doyle: Medsphere will continue to support VistA. We have the technical capability right now in the company to do that, and we’ve been doing it for quite some time. So I think VistA lives on, with us anyway. The thing about VistA is there’s a whole community that has grown up around the product because it works. It’s cost effective. Doctors like using it. You don’t have to force it down anyone’s throat to use. It’s the proprietary systems out there that don’t have any users; the clinical decision makers are forced by administrators, and they rebel because don’t like look and feel of it; it doesn’t particularly work for them. The market has really spoken for VistA.

DHP: If the military pulls out of VistA, won’t that dramatically decrease on contributions to your ecosystem?

Doyle: I think if the military does that, there’s going to be a whole bunch of VA people who support VistA, and we’re going to be the only game in town. They’re going to join with us, both formally and informally, to promote VistA. I think it’s probably just the opposite.