Per the Wikipedia entry...
"The adoption of VistA has allowed the VA to achieve a pharmacy prescription accuracy rate of 99.997%, and the VA outperforms most public sector hospitals on a variety of criteria, enabled by the implementation of VistA.[6]"
It also states that most organizations that implement see an approximately 6% improvement in efficiency and that the cost of the implementation can be covered by reducing a few unnecessary lab tests.
So why are we paying for software again? A full 60% of our IT budget is spent on support maintenance agreements (SMA) every year. We get the following benefits from these dollars...
- The right to actually use the software, usually in the form of licensing.
- The ability to call a help desk or support organization for help.
- Updates and patches.
All of this even if we don't call the help desk or upgrade the software. Furthermore all of this comes with caveats that basically void any guarantee that the software will work if we don't stay up to date version wise.
VistA and Mirth both have developers that contribute to the system, user and support groups that assist when there are problems and all of this is available for FREE. There are no guarantees, unless you want to pay someone for the support.
A full 30% of our budget is labor. The lifeblood of any knowledge based industry and at our company they are the mission alive. We have been told by our biggest vendor partner that we are sometimes a challenge to support because of the quality of our technical folks. We challenge them in ways that they usually aren't on a consistent basis. Our server, application, process, data, network, development, desktop, telco and database staff regularly find bugs and fixes that our vendors struggle to tackle.
Hmmmmmm....
What if we converted to a total Open Source solution. We could dedicate half of the existing SMA budget to grow our staff. Better yet dedicate a third to labor and a sixth of it to training and deployment of (Open Source) collaboration tools. The remainder of that money gets reinvested in the hospitals and clinics. With our new staffing model and skill set we improve the products and feed the improvements back into the industry. We push the products to easier and easier to support so that smaller facilities and clinics can afford to implement an EMR. We contribute to and participate in the support forums and train other IT professionals to use the model so that all of healthcare in this country can benefit.
No more SMAs......
Posts
2 comments:
Interesting theory. I would think that initially you could replace 10-20% of your mission critical systems with the VA solution (or another open source option) - but what of the other 80% having to do with niche areas (cancer registries, voice recognition dictation, etc.) It will take time - but nothing wrong with dreaming!
Isn't that as true with a solution like Epic? Even Group Health has a separate pharmacy solution (if I remember correctly)? Also 10-20% of the mission critical systems represent somthing like 60% of the SMA budget.
It is still a dream right now but hopefully it's a dream that will become more true some day...
Post a Comment