If one is looking for an evidenced based story of healthcare change enabled with information technology, then a look at the Veterans Administration (VA) in the US is well worth it.
Over the course of a 10 year period the holistic health service provided by the VA has transformed the quality of care it provides to its patients and they have the evidence to prove it.
Key to those improvements was the Veterans Health Information Systems and Technology Architecture (VistA) system, a health IT solution that has evolved over many years, largely led by joint efforts between their clinicians and IT teams.
Interestingly they have had great success with relatively “dated” technology ie MUMPS programming language, but their choice has something to it. Another of the largest EHR providers in the US, Epic also uses MUMPS and related Cache technologies.
Over time it is acknowledged that the architecture of the VA Vista systems has become cumbersome to scale and maintain, so it needs a technical refresh, a “modernization” as the 2010 Vista Modernization Report: Legacy to Leadership report from the US American Council for Technology/Industry Advisory Council outlines. Central to that reports recommendations are that the VA should move to open sourcing its development effort towards the generation of an eHealth ecosystem.
In recent weeks the VA has now moved these recommendations with a Request for Information, towards developing that open source ecosystem, towards “an openly architected, modular, and standards-based platform”.
This is a very welcome development in healthcare, as an international leader in the field of healthcare improvement has now acknowledged… that its own future lies in greater collaboration with an open source eHealth ecosystem, which could and should provide a win win for all..
While this change will not happen overnight, the VA are to be applauded for their leading moves in the right direction..
Frectally speaking 
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