VistA lead designer slams Hagel for iEHR approach

A lead software designer for VistA recently called out Secretary of Defense Chuck Hagel for not taking a patient-centric approach to the creation of an integrated electronic health record between DoD and the Department of Veterans Affairs. 

In an open letter posted to his personal website, health IT consultant Tom Munnecke said that despite good intentions, Hagel (pictured right) and the DoD are "paving a road to a hellish destination" by looking to outside vendors for its EHR needs.

"I was impressed with your concise and accurate assessment 'I didn't think we knew what the hell we were doing,' before a Congressional hearing April 16, 2013," Munnecke said. "I fear, however, that this is still the case."

What's more, Munnecke said, a viable solution appears to be out there for the taking in VistA.

"We have seen VistA thrive within the VA and in the Indian Health Service," Munnecke said. "Ironically, U.K. National Health Service has just announced that it will spend some of its … technology fund on further exploring the creation of an NHS version of the U.S. Veterans Health Association's open source electronic medical record."

Munnecke compared the DoD's approach to "acquiring a new aircraft carrier," saying that "just because both are expensive and time consuming, doesn't mean the processes should be managed in a similar fashion."

"Even within a hospital, the administrative information is a fundamentally different problem than dealing with clinical information such as lab, pharmacy and radiology," he said. "This ignorance has been a fatal flaw in any number of failed systems over the decades."

At a conference in Washington, D.C., last month, Navy Medicine CIO CDR Cayetano Thornton and Military Health System CIO David Bowen talked about the alleged rift between VA and DoD. Thornton insisted that DoD is maintaining open communication lines with the VA on electronic health record efforts.

In February, DoD and VA nixed plans to create a joint iEHR from scratch, citing budget and time constraints.

To learn more:
- read Munnecke's open letter

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