This week CMS announced that the oft-touted VistA system -- the EMR developed by the VA -- would be made available for free. Given that similar EMR systems are sold for up to $15,000 per seat, this might appear to be a boon to the computerization of the physician practice, while simultaneously destroying the prospects of commercial software companies in that market. But there are many uncertainties. VistA is built for government hospitals and has been converted to the private small-office environment. It doesn't really have a billing function integrated, nor does it link well with other clinical systems. Plus it's apparently tricky to install. There's at least one rival EMR system based on it and there's only a nascent open-source support movement surrounding it -- albeit one CMS is trying to encourage.
In addition, small office practices may do better with an ASP system rather than setting up their own technology. However, what VistA's availability will likely do is reduce the price of EMR systems for physicians, even if that price is only a small component of the overall "cost" of EMR adoption. It's good to see the government realizing that the most crucial part of automating healthcare is computerizing the physician's clinical workflow. - Matthew