TECH: Here comes VistA and eRx update

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 a 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 was built for government hospitals and has been converted to the private small office environment. It doesn't really have a billing function integrated, nor yet 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. And it's good to see the government realizing that the most crucial part of automating health care is computerizing the physician's clinical workflow.

I hope to have more on open-source IT in EMRs and the fate of the small office shortly.

Meanwhile, I got this update from Manhattan Research about ePrescribing.  The number of doctors using eRx is now at 14%, 80% of whom are in big groups (and probably using eRx as part of a total EMR solution).  The number using eRx on handhelds is up 300% since last year (although it's a much smaller proportion of that total and they wouldn't tell me exactly what it was --after all they are trying to sell this research!)

Finally the piece I've been working on about prescribing, including eRx, is being put into editorial today and should be out in the Fall.  I'll let you all know about that when it comes out.