logoalt Hacker News

sc68calyesterday at 6:46 PM1 replyview on HN

That's what they did. If you read the article, it discussed the whole program as being a change from an in house developed system, to an off the shelf system.

> The program launched in 2018 to replace the aging computer system used across VA’s health care network, which serves more than 9 million veterans, with an off-the-shelf product that could handle many of the same tasks: organizing important information including appointments, referrals, prescriptions and patient histories.

> David Shulkin, the secretary at the time, announced that VA would negotiate a contract to buy the records system from Cerner without competitive bidding. VA leaders said they selected the program because the Pentagon already had purchased a similar Cerner system for the military’s more than 700 hospitals and clinics.


Replies

nathan_douglasyesterday at 7:43 PM

VistA is an old system, and it's definitely "aging." But the thing is that it actually works really, really well. For instance, it kills a remarkably low number of people, which is one of the benchmarks I personally value in an EHR.

One of the interesting things about this is that, from my perspective, VistA's sort of a mesh of servers rather than the hierarchy we might expect from a federal system. Perhaps that's because of the complex interplay between federal and state and local laws. But anyway, there's probably a "station" for VistA near you that serves your area, and that's very similar (though not identical) to the "station" in the next neighboring area/metropolis/state/whatever.

But weirdly it seemed like the plan to roll this out was to replace all of the functionality at a given VistA station, rather than to do a strangler fig sort of thing and work on supplanting VistA's functionality in a specific functional area (whether locally or nationally). I don't know if that's because of the aforementioned complexity of laws, or the complexity of how the system(s) is/are administered, or other reasons that would elude me.

It's, uh, it's a fun situation.

show 1 reply