Creating Flexible Development Environments with OSS

Greg Ambrose, Deputy CIO-Product Development, U.S. Department of Veterans Affairs
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Greg Ambrose, Deputy CIO-Product Development, U.S. Department of Veterans Affairs

Greg Ambrose, Deputy CIO-Product Development, U.S. Department of Veterans Affairs

Open Source Software (OSS) is a model in which the software’s source code is available for modifications, enhancements, or augmentation by its users. This approach to software development promotes collaboration and provides advantages in developing and updating software, responding to changing requirements, and supporting software reliability and security efforts.

At Veterans Affairs (VA), we view OSS as the future of health care. Our first foray into open source solutions took place in 2011 with VistA, our electronic health record (EHR) software. This software is central to delivering quality health care to Veterans at our facilities across the nation. However, we began to notice that VistA’s rate of innovation had slowed considerably and we needed a way to accelerate development and respond to the rapidly changing needs of our customers. We looked into ways to tap into the innovation within and external to VA, and determined that the most effective method for reaching our goals would be through the establishment of an EHR open source community. In 2011, we launched the Open Source Electronic Health Record Agent, or OSEHRA, to serve as the central governing body of this community. This organization, comprised of individuals and organizations both inside and outside VA, was formed to build and support an open source community of users, developers, service providers, and researchers engaged in advancing EHR software and related health information technology. Since 2011, VA has had great success in collaborating with the open source community on VistA, and our EHR has been implemented by dozens of health care providers, companies, and organizations nationwide.

Because of VistA’s open source success, VA continued to seek ways to use OSS to better serve our customers. With OSS, we have been able to increase the transparency of our operations by encouraging a level playing field for working with VA and utilizing VA-funded resources and opportunities. In addition, OSS eliminates or reduces costs in software licensing, development, and long-term maintenance. We have also found that it provides access to a wide variety of solutions and innovations, including codes built by top developers, enabling VA to explore and evaluate a variety of tech solutions created by the open source community. OSS also enables us to become more agile in discovering and integrating software innovations, which means we can take advantage of advances in the ever-evolving IT marketplace much more rapidly.

We continuously seek out methods for increasing collaboration between VA and the open source community. On September 3, 2014, we launched a GitHub VA page to make it easier for users and developers to locate and keep track of VA’s open source projects. GitHub is a web-based repository for storing code, maintaining version control, and sharing open source solutions with OSEHRA and the greater OSS community. The GitHub page will host all of VA’s released OSS, including software under development and in testing, making it publicly available unless a business reason prevents it.

In 2015, we took steps toward expanding our OSS use by establishing a new policy requiring VA to thoroughly evaluate OSS and larger enterprise solutions when acquiring or developing new software. This is an exciting step towards better serving our Veteran’s needs. By formally requiring the evaluation of OSS for IT projects, we not only reinforce our commitment to IT innovation, but also ensure that VA chooses the best possible solutions for serving Veterans.

In 2015, our commitment to OSS is stronger than ever. We have 19 exciting projects under development on our GitHub page including:

GI Bill Comparison Tool- A web application designed to allow Veterans to calculate their educational benefits and research approved programs. The tool will make it easier for Veterans, Service members, and dependents to calculate their Post-9/11 GI Bill benefits and learn more about VA’s approved colleges, universities, and other education and training programs across the country.

Mental Health eScreening (MHE)- An application designed to give the VA Operation Enduring Freedom/ Operation Iraqi Freedom, mental health, and primary care communities the ability to automate collection and scoring of screening instruments in order to improve efficiency in evaluating and treating patients.

Maternity Tracker- This application, an enhancement of the Computerized Patient Record System (CPRS)/VistA, enables the coordination of maternity care in a seamless fashion between VA and non-VA providers in order to support optimal care of pregnant Veterans.

OSEHRA, our EHR governing body, also continues to grow and thrive. The ecosystem of members and organizations has grown exponentially since its inception. As of December 2014, it has over 2,600 unique members and 160 participating organizations including private companies, nonprofits, academic institutions, and state and federal government agencies—all of whom are working together to advance VistA and other EHR software. OSEHRA has also held three very successful Open Source Summits with a fourth scheduled for the end of July 2015. The Secretary of Veterans Affairs, the Honorable Robert A. McDonald, will be attending as the keynote speaker and we expect over 400 industry leaders, federal and state government officials, academics, clinicians, developers, and researchers to attend.

While the initial purpose of VA’s OSS initiative was to revolutionize VistA, it has truly energized our ability to develop advanced software solutions for VA and beyond, and has invigorated IT initiatives at VA. Both private corporations and government entities are always interested in identifying new ways to provide innovative IT solutions. At VA we believe OSS is that solution. It enables us to increase openness and transparency, speed innovation, reduce costs, and collaborate with the best minds in in the industry. All of these OSS benefits better equip us to meet our ultimate mission; to serve and honor the men and women who are America’s Veterans.

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