Health Care Software System, Subject of Lawsuit, Becomes Open Source

Startup Medsphere released the core elements of its OpenVista health care system as open source code this week.

Medsphere hopes to capitalize on a successful deployment at the Veterans Health Administration hospital system by adapting its software to the community hospitals and private health care providers.

OpenVista is already in operation at Midland Memorial Hospital in Midland, Texas. Medsphere's chairman and CEO is Ken Kizer, the former VA administrator who fought for a standard IT system in VA hospitals. And Vista, as it became known, was built in part on an earlier, 1960s progenitor, the MUMPS system or Massachusetts General Hospital Utility Multi-Programming System. The OpenVista posting as open source code allows hospitals and health care organizations "to leverage the billions of dollars invested in the VA's Vista system over more than 20 years," said Dr. Kizer in a statement. OpenVista is available for free download at SourceForge and the site Medsphere established to host what it hopes will be a vigorous community around OpenVista.

"This is a first step," he noted. As an OpenVista community of contributors and testers emerges, the community will "continually improve the platform as well as deliver faster upgrades and enhancements," he said.

OpenVista is geared to work with many of the third-party applications already inside hospital doors, said Frank Pecaitis, senior VP of Medsphere, as he attended the Health Information and Management Systems Conference in New Orleans this week. He said Medsphere has generated a lot of buzz at HIMSS with its open source move and "we filled every seat" when it hosted a session on OpenVista during the show.

OpenVista contains no patient billing system because the VA's Vista didn't need to send out bills to patients or insurers. The Department of Veterans Affairs paid the hospital bills out of its budget. In addition, every private hospital already has its own billing system. But OpenVista "will pass whatever appropriate case information is needed by the billing system," Pecaitis notes.

Medsphere has worked for four years on revising the VA's Vista into a system suited to private institutions, clinics, and health care organizations. The VA uses a patient's Social Security number as a unique identifier, but private hospitals need to refer to patients by a case number to protect their privacy. OpenVista generates such a number as a patient is admitted and all eight OpenVista applications use it.

The long range goal is to replace the myriad third party suppliers of piecemeal hospital systems with a more standards-based, open source system, Pecaitis says. But first institutions need to experiment with the OpenVista code, which includes both server applications and a client application.

Medsphere in effect has taken the original Vista application and migrated it to Windows, Linux, and Unix platforms. It put a more graphical user interface on it as well to make it easier for doctors and nurses to put in their clinical and patient care information.

Medsphere replaced terms used by the VA, such as "ward" and replaced it with the private hospital term of nursing unit.

OpenVista became the subject of a lawsuit last year when Medsphere's Chief Technology Officer at the time, Steve Shreeve, posted the code on June 6, then was reprimanded and fired by Medsphere June 26 for what it termed an unauthorized move. Medsphere then filed suit against Shreeve and his brother, Scott, former chief medical officer of Medsphere, seeking to recover $50 million in damages. The Shreeves countersued Nov. 8 and the dispute remains unresolved.

Kizer in an interview with Information Week in January said the suit was not about an open source posting but "about corporate governance." Steve Shreeve, contacted yesterday as OpenVista was posted again, commented in an e-mail message: "It seems like the board finds itself in the completely untenable position of suing me for doing what they apparently agree was and is the right thing to do." Neither Shreeve is currently an operating officer of the company, but Steve Shreeve remains a member of the board of directors, he said.