The Centers for Medicare and Medicaid Services (CMS), part of the Department of Health and Human Services, will offer the VistA-Office EHR E-health-record application as an alternative to commercial software. VistA-Office EHR is an expanded version of VistA, developed and used by the Veterans Health Administration, that's meant to be easier for doctor offices and small clinics to install and use.
VistA-Office EHR is "dirt cheap by computer standards," a CMS spokesman says. Doctors and clinics will likely pay less than $50 to purchase the software from CMS, including a $39 mailing fee that companies can avoid by downloading via the Web. Licensing the third-party operating system and Caché database from InterSystems Corp. brings the estimated deployment costs of VistA-Office EHR to about $2,700 for a five-doctor practice in the first year. CMS estimates it will cost about $1,100 per year to run and support the software.
Even if it delivers the promised low cost and ease of use, doctors may balk at using VistA-Office EHR. It would require doctors to change their business practices and even their culture--big challenges that have kept many from adopting IT.
Health plan WellPoint Health Networks Inc. learned nearly two years ago that giving away free IT products to doctors wasn't a sure bet for tech adoption. One in four of WellPoint's 25,000 contracted doctors passed on WellPoint's offer of free PDAs or PCs to use in their practices.
Medsphere Systems Corp. sells a version of VistA-Office EHR called OpenVista that runs on open-source platforms. Dr. Scott Shreeve, Medsphere's chief medical officer and co-founder, says CMS doesn't offer training or support for VistA-Office EHR, "which we'll do as a [technical services] provider."