VistA is an excellent software package that can scale up and out. And it is free.
Vista is kind of a special case in that it is the VA's system which they have effectively made open-source -- a fantastic contribution by VA.
However, the system, unfortunately, was developed in the "M" language (roughly equivalent to MUMPS), which is a relic. In trying to decide on which EMR system our company would commit itself to, we considered briefly working with Vista and basically selling support for it. I bailed on the product because of the language; it is just really tough to commit to a language that not extensible and lacks the features of modern day software development. Had it been written in, for example, C++, I think we would have definitely gone that route.
I think it speaks volumes, however, about EMR deployment as well as government run health care. That they did this extensive project in a language such as MUMPS is shocking -- it would be like writing new business software in NEAT/3 (NCR Corporation's proprietary business language, which I once had the extreme displeasure to have to learn). Why not develop it in a language that will thrive and grow? We're the Government, that's why.
As to pricing, there are low-end systems out there in the 10K range, but they are VERY low-end and unimpressive. I think as the mandate moves closer, we'll see some of the higher-end systems dropping in price.
EMR is fundamentally a very simple application when contrasted with other systems commonly in use in medical offices (like the billing software). There is no reason for it to be as expensive as it is. |
