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Open source, not $19 billion, may be best health care stimulus

Government may be overlooking an open-source solution that already works for the U.S. Veterans Administration: VistA.

The federal economic stimulus package provides $19 billion to upgrade the U.S. health care system to digital records. It's a nice gesture, but the U.S. federal government has already developed a robust medical ERP system that could significantly improve U.S. health care. It's called VistA. It's open source.

It's already paid for.

VistA was developed by the U.S. Veterans Administration and the medical professionals involved in its extensive hospital network. Read: doctors developing software for other doctors.

This bottom-up development effort appears to be working: the VA hospital system consistently delivers superior care at less cost, as noted by ZDNet. As a volunteer at my local VA hospital, I get to see it firsthand.

Better quality health care at a much lower price. What's the punchline?

At first glance, there is none. VistA works, and works well, particularly when packaged and delivered by companies like Medsphere, perhaps the most prominent advocate for the open-source health care ERP system.

Scratch the surface, however, and you quickly run into a major problem with VistA: MUMPS (Massachusetts General Hospital Utility Multi-Programming System). MUMPS is the archaic programming language in which VistA was written, and which perpetuates its inflexible architecture.

Though some suggest the specialized knowledge needed to program in MUMPS is a selling point, let's put it this way: in the programming universe filled with PHP, Java, .Net, and other constellations of programmers, MUMPS is like a single Red Dwarf. It's not going anywhere except into oblivion.

There are other open-source answers to the U.S. health care problem, including the federal Connect project and Axial Exchange, which was set up by former Red Hat executives to commercialize these federal efforts. But none is more proven than VistA, which has successfully served U.S. veterans for many years.

One company, Software Revolution, claims that the MUMPS-based VistA code could be converted to Java at a cost of $125 million. If even remotely true, that could well prove to be a much smarter investment than $20 billion in stimulus money. Heck, given how easily billions are being spent in Washington today, $125 million is pocket change.

Open source might prove to be the wrong answer to the health care mess. But given the VA's success with VistA, President Obama should be spending pennies on the stimulus dollar with VistA before he looks elsewhere for solutions. It's already written. By all accounts, it works well.

It just needs to shake the MUMPS out.

Follow me on Twitter @mjasay.