The Dept of Vets Affairs runs VistA, which is one of the most effective, and widely-used electronic health record (EHR) systems in the world.
They need to increase the pace of VistA innovation, as health and information tech move ahead at accelerating rates. They took a hard look at how people make and buy software in public and private sectors, and realized that the open source approach really works.
So they are creating a private sector “custodial agent” (CA) to be the repository of the source code. The CA allows developers everywhere, and every place, to enhance and otherwise build on the source code, following a common set of rules for really easy access. The CA will ensure that new, innovative code works and plays well with existing code.
Also new is the feedback loop to take the code back into VistA. The government folks commit to use the software innovations, accelerating the pace of development. With simplified, common rules, a lot more people can benefit and participate.
People can build new code, and share it with everyone else, and make money by providing services around the EHR. Other people might build new businesses around new functionality. In either case, everyone wins.
This is a first for the Federal government, and provides a pathway to make software acquisition and development much more effective than it currently is.
Check it out here.
Craig Connects 
For several years, a small group of us has been working on systemic changes in regional healthcare and public health operations, funding, regional population engagement, preventive and wellness care, enabled regional labor productivity, regional comparative and competitive advantage in a dynamic demand curve environment, and job and wage growth. We’ve been building early mover identification, proof-cases, programs, and coalitions knitting across all these aspects.
Undergirding the systemic, regional, and operational evolution there will need to be team-based and remote-capable IT including robust cross-silo health integration and tracking/analytics technology (not just add-ons to admin billing system silos). The VistA technology is the gold standard in this regard. Some of the posts in the link to our blog aim at macro and operational unbundling and integration across health care, finance, and (interestingly enough) agriculture. Read, comment, and expand the envelope. Your site is refreshing and encouraging.
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