Flint:
FAHC did not choose any of VITL's preferred vendors. They went their
own way into EMR. Thus, FAHC acquisition of their Epic system is a
model, of sorts, for getting off-list systems connected to VHIEN
(network), though not funded by VITL.
FAHC was required to file a Certificate of Need (CON) to spend their
cash (state cash?) on their new Epic EMR system. (Perhaps small
practices do not need to file a CON. Dunno.)
Any health care CON related to IT will need to be in compliance the
VITLP (plan), _once VITLP has been adopted_ by the full legislature,
Its only a "draft" until adopted.
1. VITLP _is_ still a draft, AFAIK. It not yet been adopted by the
full legislature. Only the House has adopted it. The Senate has not.
2. VITLP, draft or not, is a soft standard and does not guarantee
connectivity. I suspect it is intentionally soft so CON approval
doesn't get bogged down. Leddy and ChitCo Senators will be needed
for the Senate approval. Hence, cannot have standards running
against FAHC path.
3. VITL does have two roles. They may be incompatible roles:
1. Prepare the Plan and get it adopted by the Legislature for
the sole purpose of folding it into BISHCA's CON process.
State funds are used for this, legitimately so.
2. Run the VHEIN. Private funding here, to some extent.
Vendor list is pre-selected, but cannot be dictated.
Should off-list vendors be encouraged. BTW, Epic is not
FOSS; far from it.
With respect specifically to the FAHC CON covering their acquisition of
Epic EMR (as opposed to one of VITL's preferred vendors), the acquistion
was approved by BISHCA. There were 2 controversial issues that got
side-stepped: 1) privacy, and 2) compliance with VITLP draft.
1.
http://www.bishca.state.vt.us/HcaDiv/CON_docs/Statements_of_Decision/CONs_dkt2007/07-069-H_propSOD.pd
2.
fhttp://www.bishca.state.vt.us/HcaDiv/CON_docs/StaffReports/StaffRep_2007/docket_07-069-H.pdf
Pretty dry reading. My summary with respect to compliance with
VITLP: Technical consultant said Epic is "minimally compliant" with
draft VITLP and this does not ensure connectivity to VHIEN. Farnum
commented that FAHC's use of Epic would be consistent with the VITLP
"vision".
There are FOSS systems that are also minimally compliant and consistent
with the VITLP vision. We need to demo them. And demo connectivity.
However, O now think that Balu is correct that VHIEN is in jeopardy.
My reasons: a) Vermont funding will tighten, b) there is no pressure
for open connectivity, c) no FOSS alternative to demo.
Some other group, not VITL, will needed to add this pressure (and to ask
that FOSS gets the same breaks as FAHC). Could there be federal
funding for such a group??
-- Dan Connelly
