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WorldVistA• Nonprofit, 501(c)(3) public-benefit corporation

– Seeks to improve health worldwide by making medical software more accessible, more affordable, and better.

• Members include– Developers working, or who used to work, for U.S. DVA– OpenVistA end-users– Other organizations members or representatives

• Promote VistA Open-Source– Future development coordination

• Including “localization” and “internationalization”…

– Change management & licensing– Inter-institutional arrangements and coordination– End-User and Developer Education & Training

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WorldVistA Profile• WorldVistA's mission is to improve health worldwide by

making medical software better and cheaper• Focus on VistA: affordable, effective, well-integrated

electronic health information technology• A rapidly growing community

– 100+ members– 20% increase per meeting for last three years– Daily electronic discussions– Weekly conference calls– International participation: UK, Malaysia, India,

Mexico, etc.– Doctors, vendors, coders, organizations large and small

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David Whitten

• Medical Information Systems since 1981

• Logic and Ontology Experience since 1989

• Unofficial, Unauthorized Cyc FAQ 1994

• Co-founder, Treasurer WorldVistA 2002

• M Development Committee

• 12+ years Department Veterans Affairs

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Strategic Challenges• Medical Care Crisis

– Expense: % of GNP and Increasing Ranks of Uninsured– Error: Injury and Mortality

• Software Crisis– Relative Expense: Shift in Costs from Hardware to Software– Absolute Expense: Success Breeds Failure – Complexity– CHAOS Study: Examples & Patterns, but Not

Understanding

• Medical Informatics Crisis– ACPE Survey: Most Backward Sector of U.S. Economy– Exception: VistA, but No Good Explanation

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WorldVistA's Insights• Quality Initiatives need a “net effect” - the

network is the system• Product orientation is a paradigm trap

– We are deploying a process not a product– Product is just the enabler

• Acculturation as well as technical education is needed

• Software improvement must be– evidence-based– user-driven– continuous

• Evaluation and certification ensure high-quality