1 1 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

2 2 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

3 3 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

4 4 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

5 5 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