Contract to create VistA shepherd goes to newbie

I just learned, (from a modern healthcare article, of course) that the contract has been awarded to Tiag.

At first blush, this news was not concerning. I am only peripherally involved in the VistA community, and there are lots of solid VistA-related contracting companies that I do not know of. It was a little surprising I must admit, I was expecting this to go to Perot Systems (now Dell), or DSS, both of which have deep VistA pedigree. My second guess would have been a big contractor like IBM or CSC.

But I have done a little analysis and now I am pretty concerned about this.

First I used Google to do a site search for the term “VistA” on the Tiag website. The syntax for that is “site:http://tiag.net VistA”

Results.. nothing..

doh!

Ok, but even though there website does not list anything about VistA, maybe the leadership is invested in the VistA community. Its pretty easy to sort participation in VistA community, it all happens across the Hardhats mailing list. So I did a search on the hardhats mailing list for the proper names of each of the people listed under the Leadership Bios on the hardhats mailing list. Here is a sample for Tiag CEO Dalita Harmon. Nothing.

doh!

Ok, the Tiag leadership is not participating in the VistA development community, but perhaps they have “underling involvement”. I search on the hardhats mailing list for anything coming from tiag.net returns nothing. (it might return a thread I started about them now….)

doh!

Maybe they prefer to participate in person, attending WorldVistA meetings? Nope.

doh!

Maybe the organization is just deeply skilled in health IT. It looks like they have some military health IT experience, which is not at all the same as VA health IT. The resume of the Tiag CEO shows that she is not a computer scientist, or a self-taught developer. This is pretty important, because Tiag is registered as a small business. The CEO will probably be making significant decisions about this project, and she is not a software developer. Moreover her resume speaks to industry-hopping with “leadership experience” as the result. Given that background, there is a very real danger that she might be confident without being competent regarding VistA.

doh!

Perhaps, they have experience with Open Source? Nope.

doh!

How about experience with MUMPS? Nope.

doh!

Are these google searches working at all? Perhaps Google has not indexed tiag.net. Nope, a search for the CEOs name returns lots of pages. Including this one, which details the history and philosophy of the company, from that page:

one of our core differences is going against the industry standard of treating people like commodities.  tiag hires the best talent out there and treats them like talent

This is kind of troubling, because VistA, in my experience is one of the most complex and difficult technical arenas in health IT. The system is amazing, but making VistA go is a dark art, and experience really matters here. From what I can tell, they have no VistA experience to speak of. This, and the generally buzz-word compliant and beautiful tone of the website lead to a dangerous potential conclusion: This is an organization that has expertise in writing beautiful proposals, rather than any kind of industry experience. What if this is yet another “beltway bandit” with a limited, “across the fence” understanding of the VistA community inside the VA and no concept of the VistA community outside the VA.

doh!

At this point, I am going to put out the soft feelers to the VistA community, for indications that my research is wrong. But at first blush, it appears that the VA has chosen VistA-outsiders for this role. There a several ways that this analysis could be wrong, for instance, if they had just hired George Timson, or perhaps partnered with someone like Open Health Tools, and they have not yet updated their website. So these concerns could be simply irrelevant.  So first, I hope I am wrong in this analysis. Second, I can only hope that choosing a VistA-outsider was intentional on the part of the VA.

-if- it was intentional, it might not be a bad thing.

It appears, at first blush, that these guys are all going to be VistA newbies. The first thing they need to understand is that they are in fact newbies. I know a lot about Health IT, but knowing VistA… thats something else. Understanding what VistA appears to be, and understanding it at the level of a CAC or VistA programmer… thats something else entirely. It also appears that they are newbies to Open Source generally. I would have loved to see some Linux Foundation/Apache Foundation/Mozilla Foundation type credentials. I do not see that here either.

While I was initially investigating VistA, I wrote the WorldVistA wiki page “What is VistA really?“. Its a chronicle of a health IT outsider becoming a VistA insider (remember I said “insider” not “expert”). Nothing written in that article would come as a surprise to a VistA insider, but if you read it… and you are surprised by anything there, then that is a pretty good indicator that you are a VistA newbie.

Being a VistA newbie is fine, as long as you understand that you are a VistA newbie.

If this “Open Source VistA” thing is going to work, then the people leading that effort are going to have to be deeply aware of what “Open Source” and “VistA” really mean, -or- they are going to have to have a lot of humility.

In Open Source, reputation and leadership are the same thing. If Tiag is as unknown to the rest of the VistA community as they are to me, they have a long way to go. This does not mean they will do a bad job, Harris Corp was pretty inexperienced with Open Source, but they ended up doing a pretty good job on CONNECT. In the end, they earned a good reputation. I was pretty freaked out when that contract went to Open Source novices, but it turned out O.K. in the end.

Of course, Harris had a stellar technical team. They really understood what they were getting into from a technology standpoint. Does Tiag? One of the critical issues around an Open Source VistA process is that normal version control does not work on VistA. This has to do with the quasi-versioning capability of the KIDS system. Updates in VistA often come in the form of KIDS packages that inject code directly into the VistA database. That code, living in the database, and not on the filesystem, makes tracking VistA with traditional version control impossible. Can you imagine trying to create an Open Source governance structure without the presumption of an underlying version control system in place? The governance of most projects translates to “the process by which we decide who gets access to subversion/git/whatever”. This is just one example of how VistA context is going to be critical for any kind of workable governance. My proposals for VistA governance, are some of the oldest and complete writing on the subject. They date from 2008, which is something like 21 years ago in Internet years (which are, as everyone knows, roughly compatible with dog-years). So I am something of an “expert” on the subject of VistA governance.

There are three working definitions of ‘expert’:

1. The student: Person who understands the problem well, and might recognize the solution.
2. The amateur in experts clothing: Person who advertises that they know the solution, but in fact does not understand the problem at all.
3. The real expert: Person who has solves the problem.

I am, at least, solidly in the first category.

If “What is VistA really?” serves as a good introduction to VistA, this post will serve as a good introduction to Open Source values. What matters in Open Source is “being right” and being right comes from evidence. The evidence in this case (a bunch of Google searches) suggests that Tiag is inexperienced and over their heads on this one. The difference between Open Source developers and other developers is that we talk openly about these types of issues, and criticism, when backed by evidence, needs rebutting. Participating in community discussion and responding to community criticism is what “participating” in Open Source community means. We have lots of heated arguments, and its never personal. Its always about what the right thing is for the sake of the project in question. If Tiag thinks this post is critical, they are in for a whirlwind.

At this point I am pretty nervous. The future of VistA depends greatly on Tiag not screwing this up, and I see no evidence that they have any experience in Open Source, licensing, governance or VistA and its unique development process. There are thousand ways to make a train-wreck here and only a few ways to do this right.

I will try an update this article with more information regarding Tiag’s qualifications.

I really hope Tiag has what it takes.

-FT