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ModernHealthcare Interview
ModernHealthcare recently upgraded their site, and failed to maintain back links, so if you feel like paying for access then you can search for this article, if it helps here is the

The text that concerned me from the article...

A combination of a version of the VistA clinical information system available under the Veterans Health Administration under the Freedom of Information Act and a proprietary version of the VistA system developed by Medsphere Systems Corp. of Aliso Viejo, Calif., is to be installed in seven state-owned healthcare facilities in West Virginia.

Note that Larry Augustin had stepped down as CEO so I am now emailing Ken Kizer in his place.

From: Fred Trotter Mailed-By: To: scott.shreeve somewhere, steve.shreeve somewhere, Ken.Kizer somewhere
Date: Apr 13, 2006 3:51 PM
Subject: Re: GPL OpenVistA
Dr. Shreeve, Dr. Shreeve and Dr. Kizer,
I sent this letter to you last year regarding your status as an "open source" company. After which I had a very pleasant conversation with Dr. Shreeve regarding your intention to release your code under the GPL. Currently I read the following carefully crafted statements from your website under "About Us".

Medsphere leverages open source technology...

Open. Medsphere embraces the open source movement...

However, this recent article
indicates that you have in fact closed the source on your implementation of VistA. Taking a generously licensed codebase and creating a proprietary version from it is very common practice. However for those of us in the Free Software movement, this is a tremendous problem. More specifically while you have made your version of VistA "less-free" others have been working to make VistA "more-free", WorldVistA continues to release improvements to VistA under the GPL. This means that your version of VistA will rapidly become incompatible with the codebase available under the GPL. I would like to once again privately request that you consider releasing your code under the GPL and averting this unneeded fork.

The next step is for me to make this request in an open letter and a petition. I know that there are many people in the large VistA community that would like to collaborate with you on the VistA codebase, but are currently unable to do so with this "Hybrid" model. Many of them are disappointed with MedSpheres unwillingness to collaborate on the project, but so far have remained silent on the issue in the hopes that Medsphere would make good on the various statements of intent to open your codebase.

Please consider embracing the "Free and Open Source Software" movement fully, and give back to the community that has given you so much.

Fred Trotter

This time I got a several replies back!!

From: Steve Shreeve Mailed-By:
To: "fred.trotter" , "Kenneth W. Kizer" , Scott Shreeve
Cc: Ben Mehling , George Timson
Date: Apr 13, 2006 4:35 PM
Subject: RE: GPL OpenVistA

We share your enthusiasm regarding open source!

In fact, our recent GPL'ed contribution of "Medsphere FileMan" (dubbed by many as FileMan 23) includes arguably the most sweeping and advanced changes made to the VistA codebase outside the VA in the past several years. Did you miss that release? If so, let me know and I can get you that code.

The press article that you cited regarding a "hybrid VistA" is simply the interpretation of a reporter who was trying to describe the work we had done to the core VistA system to install it in a production customer environment.

The new work that we have done on the graphical user interface is slated to be released once we have completed our testing work. There are at least two other major projects that we will also be releasing that will fundamentally change the way developers work with VistA and the way that new development can take place. We're working to release a fully-cross platform and completely open source stack, from top-to-bottom towards the latter part of this year. We are working long hours to make this a reality.

If you'd like to schedule a time to come meet with us in Southern California, please let me know.

Best regards,



Steve Shreeve
Chief Technology Office, Co-founder
Medsphere Systems Corporation
120 Vantis, Suite 405
Aliso Viejo, CA 92656
steve.shreeve hello

Note that CEO Ken Kizer recieved this email. And that it says explicitly:

We're working to release a fully-cross platform and completely open source stack, from top-to-bottom towards the latter part of this year. We are working long hours to make this a reality.
As you can imagine I was very happy!! Even happier when I got this message.

From: Kenneth W. Kizer Mailed-By:
To: "fred.trotter" Date: Apr 13, 2006 10:37 PM
Subject: RE: GPL OpenVistA

It appears that Steve has responded to you, but I thought that you might be interested in the attached comments I gave last week.


Kenneth W. Kizer, MD, MPH
President & CEO
Medsphere Systems Corporation
120 Vantis, Suite 405
Aliso Viejo, CA 92656
TEL 949.297.4050
FAX 949.266.8937
e-mail kenneth.kizer lemon

attachment: Testimony, Subcommittee on Health, Committee on Ways & Means, House of Representativbe, 040606.doc

The attachment was a copy of
Ken Kizers testimony in front of congress, which by the way is an excellent argument that federal funds should be earmarked for "open source" in healthcare IT.

Note that Ken Kizer is acknowledging that he got the email from Steve Shreeve. As you can imagine I was as happy as clam at high tide.