Apr 11 2013
After reading Bob Brewin’s piece Did Jon Stewart Foil the Pentagon’s Health Records Plan? I have decided that Jon Stewart is a worthy recipient of the Unlimited Free Passage on the Underground Railroad certificate. He understands the problems that the hardhats have been facing in the development of VistA over the years, and also seems to understand the success that it has enjoyed despite the hardships over the years. I hope that this recognition will help him see some opportunities for improving government, health care, and service to our Veterans. It is also an amazing story of how a bottom-up, decentralized approach to innovation can work, even in the most hardened bureaucracy.
The VA MUMPS Underground Railroad was formed in the early days of the VistA development in response to the attempts of the centralists to shut down a field-based decentralized approach. The Hardhats were the technical folk who wrote the code to make it happen, but VistA was always more than just source code, so we needed recognize the many others who were involved in making it a success as described in Phillip Longman’s book Best Care Anywhere and this video. US Medicine editor Nancy Tomich describes the situation. Nancy and I are now working on the New Health Project to carry things to the next generation.
The Underground Railroad has been struggling to build a common vision of VA/DoD health sharing for decades, and not without its casualties, so it is good to finally see some media attention to the issue.
This is the most prestigious award offered by the Underground Railroad, having previously been given in 1982 to Chuck Hagel:
In keeping with the Underground Railroad’s history, his certificate can only be given in person, with appropriate ceremonial presence.
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