Rural communities are particularly underserved when it comes to Healthcare IT and EHR implementation. With all the buzz lately about incentives and the need to expand EHRs nationally, who would have thought  West Virginia might be “ground zero” for the push in that direction?

In his recent New England Journal article, newly appointed Health IT Czar Dr. David Blumenthal sadly reported that less than 10% of hospitals in the US had implemented Electronic Health Records, and that there were still significant barriers to large scale adoption of EHRs.

And yet, one of the poorest and least technical states in the Union, West Virginia just created an entire paperless system for all of its state run hospitals and nursing homes. They did it by making use of open source software – OSS.

As most users of the internet know, OSS is “free software” that fits certain criteria as defined by the Open Source Initiative, The federal government created a functional EHR system paid for by taxpayers years ago, the VA’s VistA. As part of its plan to push EHRs and Healthcare IT, the government has made the VistA software available as OSS to any hospital that wants it. Yet, few have taken advantage of it. In a recent article in the Boston Globe, Phillip Longman, author of a book about improvements in the VA, “Best Care Anywhere,” said VistA is an unrecognized and underutilized national resource. “It’s really insane that we have a fully developed health information technology system that is bought and paid for and free to anybody who wants it. . . and yet we don’t have any take-up in the US, or not much to speak of,” he said.

West Virginia Democratic Senator, Jay Rockefeller would certainly agree with Longman. Having seen firsthand how his state was able to go paperless on a budget by leveraging VistA, Rockefeller has drafted legislation that would promote EHR adoption through open source systems. The proposed bill is called the Health Information Technology Public Utility Act of 2009. According to a Press Release on the Senators website the bill will, “build upon the successful use of “open source” electronic health records by the Department of Veterans Affairs as well as the “open source exchange model,” which was recently expanded among federal agencies through the Nationwide Health Information Network-Connect initiative.

In the release the Senator went on to say, “We need advancements in health information technology across the board to improve the quality of care Americans receive. To make this happen, we need universal access to affordable and interoperable health information technology – from small, rural health clinics to large, urban hospitals.”

Health IT experts are quick to point out that VistA is not the “magic bullet” for EHR adoption in rural America.  It is a good start. And while the software is free, in many instances implementation of VistA will require millions of dollars in hardware and add-ons to make it fully functional. Money for which is just not available in most rural areas.The National Rural Health Association (NRHA) will be holding its convention in Miami next week. Access to and funding for EHRs and Healthcare IT in rural areas is expected to be one of the main focuses of the expo. Watch these pages for direct reports from the show.