First industry asked the government to get involved to help drive EMR
adoption. Now, in a classic example of "be careful what you ask for," CMS
has announced that they will provide free Vista and VistaOffice
software to physicians participating in Medicare -- which is virtually
all physicians. (The CMS page on Vista is here.)
This is a dramatic announcement, but in truth, Visa has been available
to anyone filing a Freedom of Information Act request. From the New York Times:

Medicare has not estimated what its software giveaway is worth. But
Duncan Pringle, chief Vista technologist at Perot Systems, said that
each doctor in a practice paid about $20,000 to $25,000 [per physician] to get started
with a commercial system, including costs of software, a license fee
charged to each doctor, installation and servicing.

Vista would cost $10,000 to $12,000 for an entire medical practice.
That means that a practice of five doctors might pay $100,000 to
computerize, but if the doctors used the Medicare system they might pay
only $10,000 for the whole office. [Not including hardware and network.]

Vista is already available as open source software from WorldVista
and others, and the CMS announcement differs little from "buying" open
source. Of course, price is not the only barrier to adoption.

"Vista is a good system and it all sounds great," said Dr. Thomas
Jevon, a family physician in Wakefield, Mass. But, he added, "anyone
who uses a computer can get frustrated and waste time trying to make it

And for doctors, whose time is typically valued at $250 an hour, that time adds up.

a program takes 10 minutes away from your hour each day, that is
costing you tens of thousands of dollars a year," Dr. Jevon said.
"That's what's bugging doctors."

The industry has yet to react, but many companies and investors have
their sights on the same market segment that CMS hopes to provide Vista.

"There are a lot of fantastic vendors," Dr. Kursunoglu said, "but,
realistically, we're in a time period where reimbursement is going down
and costs are rising. This is free."

Visa would seem a natural platform for medical device and middleware vendors to target for integration.

[Hat tip: Fierce Healthcare]

UPDATE: I've sure been getting a lot of search engine hits on "vista" and "vistaoffice" since posting this.

UPDATE: And oops, the New York Times gets the "free" part wrong.