# How much should software cost?

The biggest VA outlay — and its biggest savings generator — was the Vista’s Computerized Patient Record System, the home-grown system for electronic health records that was found by the study to cost $3.6 billion. Other IT networks for administering medications with bar codes, picture archiving and communication systems and the Laboratory Electronic Data Interoperability application together cost $470 million.

Lots of money. Result – you can predict this right? Big government bureaucracy. Massive billion dollar software development project. And the result is:

The bottom line: “We conservatively estimate that the VA’s investments in the four health IT systems studied

yielded $3.09 billion in cumulative benefits net of investment costsby 2007,” say the authors, a team from Center for IT Leadership at Partners Healthcare in Charlestown, Mass. The results looks at measures such as reduced workloads, freed workspace and savings from items such as unneeded medical tests and avoided hospital admissions.

Ok. One should cultivate skepticism of such studies, but it is interesting. The system, by the way is not open source – it is public domain. And it’s based on the venerable MUMPS so there, all you language purists. Look at this code fragment, from the Wiki entry, and weep.

%DTC %DTC ; SF/XAK - DATE/TIME OPERATIONS ;1/16/92 11:36 AM ;;19.0;VA FileMan;;Jul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