Tom Munnecke, one of the original designers of the Department of Veterans Affairs' VistA system in the late 1970s, is concerned that planning for a next-generation EHR isn't taking into account many of the lessons learned from the early days of VistA. "To begin with, we need to recognize how well VistA works. Given other large-scale government information technology efforts, this might even be considered miraculous. The billions spent on the Defense Department's AHLTA [it might as well stand for 'Ah Heck, Let's Do it Again'] have led to a system which is so bad that it is one of the leading complaints cited by doctors when they leave military service," Munnecke writes in a FierceGovernmentIT guest commentary. "In contrast to DoD's 'break and replace' development strategy, VistA has been under continuous evolution over the past 32 years," Munnecke adds. "VistA never started with a vision of the one correct way to the perfect EHR. Rather, it was a process of discovery, searching and amplifying what worked." He also defends the oft-criticized MUMPS programming language that VistA was created in. FierceGovernmentIT