The Wall Street Journal (paid subscription required) is reporting that HMO Kaiser Permanente is going to be spending $1.8 billion to ‘put the medical records of its 8.4 million patients online…’ with proprietary vendor Epic Systems. $1.8 billion? Whew! Perhaps they haven’t heard of Free/Open Source software like VistA. Per the article, Kaiser has 8.4 million patients. That comes out to $214 per patient which seems rather pricey. Especially in view of what they don’t get: portability outside of Kaiser, standardization of interface outside of Kaiser, 3rd party verification of confidentiality or clinical process, any ownership at all of source code and single point of failure by relying on one vendor. I suppose it is progress over a paper record if they can pull it off.