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Re: Editorial: RHIO's and the Illusion of Health I
by J. Marc Overhage on Monday December 19, 2005 @ 09:27 PM
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A few notes.
First, while the Vista application is used nationwide it is not really different from the Siemens Invision system whicih is also used nationwide. The VA does not have nationwide interoperability today. You can peak at another VA medical centers data but you cannot use data from there for decisions upport. There are hundreds of Siemen's Invison customers (I use them only as an example that I have direct experience with -- there are others) who use the same software with substantially the same interfac across the country but without data integration.
More directly, there is absolutely ZERO probability that we will see a single application across any substantial fraction of our fragmented healthcare enterprise anytime in the next several decades. For better or worse we have a widely distributed healthcare "system" and each component of that system has its own contraints and challenges. While VISTA is available to physician practices for example, it provides very little support for pediatricians and so isn't suitable for them. Further, while there is some work going on to address this, I can't imagine how VISTA could work for the 2 person practice which dominates our healthcare environment. I do want to be clear that I think the VA has done great work creating and implementing VISTA and I'm not bashing it just pointing out why a single solution is unlikely in healthcare just as it is unlikely in retail. You could ask the same questiion about why every POS (point of sale) system doens't work exactly the same way avoiding works having to relearn an interface when they change jobs from Starbucks to McDonalds to the Gap. |
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