Buried in the NEJM article Use of Electronic Health Records in U.S. Hospitals is the statistic that the proportion of hospitals that have full
implementation of EMR’s nearly doubles from 1.5 to 2.9% of all hospitals when the public domain VA VistA system is taken into account:

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Full Press Release here. CARLSBAD, Calif. – March 4, 2009 – Since the implementation of Medsphere’s OpenVista electronic health record (EHR), Midland Memorial Hospital (MMH) has realized a host of improved clinical results, including fewer patient deaths and medical errors and decreased infection rates, an independent case study confirms.

The 2008 study (summarized in a PowerPoint presentation) was initiated by Medsphere to evaluate the effectiveness of OpenVista and was conducted by a third-party organization without Medsphere involvement.

RPMS is a VistA derivative used in the ambulatory care setting for the Indian Health Services. According to this announcement, it is now CCHIT certified. “The Indian Health Service (IHS) has been notified that the newest version of the IHS health information system
has earned certification by the Certification Commission for Healthcare Information Technology (CCHIT).

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Must read article by Joseph Conn here: “…The question is whether the Veterans Health Information Systems and Technology Architecture, or VistA—the clinical information system that powers the VA health system—will wither or bloom in the months and years ahead. It’s an issue that has implications not only for millions of veterans but also millions of other potential users of open-source and proprietary versions of VistA, both in the private and public sectors in the U.S. and abroad…”

Kevin Toppenberg’s VistA Menu Map can be found here and it is spectacular in how much it has. Everything for running a national hospital system including all the software to run a hospital cafeteria and dietetics service to a library. The amount of software is simply breathtaking. From the page: “A note of explaination about this file:
The VistA system is menu driven. There are over 9,000 separate options that could be directly called. Obviously this is too many to make any sense of. This document is a printout of all these options, organized into menus, as found in VistA. I created this file because I wanted a way of looking at the “forest” as well as the individual “trees”. I hope it helps someone…”

The latest GAO report on VistA modernisation efforts ca be found here.

There has been much discussion in the Open Source health world about the VA reorganization. While many feel the centralization of development will stifle the innovation that created VistA, the current report cites the need to fix organizational leadership and project management gaps as key issues throttling VistA upgrades and modernization. This report can be an interesting focal point for discussion on the proposed upgrades as well as the implications for OpenVistA.

Electronic healthcare has an article (paid subscription required) entitled: ‘Implementation of the Veterans Health Administration VistA Clinical Information System around the World’. The success story of the Veterans Health Administration (VHA) within the US Department of Veterans Affairs has been well documented and is generally well known. What is generally not known is that the VHA’s clinical information system, known as VistA, and the computerized patient record system clinical user interface front end have been successfully transported and implemented to a number of non-VHA healthcare organizations across the United States. Moreover, VistA software modules have been installed, or are being considered for installation, in healthcare institutions around the world in countries such as Mexico, Finland, Jordan, Germany, Nigeria, Egypt, Malaysia, India, Brazil, Pakistan and Samoa.

Modern Health Care (registration required) Joseph Conn is reporting that: ‘Perot Systems, Plano, Texas, has been awarded a contract to install a version of the Veterans Health Administration healthcare information-technology system, VistA, at 46 hospitals and about 500 healthcare clinics in the Middle East nation of Jordan, according to several sources…’ Linux Medical News sources state however that the contract has not been signed yet and that it may be for some Jordanian hospitals, with the Jordanians themselves converting the rest.

WorldVistA held its 7th VistA Community Conference at Shepherd University June 27-29, 2008. Key note speakers included Dr. Kolodner, National Coordinator for Health IT, and Jessica Kahn, Medicaid Transformation Project Manager. Attendees included representatives from India, Malaysia, Puerto Rico, and many other public and private sector health care organizations across the U.S. More information about the conference, and presentations made can be found on the WorldVistA web site at www.worldvista.org . It is also recommended that individuals consider visiting the Shepherd University health IT web site at www.shepherd.edu/surc/cosi .

HealthBeatBlog has an article on the current Veterans Affairs VistA situation: ‘In the past I’ve spoken highly of VistA, the Veteran’s Administration computerized health records system—and with good reason. VistA has a lot going for it. In 2006, it won an “Innovations in American Government Award” from Harvard. Studies show that use of VistA has improved VA productivity by 6 percent a year since national implementation was achieved in 1999. In a time of sky rocketing health care costs, VA care has become 32 percent less expensive than it was in 1996 in part thanks to VistA. The computerized system also has helped the VA reach an amazing prescription accuracy rate of over 99.997 percent. And last—but certainly not least—VistA is a flexible program that allows for much independent tinkering in the name of improvement, both by techies outside of the VA and those within the administration.

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