From the hardhats list on Google Groups: “I have been watching some of the steps VA has taken over this past year with regards to management of health IT systems that I would consider to be major strategic missteps. The following are some informal observations.”
Tag Archives: VistA
Top “10 or more” Reasons the VA Should Protect the Public Domain Nature of VistA
The VA’s superb record in turning around its health system to become one of the best in the world in quality and cost management has not escaped attention. The fact that the VistA software, training and documentation is freely available as public domain is making the DNA of this transformation available to health systems everywhere. The Cerner press release announcing the VA’s intention to integrate a proprietary laboratory component into the public domain VistA software ecosystem has the potential if carried out to severely hamper the strategic leveraging of the VA transformation across the US and the rest of the world.
Your Health Care Quality, Privacy, Security and Tax Dollars Are at Stake
A stark future awaits American health care if the Veterans Affairs (VA) system and Cerner is allowed to go forward with announced plans to replace the VA’s successful public domain laboratory software, in need of update, with a proprietary one. The VA would give large amounts of cash that would greatly assist a single proprietary company in dominating EHR software in both the public and private sector. A free, thriving EHR ecosystem will be destroyed and replaced with a monopoly or cartel at great expense in which the quality, privacy and security of such software is a trade secret, un-examined and un-examinable. If this is allowed, it could lead to Americans essentially renting their own medical data back from the Cerners of the world at great expense.
VistA – The First Amputation
In an unprecedented announcement, the VA has signed a 9 year deal with Cerner to replace laboratory information system at 150 hospitals and 800 clinics.
This is both a highly concerning but also highly provocative announcement given its implications. Which side of the sword you will feel as a result depends on your perspective.
PR: Introduction to WorldVistA EHR System Administration Education Conference Dec 7-9th, 2007
Press Release: “The not-for-profit Harris County Health Information Cooperative (HCHIC) is sponsoring an intensive, vendor-neutral Educational Conference: “Introduction to WorldVistA EHR System Administration”. This three day weekend education event December 7th-9th, 2007 will be held in Houston, Texas. This conference will be limited to 20 participants and has a low introductory rate. 10% of the proceeds benefit the not-for-profit WorldVistA organization with the rest of the proceeds benefiting the not-for-profit HCHIC. More information and enrollment information here.
Eight Hour Sacramento VistA Failure Last August
Modern Healthcare’s Joseph Conn has an article on a large 8 hour VistA outage at the Sacramento VA facility that occurred on August 31st, 2007. Some believe that a VA security reorganization centralizing control at the expense of reliability has gone too far: “Davoren said there has been a welcome consciousness-raising within the VA about privacy and security issues, but heightened security measures also have had drawbacks, including difficulty scheduling teleconferences and other snafus. �For example, to fully comply with security requirements on our examination-room PCs, we must log out of both a clinical application such as our Computerized Patient Record System and the Microsoft Windows operating system each time we leave the room even for a moment, yet it may take as long as 12 minutes to log back on when we return. Given a 20- or 30-minute visit with their veteran patient, the clinician is thus forced to choose to �do the right thing� for either the patient or the system, but cannot do both, �the bad news is that centralization of physical IT resources to the (regional approach) has directly led to more system downtime for individual medical centers than they have ever had before, resulting in hundreds of simultaneous threats to the safety of our veteran patients.�
West Virginia ‘Open for Business’ to VistA, RPMS and Other Open Source Healthcare Solutions
The Governor’s strategic plan for improving healthcare in West Virginia was just completed and published in April 2007. The HealthyWV Strategic Plan describes what the state intends to do to improve healthcare in the state over the next 5-10 years. This article describes several major initiatives being undertaken to install the ‘open source’ VistA and/or RPMS electronic health record (EHR) system in healthcare facilities across the state of West Virginia.
CCHIT-Certified WorldVistA EHR Delayed by End User Agreement
Joseph Conn has This article on why the release of CCHIT-certified WorldVistA EHR has been delayed: “The delay can be attributed in large measure to unique legal and business considerations that arose by virtue of certification as an open-source software product, according to Joseph Dal Molin, interim president and vice president of business development for WorldVistA. “The main thing that has been the stumbling block for us is translating the (24-page) CCHIT agreement into an end-user agreement,” Dal Molin said in a telephone interview. “We need to maintain certification in an open-source world. As bizarre as it may seem, we didn’t anticipate that as part of the (development) effort.”
Some VistA Myths and Facts
There is always myths that surround the Veterans Affairs (VA) VistA Electronic Health Record. I have not found a compendium of these myths and the facts so I wrote this list. As well I was partially inspired by Fred Trotter’s recent ‘Antiquated or Proven?’ response to a detractor of VistA. Please feel free to add to this list by replying below.
Myth: The VA is �getting rid of�, �abandoning�, �phasing out� VistA.
RPMS: An Alternative to VistA
RPMS may be an alternative to VistA that you may want to consider. If one were looking to acquire and implement a comprehensive “open source” electronic health record (EHR) system, serious consideration should be paid to the Resource and Patient Management System (RPMS) used by the Indian Health Service (IHS). RPMS is an adaptation of the VistA health information system originally developed by the U.S. Department of Veterans Affairs (VA), modified to meet the needs of IHS. RPMS is an integrated health information system ideally suited for implementation in healthcare facilities of varying sizes and complexity. Patients treated at IHS facilities tend to include a diverse mix of all age patients, males and females. While RPMS is deployed at many IHS inpatient facilities, it is more heavily utilized in ambulatory care settings.
Article here.