VistA - AbsoluteAstronomy.com

The Veterans Health Information Systems and Technology Architecture (VistA) is an enterprise-wide information system built around an Electronic Health Record

Electronic Health Record

An electronic health record is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations...

(EHR), used throughout the United States Department of Veterans Affairs

United States Department of Veterans Affairs

The United States Department of Veterans Affairs is a government-run military veteran benefit system with Cabinet-level status. It is the United States government’s second largest department, after the United States Department of Defense...

(VA) medical system, known as the Veterans Health Administration

Veterans Health Administration

The Veterans Health Administration is the component of the United States Department of Veterans Affairs led by the Under Secretary of Veterans Affairs for Health that implements the medical assistance program of the VA through the administration and operation of numerous VA outpatient clinics,...

(VHA).
It's a collection of about 100 integrated software modules.

By 2003, the VHA was the largest single medical system in the United States, providing care to over 4 million veterans, employing 180,000 medical personnel and operating 163 hospitals, over 800 clinics, and 135 nursing homes. About a quarter of the nation's population is potentially eligible for VA benefits and services because they are veterans, family members, or survivors of veterans.

By providing electronic health records capability, VistA is thereby one of the most widely used EHRs

Electronic Health Record

An electronic health record is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations...

in the world. Nearly half of all US hospitals that have a full implementation of an EHR

Electronic Health Record

An electronic health record is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations...

are VA hospitals using VistA.

Features

The Department of Veterans Affairs

United States Department of Veterans Affairs

(VA) has had automated data processing systems, including extensive clinical and administrative capabilities, within its medical facilities since before 1985. Initially called the Decentralized Hospital Computer Program (DHCP) information system, DHCP was enshrined as a recipient of the Computerworld Smithsonian Award

Smithsonian Award

The Computerworld Smithsonian Award is given out annually to individuals who have used technology to produce beneficial changes for society. Nominees are proposed by a group of 100 CEOs of information technology companies...

for best use of Information Technology in Medicine in 1995.

VistA supports both ambulatory and inpatient care, and includes several significant enhancements to the original DHCP system. The most significant is a graphical user interface

Graphical user interface

In computing, a graphical user interface is a type of user interface that allows users to interact with electronic devices with images rather than text commands. GUIs can be used in computers, hand-held devices such as MP3 players, portable media players or gaming devices, household appliances and...

for clinicians known as the Computerized Patient Record System (CPRS), which was released in 1997. In addition, VistA includes computerized order entry, bar code medication administration, electronic prescribing

Electronic prescribing

Electronic prescribing or e-prescribing is the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of...

and clinical guidelines

Guideline (medical)

A medical guideline is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare...

.

CPRS provides a client–server interface that allows health care providers to review and update a patient's electronic medical record. This includes the ability to place orders, including those for medications, special procedures, X-rays, nursing interventions, diets, and laboratory tests. CPRS provides flexibility in a wide variety of settings so that a consistent, event-driven, Windows

Window (computing)

In computing, a window is a visual area containing some kind of user interface. It usually has a rectangular shape that can overlap with the area of other windows...

-style interface is presented to a broad spectrum of health care workers.

Achievements

For its development of VistA, the United States Department of Veterans Affairs

United States Department of Veterans Affairs

(VA) / Veterans Health Administration

Veterans Health Administration

(VHA) was named the recipient of the prestigious Innovations in American Government Award presented by the Ash Institute of the John F. Kennedy School of Government

John F. Kennedy School of Government

The John F. Kennedy School of Government at Harvard University is a public policy and public administration school, and one of Harvard's graduate and professional schools...

at Harvard University

Harvard University

Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...

in July, 2006. The VistA electronic medical records system is estimated to improve efficiency by 6% per year, and the monthly cost of the EHR

Electronic Health Record

An electronic health record is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations...

is offset by eliminating the cost of even a few unnecessary tests or admissions.

The adoption of VistA has allowed the VA to achieve a pharmacy prescription accuracy rate of 99.997%, and the VA outperforms most public sector hospitals on a variety of criteria, enabled by the implementation of VistA.

VA hospitals using VistA are one of only thirteen hospital systems that have achieved the qualifications for HIMSS

Healthcare Information and Management Systems Society

The Healthcare Information and Management Systems Society is a not-for-profit organization dedicated to improving the quality, safety, cost-effectiveness, and access to healthcare through the best use of information technology and management systems. Originally founded in 1961 as the Hospital...

stage 7, the highest level of electronic health record integration,while a non-VA hospital using VistA is one of only 42 US hospitals that has achieved HIMSS stage 6.

Licensing and dissemination

The VistA system is public domain

Public domain

Works are in the public domain if the intellectual property rights have expired, if the intellectual property rights are forfeited, or if they are not covered by intellectual property rights at all...

software, available through the Freedom Of Information Act

Freedom of Information Act (United States)

The Freedom of Information Act is a federal freedom of information law that allows for the full or partial disclosure of previously unreleased information and documents controlled by the United States government. The Act defines agency records subject to disclosure, outlines mandatory disclosure...

directly from the VA website, or through a growing network of distributors. Astronaut is an automated VistA installer suite which installs VistA in less than 30 minutes. Installation instructions for the Astronaut VistA Installer Suite can be found here. Astronaut has done many bug fixes, upgrades and enhancements to VistA making it suitable for use in the private sector.

Database backend

VistA was developed using the M or MUMPS

MUMPS

MUMPS , or alternatively M, is a programming language created in the late 1960s, originally for use in the healthcare industry. It was designed for the production of multi-user database-driven applications...

language/database. The VA currently runs a majority of VistA systems on the proprietary InterSystems

InterSystems

InterSystems Corporation is a privately held vendor of software for high-performance database management, rapid application development, integration, and healthcare information systems...

Caché

Caché (software)

InterSystems Caché is a commercial object database management system from InterSystems Corporation. It provides object and SQL access to the database, as well as allowing direct manipulation of Caché’s underlying data structures. The company claims Caché is the world’s fastest object database...

version of MUMPS, but an open source

Open source

The term open source describes practices in production and development that promote access to the end product's source materials. Some consider open source a philosophy, others consider it a pragmatic methodology...

MUMPS database engine, called GT.M

GT.M

GT.M is a high-throughput key-value database engine optimized for transaction processing. GT.M is also an application development platform and a compiler for the ISO standard M language, also known as MUMPS.GT.M, an abbreviation for Greystone Technology M, was developed by the Greystone Technology...

, for Linux

Linux

Linux is a Unix-like computer operating system assembled under the model of free and open source software development and distribution. The defining component of any Linux system is the Linux kernel, an operating system kernel first released October 5, 1991 by Linus Torvalds...

and Unix

Unix

Unix is a multitasking, multi-user computer operating system originally developed in 1969 by a group of AT&T employees at Bell Labs, including Ken Thompson, Dennis Ritchie, Brian Kernighan, Douglas McIlroy, and Joe Ossanna...

computers has also been developed. Although initially separate releases, publicly available VistA distributions are now often bundled with the GT.M database in an integrated package. This has considerably eased installation. In addition, the free and open source nature of GT.M allows redundant and cost-effective failsafe database implementations, increasing reliability for complex installations of VistA.

An open source project called EsiObjects has also allowed the (ANSI- Standard) MUMPS language and database technology to evolve into a modern object-oriented language (and persistent-object store) that can be integrated into mainstream, state-of-the-art technologies. For the Caché MUMPS database, a similar object-oriented extension to MUMPS called Caché ObjectScript

Caché ObjectScript

Caché ObjectScript is a part of the Caché database system sold by Intersystems Corp. The language is a functional superset of the ANSI-standard M programming language. MUMPS programmers can run existing MUMPS routines under Caché with little or no change...

has been developed. Both of these have allowed development of the MUMPS database environment (by programmers) using modern object-oriented tools.

M2Web is an open source web gateway to MUMPS for use with VistA.

A free open source module from M/Gateway called MGWSI has been developed to act as a gateway between GT.M, Cache, or M21 MUMPS databases and programming tools such as PHP, ASP.NET, or Java, in order to create a web-based interface.

HealtheVet

The VHA has an ongoing pilot project, known as HealtheVet (HeV) that envisions the next generation of VistA, with further modernization of database capabilities and interfaces.

MyHealtheVet is another initiative that allows veterans to access, and create a copy of, their health records online. This allows veterans to port their health records to institutions outside the VA health system or keep a personal copy of their health records, a Personal Health Record (PHR)

Personal health record

A personal health record or PHR is a health record where health data is curated by an individual user themselves. This stands in contrast with the more widely used electronic medical record which is held by institutions such as a hospital and contains data entered by clinicians or billing data in...

VistA Imaging

The Veterans Administration has also developed VistA Imaging

Vista imaging

VistA Imaging is an FDA-approved Image Management system used in the Department of Veterans Affairs healthcare facilities nationwide. It is one of the most widely used image management systems in routine healthcare use, and is used to manage many different varieties of images associated with a...

, a coordinated system for communicating with PACS

Picture archiving and communication system

A picture archiving and communication system is a medical imaging technology which provides economical storage of, and convenient access to, images from multiple modalities . Electronic images and reports are transmitted digitally via PACS; this eliminates the need to manually file, retrieve, or...

(radiology imaging) systems and for integrating others types of image-based information, such as EKGs, pathology slides, and scanned documents, into the VistA electronic medical records system. This type of integration of information into a medical record is critical to efficient utilization.

VistA Imaging has been made freely available in the public domain for private/public hospital use through the Freedom of Information Act. It is available through the Department of Veteran's Affairs software request office. (Licensing of several proprietary modules are required for it to function correctly.)

It can be used independently or integrated into the VistA electronic health record system (as is done in VA health facilities).

Role in development of a national healthcare network

The VistA electronic healthcare record has been widely credited for reforming the VA healthcare system, improving safety and efficiency substantially. The results have spurred a national impetus to adopt electronic medical records similar to VistA nationwide.

VistA Web

VistA Web

VistAWeb is a portal accessible through CPRS , the graphical user interface forthe Veterans Health Information Systems and Technology Architecture , the electronic health record used throughout the United States Department of Veterans Affairs medical system .This portal has...

collectively describes a set of protocols that in 2007 was being developed and used by the VHA to transfer data (from VistA) between hospitals and clinics within the pilot project. This is the first effort to view a single patient record so that VistA becomes truly interoperable among the more than 128 sites running VistA today.

BHIE

BHIE

BHIE is an acronym for Bidirectional Health Information Exchange, a series of communications protocols developed by the Department of Veterans Affairs...

enables real-time sharing of electronic health information between DoD and VA for shared patients of allergy, outpatient pharmacy, demographic, laboratory, and radiology data. This became a priority during the Second Iraq War, when a concern for the transition of healthcare for soldiers as they transferred from active military status to veteran status became a national focus of attention.

A Clinical Data Repository/ Health Data Repository (CHDR) allows interoperability between the DoD's Clinical Data Repository (CDR) & the VA's Health Data Repository (HDR). Bidirectional real time exchange of computable pharmacy, allergy, demographic and laboratory data occurred in phase 1. Phase 2 involved additional drug–drug interaction and allergy checking. Initial deployment of the system was completed in March 2007 at the El Paso, Augusta, Pensacola, Puget Sound, Chicago, San Diego, and Las Vegas facilities.

The combination of VistA and the interoperable projects listed above in the VA/DoD systems will continue to expand to meet the objectives that all citizens will have an electronic record by 2014.

Because of the success of these programs, a national move to standardize healthcare data transmission across the country was started. Text based information exchange is standardized using a protocol called HL7 (Health Level 7

Health Level 7

Health Level Seven , is an all-volunteer, non-profit organization involved in development of international healthcare informatics interoperability standards...

), which is approved by the American National Standards Institute

American National Standards Institute

The American National Standards Institute is a private non-profit organization that oversees the development of voluntary consensus standards for products, services, processes, systems, and personnel in the United States. The organization also coordinates U.S. standards with international...

. DICOM

Digital Imaging and Communications in Medicine

DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems...

is an international image communications protocol standard. VistA is compliant with both.

VistA has been interfaced with commercial off-the-shelf products, as well. Standards and protocols used by VA are consistent with current industry standards and include HL7, DICOM, and other protocols.

Tools for CCR/CCD support have been developed for VistA, allowing VistA to communicate with other EHRs

Electronic Health Record

An electronic health record is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations...

using these standardized information exchange protocols. This includes the Mirth

Mirth (software)

Mirth is an open source cross-platform HL7 interface engine that enables bi-directional sending of HL7 messages between systems and applications over multiple transports available under the Mozilla Public License 1.1 license.-Background:...

open source cross platform HL7 interface and NHIN Connect, the open source health information exchange adaptor.

In 2009, a project was undertaken to facilitate EHR communication between the VA (using VistA) and Kaiser Permanente (using Epic) using NHIN Connect. (Both VistA and the commercial EHR Epic use a derivative of the MUMPS database, thereby facilitating data exchange.) When completed, two of the largest medical record systems in the US will be able to exchange health data. Public-domain VistA derivatives are also expected to be able to use NHIN Connect.

The VistA EHR has been used by the VA in combination with Telemedicine to provide surgical care to rural areas in Nebraska and Western Iowa over a 400000 square miles (1,035,995.2 km²) area.

Usage in non-governmental hospitals

Under the Freedom of Information Act (FOIA), the VistA system, the CPRS interface, and unlimited ongoing updates (500–600 patches per year) are provided as public domain software.

This was done by the US government in an effort to make VistA available as a low cost Electronic Health Record

Electronic Health Record

An electronic health record is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations...

(EHR) for non-governmental hospitals and other healthcare entities.

With funding from The Pacific Telehealth & Technology Hui, the Hui 7

Hui 7

The Hui 7 were a team assembled and funded by The Pacific Telehealth & Technology Hui to convert the Veterans Administration's VistA electronic medical record to a platform suitable for private use...

produced a version of VistA that ran on GT.M

GT.M

in a Linux

Linux

operating system

Operating system

An operating system is a set of programs that manage computer hardware resources and provide common services for application software. The operating system is the most important type of system software in a computer system...

, and that was suitable for use in private settings. VistA has since been adopted by companies such as Blue Cliff, DSS, Inc., Medsphere, and Sequence Managers Software to a variety of environments, from individual practices to clinics to hospitals, to regional healthcare co-ordination between far-flung islands. In addition, VistA has been adopted within similar provider environments worldwide. Universities, such as UC Davis and Texas Tech implemented these systems. A non-profit organization, WorldVistA

WorldVistA

WorldVistA is an open source implementation of the Veteran Administration's Electronic Health Record system intended for use in health care facilities outside the VA.-Background:...

, has also been established to extend and collaboratively improve the VistA electronic health record and health information system for use outside of its original setting.

VistA (and other derivative EMR/EHR systems) can be interfaced with healthcare databases not initially used by the VA system, including billing software, lab databases, and image databases (radiology, for example).

VistA implementations have been deployed (or are currently being deployed) in non-VA healthcare facilities in Texas, Arizona, Florida, Hawaii, New Jersey, Oklahoma, West Virginia, California, New York, and Washington, D.C.

In one state, the cost of a multiple hospital VistA-based EHR network was implemented for one tenth the price of a commercial EHR network in another hospital network in the same state ($9 million versus $90 million for 7–8 hospitals each). (Both VistA and the commercial system used the MUMPS database).

VistA has even been adapted into a Health Information System (VMACS) at the veterinary medical teaching hospital at UC Davis.

International deployments

VistA software modules have been installed around the world, or are being considered for installation, in healthcare institutions such as the World Health Organization

World Health Organization

The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

, and in countries such as Mexico, Samoa, Finland, Jordan, Germany, Kenya, Nigeria, Egypt, Malaysia, India, Brazil, Pakistan, and Denmark.

In September 2009, Dell Computer bought Perot Systems, the company installing VistA in Jordan.

History

The concept that eventually became VistA was initiated and planned at the beginning of the 1970s by the National Center for Health Services Research and Development of the U.S. Public Health Service

United States Public Health Service

The Public Health Service Act of 1944 structured the United States Public Health Service as the primary division of the Department of Health, Education and Welfare , which later became the United States Department of Health and Human Services. The PHS comprises all Agency Divisions of Health and...

(NCHSR&D/PHS). (The NCHSR&D is now known as the Agency for Healthcare Research and Quality (AHRQ)

Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality is a part of the United States Department of Health and Human Services, which supports research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective...

.)

As a proof of concept, the U.S. Navy's clinic at the Brunswick Naval Air Station had used an early version of the system software to develop an operational, automated, clinic-management and medical-record system that was "paperless".

The National Center for Health Sciences Research and Development then turned to an agency of the U.S. Department of Commerce, the National Bureau of Standards (NBS, reorganized in 1988 as the National Institute of Standards and Technology

National Institute of Standards and Technology

The National Institute of Standards and Technology , known between 1901 and 1988 as the National Bureau of Standards , is a measurement standards laboratory, otherwise known as a National Metrological Institute , which is a non-regulatory agency of the United States Department of Commerce...

), to turn the systems-technology strategy into a systems-architecture design.

Under the farsighted leadership of the VA's Chief Medical Director, Dr. John Chase, the VA's Department of Medicine and Surgery (now known as the Veterans Health Administration (VHA)), then agreed to deploy the system at the largest medical system of that time, the VA hospitals.

Both Dr. Robert Kolodner (National Health Information Technology Coordinator) and George Timson (an architect of VistA who has been involved with it since the early years) date VistA's actual architecture genesis, then, to 1977. The program was launched in 1978 with the deployment of the initial modules in about twenty VA Medical Centers. The program was named the Decentralized Hospital Computer Program (DHCP) in 1981.

The physicians in VA Medical Centers, with leadership from the National Association of VA Physicians (NAVAP, renamed NAVAPD in 1989 when Dentists were added) and its Executive Director, Dr. Paul Shafer, made sure that the VA understood the importance of clinician-directed development and refinement of this new clinical-information system.

In December 1981, Congressman Sonny Montgomery of Mississippi arranged for the Decentralized Hospital Computer Program (DHCP) to be written into law as the medical-information systems development program of the VA. VA Administrator Robert P. Nimmo signed an Executive Order in February 1982 describing how the DHCP was to be organized and managed within the VA's Department of Medicine and Surgery.

In consultation with F. Whitten Peters and Vincent Fuller of the Williams and Connolly law firm, it was established at the beginning of the 1980s that the software existing in the VA (derived from the PHS projects) was legally in the public domain and must be made available without proprietary or other restrictions to other government and private-sector organizations for their use.

In parallel with the VA's DHCP development, the (PHS) Indian Health Service

Indian Health Service

Indian Health Service is an Operating Division within the U.S. Department of Health and Human Services . IHS is responsible for providing medical and public health services to members of federally recognized Tribes and Alaska Natives...

deployed a system with similar structure throughout their hospitals and clinics as the Resource and Patient Management System (RPMS). This implementation emphasized the integration of outpatient clinics into the system, and many of its elements were soon re-incorporated into the VA system (through a system of technology sharing). Subsequent VistA systems therefore included elements from both RPMS and DHCP.

The U.S. Department of Defense (DoD) then modified the PHS/VA system for use in DoD healthcare facilities and renamed it the Composite Health Care System (CHCS)

Composite Health Care System

The Composite Health Care System is a VMS-based medical informatics system designed by Science Applications International Corporation and used by all United States and OCONUS military health care centers...

.

Meanwhile, in the early 1980s, major hospitals in Finland were the first institutions outside of the United States to adopt and adapt the VistA system to their language and institutional processes, creating a suite of applications called MUSTI and Multilab. (Since then, institutions in Germany, Egypt, Nigeria, and other nations abroad have adopted and adapted this system for their use, as well.)

The name "VistA" (Veterans Health Information System and Technology Architecture) was adopted by the VA in 1994, when the Under Secretary for Health of the U.S. Department of Veterans Affairs (VA), Dr. Ken Kizer, renamed what had previously been known as the Decentralized Hospital Computer Program (DHCP).

The four major adopters of VistA – VA (VistA), DoD (CHCS), IHS (RPMS), and the Finnish Musti consortium – each took VistA in a different direction, creating related but distinct "dialects" of VistA. VA VistA and RPMS exchanged ideas and software repeatedly over the years, and RPMS periodically folded back into its code base new versions of the VA VistA packages. These two dialects are therefore the most closely related. The Musti software drifted further away from these two but retained compatibility with the infrastructure of RPMS and VA VistA (while adding additional GUI and web capabilities to improve function). Meanwhile, the CHCS code base diverged from that of the VA's VistA in the mid-eighties and has never been reintegrated. The VA and the DoD had been instructed for years to improve the sharing of medical information between the two systems, but for political reasons made little progress toward bringing the two dialects back together. More recently, CHCS's development was brought to a complete stop by continued political opposition within the DoD, and it has now been supplanted by a related, but different, system called AHLTA. While AHLTA is the new system for DoD, the core systems beneath AHLTA (for Computerized Physician Order Entry, appointing, referral management, and creation of new patient registrations) remain those of the underlying CHCS system. (While some ongoing development has occurred for CHCS, the majority of funds are consumed by the AHLTA project.) Thus, the VistA code base was split four ways.

Many VistA professionals then informally banded together as the "Hardhats" (a name the original VistA programmers used for themselves) to promote that the FOIA (Freedom of Information Act) release of VA VistA (that allows it to be in the public domain) be standardized for universal usage.

WorldVistA

WorldVistA

WorldVistA is an open source implementation of the Veteran Administration's Electronic Health Record system intended for use in health care facilities outside the VA.-Background:...

was formed from this group and was incorporated in March 2003 as a non-profit corporation. This allowed the WorldVistA board of directors to pursue certain activities (obtaining grants, creating contracts, and making formal alliances) that they otherwise could not pursue as an informal organization. It is, however, an organization independent of the VA system and its version of VistA therefore differs from that of the VA's. Nevertheless, it maintains as an objective that its public version be compatible (interoperable) with the VA's official version. It has developed packages of WorldVistA for multiple operating systems, including Linux (Debian/Ubuntu and Red Hat)-based and Microsoft Windows-based operating systems. Co-operation with the maintainers and vendors of OpenVistA, another widely deployed open source public version of VistA, helps maintain interoperability and a standardized framework.

Therefore, it is through the joint achievement of thousands of clinicians and professional systems experts from the United States and other nations that the VistA system has developed, many of them volunteers.

Supporters of VistA

There have been many champions of VistA as the electronic healthcare record system for a universal healthcare plan. VistA can act as a standalone system, allowing self-contained management and retention of healthcare data within an institution. Combined with BHIE

BHIE

BHIE is an acronym for Bidirectional Health Information Exchange, a series of communications protocols developed by the Department of Veterans Affairs...

(or other data exchange protocol) it can be part of a peer-to-peer model of universal healthcare. It is also scalable to be used as a centralized system (allowing regional or even national centralization of healthcare records). It is, therefore, the electronic records system most adaptable to a variety of healthcare models.

In addition to the unwavering support of congressional representatives such as Congressman Sonny Montgomery of Mississippi, numerous IT specialists, physicians, and other healthcare professionals have donated significant amounts of time in adapting the VistA system for use in non-governmental healthcare settings.

The ranking member of the House Veterans Affairs Committee's Oversight and Investigation Subcommittee, Rep. Ginny Brown-Waite

Ginny Brown-Waite

Virginia "Ginny" Brown-Waite is the former U.S. Representative for , serving from 2003 until 2011. She is a member of the Republican Party....

of Florida, recommended that the Department of Defense

United States Department of Defense

The United States Department of Defense is the U.S...

(DOD) adopt VA's VistA system following accusations of inefficiencies in the DOD healthcare system. The DOD hospitals use Armed Forces Health Longitudinal Technology Application (AHLTA) which has not been as successful as VistA and has not been adapted to non-military environments (as has been done with VistA).

In November 2005, the U.S. Senate passed the Wired for Health Care Quality Act, introduced by Sen. Enzi of Wyoming with 38 co-sponsors, that would require the government to use the VA's technology standards as a basis for national standards allowing all health care providers to communicate with each other as part of a nationwide health information exchange. The legislation would also authorize $280 million in grants, which would help persuade reluctant providers to invest in the new technology. There has been no action on the bill since December 2005. Two similar House bills were introduced in late 2005 and early 2006; no action has been taken on either of them, either.

In late 2008, House Ways and Means Health Subcommittee Chair Congressman Pete Stark (D-CA) introduced the Health-e Information Technology Act of 2008 (H.R. 6898) that calls for the creation of a low-cost public IT system for those providers who do not want to invest in a proprietary one.

In April 2009, Sen. John D. Rockefeller of West Virginia introduced the Health Information Technology Public Utility Act of 2009 calling for the government to create an open source electronic health records solution and offer it at little or no cost to safety-net hospitals and small rural providers.

VistA Derivatives

Astronaut VistA -- a installer suite for different versions of VistA with multiple enhancements and bug fixes.
WorldVistA
WorldVistA
WorldVistA is an open source implementation of the Veteran Administration's Electronic Health Record system intended for use in health care facilities outside the VA.-Background:...

or WorldVistA EHR
OpenVistA (Medsphere)
vxVistA (DSS)
OnDemandCARE – a VistA-based EHR package (Sequence Managers Software)
BlueCliff VistA-EMR (Blue Cliff)

An effort has been made by the Astronaut team, WorldVistA team and members of the VistA Software Alliance to standardize structure between the platform derivatives to allow for future interoperability, as part of the vision for a national healthcare network record system.

External links

Vistapedia: the WorldVistA Wiki
Hardhats – a VistA user community
Hardhats Google Group – a forum to discuss installation of WorldVistA
VISTA Monograph (Veterans Administration)
VistA Monograph wiki (OLPC project)
VistA Software Alliance (VistA Software Vendor Trade Organization)
VistA / CPRS Demo site (Department of Veterans Affairs)
VA VistA software FTP site (Department of Veterans Affairs)
The Pacific Telehealth & Technology Hui
VistA Imaging overview (Department of Veterans Affairs)
BHIE – Bidirectional Health Information Exchange protocols of the Department of Veterans Affairs
Why is VistA good? – Ash Institute News Release
VistA Glossary LiuTiu Medical Administrative Lexicon (Brokenly translated into English from Russian)
Ubuntu Doctors Guild Information about implementing VistA and other open source medical applications in Ubuntu Linux

Videos about VistA:

VistA at the VA
History of Vista Architecture Interview with Tom Munnecke
Interview with Rob Kolodner regarding VistA's potential for the National Health Information Network
National Health Information Network
The Nationwide Health Information Network is an initiative for the exchange of healthcare information being developed under the auspices of the U.S. Office of the National Coordinator for Health Information Technology...
Impact of VistA Interview with Dr. Ross Fletcher
Interview with Philip Longman
Events leading up to the development of VistA Interview with Henry Heffernan
History of Vista Interview with Ruth Dayhoff
Early development of the Decentralized Hospital Computer Program Interview with Marty Johnson
Early days of the VA "Underground Railroad" Interview with Tom Munnecke

The source of this article is wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL.

Features

Achievements

Licensing and dissemination

Database backend

HealtheVet

VistA Imaging

Role in development of a national healthcare network

Usage in non-governmental hospitals

International deployments

History

Supporters of VistA

VistA Derivatives

See also

External links