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Subject: VA drives open-source health records initiative
- From: "Ed Dodds" <dodds@e-dodds.com>
- To: "Andy Moir \(E-mail\)" <andy.moir@comcast.net>, "ihc@Lists. Oasis-Open. Org \(E-mail\)" <ihc@lists.oasis-open.org>
- Date: Wed, 24 Nov 2004 10:02:29 -0600
Agency could spur adoption of e-health systems worldwide
BY Bob
Brewin
Published on Nov. 22, 2004
Twenty-year-old software developed by the
Department of Veterans Affairs could serve as the low-cost building block of a
nationwide electronic health care record (EHR) system President Bush wants
officials to deploy within the next decade, according to health management
experts.
This open-source software, based on the VA's
Veterans Health Information Systems Technology Architecture (Vista), could also
become the basis of affordable EHR systems worldwide, said Maury Pepper, a St.
Louis-based computer consultant. Pepper serves as chairman of WorldVista, an
organization dedicated to making health care technology more affordable
worldwide with systems based on Vista.
Officials at the Centers for Medicare and Medicaid
Services (CMS) want to use Vista to stimulate the adoption of EHR systems by
doctors with a new public-domain version of the software, Vista-Office EHR,
developed in conjunction with VA officials.
Capt. Cynthia Wark, a Public Health Service nurse
who is the acting deputy director of the information systems group at CMS'
Office of Clinical Standards and Quality, said agency officials are developing
Vista-Office to improve the quality of health care while promoting the adoption
of health care information technology by doctors' offices and clinics. Officials
are targeting Vista-Office to small medical offices that have one to eight
doctors. They have been slow to buy new technology because of its cost. Wark
estimated the software needed in a small doctors' office to cost between $10,000
and $20,000.
Vista-Office will provide doctors and clinicians
with a number of modules adopted from Vista, including the Computerized Patient
Record System, which replaces paper charts. CMS developers are adding new
modules, including software for pediatricians and gynecologists and a patient
registration system, Wark said.
Mike Ginsburg, project manager for the Vista Office
software at the Iowa Foundation for Medical Care, a CMS contractor, said agency
officials will begin testing Vista-Office with small clinical practices next
month. CMS officials plan to make the software electronically available in July
2005 to the roughly 500,000 U.S. physicians via downloads from CMS' Web site.
Vista-Office is available for free, but when
officials release the final version, doctors would have to pay a license fee to
use the underlying Caché programming language and database management systems
from InterSystems, based in Cambridge, Mass. VA officials use Caché to run Vista
in 172 hospitals and 400 clinics. The language is based on the Massachusetts
General Hospital Utility Multiprogramming Systems (MUMPS) programming language
developed in the late 1960s.
Dr. Stan Saiki Jr., director of the joint Defense
Department/VA Pacific Telehealth and Technology Hui (meaning partnership) at
Tripler Army Medical Center in Honolulu, said this partnership resolved the
license fee issue last year with the release of its Hui OpenVista enterprise
software.
Instead of using MUMPS Caché, Saiki said, Hui
OpenVista runs on open-source MUMPS called Greystone Technology M from the
Sanchez Computer Associates division of Fidelity National Financial, in
Jacksonville, Fla. The complete Hui OpenVista package runs on the open-source
Linux operating system software, which provides users with a complete, free and
sophisticated EHR system, Saiki said.
Saiki said Pacific Telehealth has had about 1,000
downloads of Hui Open Vista software package from its Web site and envisions it
serving health care facilities worldwide. Pacific Telehealth developers have
built an application service provider prototype of Hui Open Vista, Saiki said.
The software is housed on central servers, relieving the need to hire an IT
staff to maintain an in-house EHR system.
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