WorldVistA EHR is an alternative implementation of and based on the U.S. Department of Veterans Affairs electronic health record (EHR), Veterans Health Information Systems and Technology Architecture (VistA). It is licensed under the General Public License, GPL, and thus open-source software. It is owned by a charitable organization with the name WorldVistA. It is developed by medical and software professionals on a voluntary basis and not for profit. The group members loosely call themselves "Hardhats".
WorldVistA was incorporated on March 18, 2002, as a non-profit corporation in the state of California, in the United States of America. It is a charitable organization approved by the US Internal Revenue Service under Section 501(c)(3) of the Federal Tax Code.
WorldVistA EHR was formed to extend and improve the VistA electronic health record, and to enable it for use outside of the original setting. It serves as the official entity for the informal Hardhat developer community, and as such depends on volunteer labor. There is no publicly accessible issue database where users can post issues; instead, users seem to favor the Hardhats discussion forum for this purpose . WorldVista sponsors an annual conference and educational seminars about the WorldVista software.
WorldVistA is developed by a series of physicians (and other medical professionals) and software professionals that donate their efforts as volunteers. This group loosely referred to themselves as Hardhats (and continues to do so) before the name of the project was officially changed to WorldVistA. WorldVistA has developed and distributes a "toaster" version of VistA, which is a self-contained software package that integrates both the MUMPS database (GT.M version) and the VistA software.In 2009, the self-installing Linux toaster version was enhanced with a GUI-based patient registration module, web interface, and other enhancements, and incorporated into a self-installing package for both Debian/Ubuntu and Red Hat Linux. This freely available version of WorldVistA is known as Astronaut VistA. This version is packaged with both an enhanced GUI as well as a web interface (which allows connection through an intranet or through the Internet). An introduction to this package is here in a PDF slide presentation. A similar package for Windows-based servers is in alpha (early development) stage.
On January 31, 2008 WorldVistA released WorldVista HER VOE/1.0.This is the only open source electronic medical record that meets Certification Commission for Health Information Technology (CCHIT) ambulatory electronic health record (EHR) criteria for 2006 . Some of World Vista features include:
- Patient registration - It provides a patient data entry and data collection interface.
- Clinical reminders for chronic disease management - Used as a clinical decision support system to aid and improve treatment decisions and improving patient care.
- Clinical order entry - Used to order treatments, medication, or other medical related services.
- Progress note templates - Used by health care provider for planning, documenting, and communicating patient care to nurses and other health care staff.
- Results reporting - It permits each center to construct and run its own patients’ reports.
WorldVistA EHR also includes functionality tailored to meet the specific needs:
- Ability to interface to existing practice management / billing systems, lab services and other applications
- Scanning and inclusion of scanned documents into the medical record
- Prescription finishing and faxing
- Clinical quality measure reporting capabilities
- Support for disease management, using clinical reminders
- Templates for obstetrics/gynecology (OB/GYN) and pediatrics care
Purpose of WorldVistA
WorldVistA goes back to March 18, 2002 when it was first incorporated as non-profit organization in the state of California, in the United States of America. It has been known ever since as charitable organization that approved by the US Internal Revenue Service under Section 501(c)(3) of the Federal Tax Code.
Doctors, nurses and other healthcare professionals should have immediate and uninterrupted access to critical patient’s information including patient’s records. Historic data as well as current medication and allergy information can assist in providing better care when needed most. Electronic Health Record Systems are designed to collect, store, and disseminate information to healthcare professionals on demand in a secured access fashion. WorldVistA works to make that happen with a powerful, open-source, free medical software system called VistA (Veterans Health Information Systems and Technology Architecture). WorldVistA works to help clinicians around the world learn, set up, and use VistA to improve medical care and, continuously update VistA to meet the changing needs of patients and clinicians.
EHR brings a new and challenging task to all stakeholders and should be playfully introduced. It is recommended that:
- The users of medical software must be heavily involved in the developmental stages.
- The software must be highly adaptable to local medical practices.
- The software must update continuously to keep up with changes in medical knowledge and law.
- The process of updating medical software must protect patient health and privacy.
Drawing on experience with medical software going back four decades, the U.S. Department of Veterans Affairs (VA) originally designed VISTA's
- software structure
- software lifecycle
- community organization
- expertise lifecycle
- economic relationships to make these things possible
WorldVistA works to adapt and extend the VA models and the values and principles on which they are based beyond the U.S. federal government. Only a system based on these principles can fulfill the promise of using computers to improve health for everyone, everywhere. WorldVistA intends to realize that dream.
--Sfjafari 16:43, 4 September 2011 (CDT)
- Adapt, extend and disseminate the evidence based model, values, principles and processes that are the foundation of WorldVistA EHR to the global health community.
- Enhance WorldVistA EHR with pediatrics, obstetrics, emergency room, and other functionality, such as billing.
- Support those who choose to adopt the WorldVistA EHR system by simplifying the installation process and providing a software update and maintenance service.
- Grow and coordinate a dynamic community of WorldVistA EHR users and developers based on principles of open, collaborative, peer reviewed software development and dissemination.
WorldVistA EHR features:
The following features were added to the VistA software distributed through FOIA to better serve the needs of physician offices.
- Simplified installation
- Pediatrics progress note templates based on the Indian Health Services (IHS) progress note templates and American Academy of Pediatric Bright Futures templates.
- OB/GYN note templates based on the IHS progress note templates.
- Patient registration that can be customized to integrate seamlessly with registration processes that are unique to individual physician offices.
- Risk, social and medical factors fields to record information such as native language, translator needed, country of birth, and year arrived in U.S.
- Medical record numbers or social security numbers can be used to identify patients.
- DOQ-IT (Doctor’s Office Quality-Information Technology) Reminders
- Clinical Reminders related to the Registered DOQ-IT measure
- Codified data in compliance with the requirements specified by the DOQ-IT quality improvement measures.
- Technical manuals, user guides, and online help contained within the Computerized Patient Record System (CPRS).
- Standard laboratory and medication orderable files that comply with DOQ-IT measures and information topp 100 prescribed medications.
- Pharmacy functionalities that allows prescriptions to be printed for signature and/or faxed with an electronic signature.
- Laboratory interface that can integrate with external lab services to enable automated order entry and results reporting.
- Open source integration platform to build interfaces to billing/practice management systems.
Adoption by Other Organizations
Between 1982 and 1993, WorldVistA was adapted by the Indian Health Services (IHS) and by a number of countries such as Finland, Germany, Egypt, and Nigeria.  The IHS also developed a derivative of VistA called the Resource and Patient Management System.
Software Download Site
WorldVista promotes public involvement in a variety of ways. The public can get involved by joining the Hardhats mailing list, using the Sourceforge Forums, using the OpenForum wiki, and attending Friday community conference calls. It is also possible for the public to get involved in software development by taking part in technical meetings and development meetings. 
- "History." — Welcome to the WorldVistA Homepage. N.p., n.d. Web. 17 Oct. 2014. http://worldvista.org/AboutVistA/VistA_History
 WorldVista webmaster. WorldVistA EHR. Web page describing the WorldVista EHR product (2008), http://worldvista.org/World_VistA_EHR (accessed November 15, 2008)
 Get Involved: http://www.worldvista.org/Getting%20Involved