Veterans Health Information Systems and Technology Architecture (VistA)

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In the late 1970's, the Office of Data Management and Telecommunications (ODM&T) was given the job to computerize the VA nationwide [Brown, SH,2003] It was developed using MUMPS programming language.

Frustrated with slow systems development by the (ODM&T), which took 14 years to deploy a laboratory system to six sites, the Department of Medicine & Surgery created the Computer-Assisted System Staff (CASS) in 1977. Their Decentralized Hospital Computer Program (DHCP) included programs for administration, mental health, radiology and dietetics. The ODM&T tried to shut down development, but DHCP developers continued their work. Eventually VA Administrator Robert Nimmo approved a policy giving facility directors the power to choose computer applications in 1982. A first group of 25 sites and 11 applications was in place by 1983.

In 1982, the VistA system was implemented at eight sites. As of 2001, it was the largest system in use in the US, with medical documentation and ordering available at every VA hospital in the country. In September 2002, 90.6% of all inpatient and outpatient pharmacy orders were entered by the provider. Today, the system is in use in hundreds of hospitals and clinics worldwide, not just in the VA Hospital System.

VistA consists of nearly 100 applications. Two relatively new applications include Computertized Patient Record System (CPRS) and Barcode Medication Administration (BCMA). A complete description and list of all applications can be found at the Vista website. http://www.va.gov/vista

One important drawback of VistA is that site-specific data dictionaries prevents data summarization between sites, or on a system-wide level.

The Veterans Health Information Systems and Technology Architecture (VistA) is an enterprise-wide information system built around an electronic health record, used throughout the United States Department of Veterans Affairs (VA) medical system, known as the Veterans Health Administration (VHA).

VistA was developed using the M or MUMPS language/database. The VA currently runs a majority of VistA systems on InterSystems Caché. VistA can also run on GT.M, an open source database engine for Linux and Unix computers. Although initially separate releases, publicly available VistA distributions are now often bundled with the database in an integrated package. This has considerably eased installation.

The Department of Veterans Affairs has had automated data processing systems within its medical facilities since before 1985,beginning with the Decentralized Hospital Computer Program (DHCP) information system, including extensive clinical and administrative capabilities. In 1995, DHCP was enshrined as a recipient of the Computerworld Smithsonian Award for best use of Information Technology in Medicine.

The most significant is a graphical user interface known as the Computerized Patient Record System (CPRS) for clinicians released in 1997.


By 2001, the VHA was the largest single medical system in the United States, providing care to 4 million veterans, employing 180,000 medical personnel and operating 163 hospitals, over 800 clinics and 135 nursing homes.[2] By providing electronic health records capability, VistA is thereby one of the most widely used EHRs in the world.

Reference

1. Department of Veterans Affairs: Veterans Health Administration 2. Brown, Stephen H. (2003). "VistA, U.S. Department of Veterans Affairs national scale HIS". International Journal of Medical Informatics 69: 135-156, Bethesda, MD (USA). doi:10.1016/S1386-5056\(02\)00131-4) (inactive 22 June 2008).


References

Brown, SH, Lincoln MJ et al. VistA - U.S. Department of Veterans Affairs national-scale HIS. International Journal of Medical Informatics.69(2003):135-156.

Category EMR