Next week, the CMS will hold a meeting with
information technology vendors interested in using a proposed version of the
Department of Veterans Affairs' comprehensive computerized electronic record
and IT system -- the Veterans Health Information Systems Technology
Architecture, or Vista -- modified for use in physician offices.
The
CMS/VA effort aims to bring the Vista Office Electronic Health Record, a
proven, affordable version of an electronic medical records system, to the
small-group office practice, where EMR penetration rates are lowest due to
system costs.
The vendors meeting on the Vista-Electronic Health
Records project is scheduled for Oct. 20 in Washington, D.C.
At the
meeting, CMS and VA officials will gauge the level of vendor interest in the
project as well as raise awareness of the initiative, according to Capt.
Cynthia Wark, an officer in the Public Health Service and deputy director of
the information systems group in the CMS' Office of Clinical Standards and
Quality.
"We just want to figure out if we put this out on the street,
are any of the vendors going to pick up on it," said Wark. "We're trying to
gauge the interest. The other thing is to let people know what we're doing."
Wark is a registered nurse with certification in medical informatics
from the American Nurses Association. She comes to the job from the Indian
Health Service, which uses a modified version of the VA clinical IT system.
Under CMS' Physician Focused Quality Initiative, the federal agency
has joined with the VA in a plan to scale the massive Vista program to office
size.
"One of our goals is to help physician offices get over the
impediment of an investment in a software product -- and why not do it (with
Vista) since the government has invested a lot of money in a product that
without too much modification physicians can use in their office," Wark said.
Vista, which comprises about 100 program modules -- including programs
to run activities as far-ranging as an inpatient pharmacy or an out-patient
mental health service -- also includes a module called Computerized Patient
Record System, or CPRS, which is an electronic medical record system. The
Vista CPRS has already been adapted to the office practices by several private
consultants working independently of CMS. (See the current
Health IT Strategist.)
Copies of the Vista
software are available free under the Freedom of Information Act, but the VA
provides no support for installation and maintenance of Vista by outside
users. License fees also are required for the Cache database and computer
language on which the system runs on the server side, and for Windows for some
applications that have a graphical user interface on the provider side.
The Pacific Telehealth and Technology Hui, based in Hawaii, a joint
venture of the VA and the Defense Department, has ported Vista to the
open-source Linux operating system and GT.M database. Their aim was make the
system more broadly available by reducing licensing fees. The software can be
downloaded for free on the Internet at the Web site of
WorldVista, a not-for-profit
organization of Vista supporters.
CMS' Vista Office EHR will run on
the Cache database and the Windows operating system, according to Dennis
Stricker, CMS' director of the information systems group in CMS' Office of
Clinical Standards and Quality.
Vista is the IT backbone of the VA's
vast healthcare system that provides care to more than 7 million people at
1,300 care sites, including more than 800 out-patient clinics and more than
150 hospitals.
