The effort that we here at UW are making to develop an introduction to the VistA information architetcure is using a combined approach of the VA and IHS (and the DoD CHCS to the extent we can get open documentation). We have faculty in active dialog with individuals in IHS and we are basing the discussion framework on the US and and international health informatics standards that place EHR in the center in support of Patient care and Resource Management in a supporting/enabling position. We are working to show first how the conceptual content is defined by these health informtics standards in functions, data architecture and behavior in an implementation independent way and then depict how the implementation of not only the current VistA architecture but also potential evolutionary changes will reflect the conceptual content needs in a Zachman architecture "Enterprise Architecture Planning" manner reflecting best recommended Life Cycel Principles. The work of the MDC in describing the application of these principels to the M data mangement Platform will be reflected so that Enterprise information architectures cabn be created by individual healthcare enterprises from VistA and other components to suit their business needs. These ideas will reflect what the CCHIT organization is attempting to do in its role for the full healthcare informatics market. This documentation is open and World VistA has working versions of evolutionary versions. As we get more explicit information on the IHS architecture and its uses the areas of commonality and standards conformacne will be described and we hope IHS speakers will visit our campus to discuss and speak on the myriad of issues involved. Nay specific IHS contacts would be welcome and their input will become vailbale to the the hardhats via realsed versiosn of our open documnetation; LIke wise, any comments, arguments or peprspectives are welcome and will be disgested by the BHI forum here. The documents shortly will be presented on a BHI website with links to the specific VA and IHS FOIA-released documentation applicable to the modules with the various topic areas; links to Harhats wikkis on implementation issues will be included as the site evolves.
Sincerely Arden
On Wed, 20 Apr 2005, Kevin Toppenberg wrote:
I have become the conduit for anonymous posts. Here is another:
Just for the record, I don't like to be in the middle of these things, and will only post a few more such replies. He are all adults. I think we can keep our converstations civil. There is no need to hide behind anonyminity.
Kevin
... I’m sending this to you and not to Hardhats because I don’t want incite the wrath of its membership, but I feel compelled to set the record straight when such egregious misstatements are rendered. Regarding the “anonymous source”, the concluding paragraph illustrates a total lack of understanding of the IHS environment and the IHS relationship with VHA. I have worked for many years in VA and in IHS and am probably better suited to commenting on this than most people. These comments follow, which you are welcome to share if done so anonymously:
IHS Empire – This criticism should more appropriately be leveled at VHA. IHS has not created an empire and has been very willing to share what they have done and to incorporate what others have done. The VA, for the most part, fails to understand the differences between the respective agencies and the populations that they serve – hence the need for IHS to modify existing and create additional functionality to meet the needs of their patients.
Lagging Behind – The IHS EHR product, a component-based, extensible, graphical EMR, is actually well ahead of CPRS in almost every respect.
Stuff VA Didn’t’ Get – Like what? Look at all the things the VA uses that originated in IHS: PCE, Health Summary, Women’s Health, to name a few. The barrier has always been the VA’s reluctance to accepting outside technologies, never IHS’s unwillingness to share.
$311 Million – IHS’s budget is much smaller than VA, yet they have accomplished so much. To be fair, a large part of this is due to their ability to utilize what VA has invested so much in creating. They aren’t trying to recreate anything, just adapting and augmenting what currently exists.
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