Is there not one standalone community clinic that is currently running
VistA?

David

----- Original Message -----
From: "Wayne Wilson" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Tuesday, January 07, 2003 8:27 AM
Subject: Different niches and the role of training ( was Re: Sherlock
Holmes)


> Dr. David H Chan wrote:
>
> > John, can you recommend me to community practices you know who have
> > successfully deployed VistA as an EMR? I would very much love to learn
> > from
> > them and see if VistA has a role to play in Canada.
> >
> >
> I think it's important to think about the relative context of how these
> systems are installed, supported and used.
> While some family practice or GP are operationally connected with large
> health care organizations and thus can use the systems deployed by those
> organizations (which includes the services of a multi-person
> professional IT staff), many, if not the majority, are not so connected.
>
> This is indeed the challenge for  VISTA, which has  a heritage in the
> large entity world.  Can it make or even should it make the transition?
> That is to say, maybe VISTA fulfills a different niche.  Seen in this
> light, John is right, there is nothing close to it available in the open
> source world, and maybe there will never be anything close to it.  It's
> a relatively small market with high costs.
>
> Small practice's on the other hand, assuming they stay small and
> independent would be another niche, and that niche seems to be where a
> lot of the action is in open source medical systems.  (A much larger
> market)
>
> Another very viable niche is in public health (analysis, warning,
> reporting, registries, etc.).  (A small market again, so maybe only one
> OSS option?)
>
> All of these niche's need to interchange information with each other,
> albeit with different aims in mind and different privacy and security
> issues to be resolved.  However, this interchange could and probably
> should be de-coupled from the actual systems.
>
> The other valuable observation that has been made in these discussions,
> one that can be capitalized on, is the opportunity to provide a more
> relevant training experience.  Someone associated with the AAMC commons
> activity mentioned to me at the OSHCA conference that most family
> practice (and GP's I would assume) get trained in a hospital
> organization but eventually practice in a much smaller organization.
> The kinds of systems they train on are rarely available for use once
> they move on to their career.  That creates a huge opportunity (and
> challenge)  for academic medical centers to take on the task of training
> folks on the kinds of systems they are likely to be using.
>

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