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Veterans Health Information Systems and Technology Architecture (VistA)


Established in 1996, VistA is an automated system built on a client-server architecture written in MUMPS, Delphi and Java. VistA is used by the Department of Veterans Affairs (VA) health care facilities to keep track of patient data in a database. The entire system has been placed in the public domain, meaning that it is free of charge to download directly off of the VistA web page. One reason that the VA decided to do this is in order to encourage non-government hospitals and medical institutions to adopt the system as a form of EHR or EMR.

The Veterans Health Administration (VHA) is currently developing the next generation piece of software that will eventually replace VistA. It is called HealtheVet (pronounced Healthy Vet). It will utilize more modern programming languages in order to increase speed and it will also include an application for Veterans to access their health information outside of VA facilities.

CPRS

The biggest, most useful aspect of VistA is the Computerized Patient Record System (CPRS). It is a program with a GUI that allows for the viewing and editing of patient information. It also includes:
  • Real-Time Order Checking System - alerts the clinician of possible ordering problems before they are processed.
  • Notification System - notifies the clinician of important upcoming clinical events.
  • Patient Posting System - displayed on each patient's CPRS screen with patient specific notices, such as allergies and health warnings.
  • Remote Data View - allows doctors to view data from VA facilities other than their own.
  • Electronic Prescriptions - enables for the ordering of patient prescriptions directly to the pharmacy from the GUI. This has allowed for the VHA to increase their prescription accuracy rate up to a staggering 99.997%.
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A screenshot of a patient's CPRS obtained from Wikipedia










Other Features of VistA

  • VistA Imaging - A Picture Archiving and Communication System (PACS) used to digitally store medical images such as X-rays, PET scans and ultrasounds. It can be used in tandem with VistA or independently. It is also available for free being in public domain.
  • Incident Reporting - Organizes incident data and reports and sends it via the Internet to the National Quality Assurance Database for Headquarters.

Applications

VistA has become a proving ground for EHRs and EMRs. Since he VHA has become the largest medical system in the United States more and more government agencies are adopting VistA, as well as non-governmental facilities. After criticism of its EHR system, the US Department of Defense has begun to adopt VistA.

HealtheVet

HealtheVet is the in-development sucessor to VistA, utilizing modern database technologies and building on the success of VistA.
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An information flowchart showing where HealtheVet enters the flow


Web Resources

CPRS Demo
World VistA
VistA software FTP site

Related Terminology

CPRS, EHR, MUMPS, Delphi, Java

References

Business Week article "The Best Medical Care In The U.S."
An editorial by Senator Tom Carper "EHR’s Value Proven at VA"
World VistA Wiki
VistA Monograph