Electronic Health Record systems (EHR) are essential to improving
health quality and managing health care delivery, whether in a large
health system, hospital, or primary care clinic. The U.S. Department of Veterans Affairs
(VA) has developed and continues to maintain a robust EHR known as VistA
– the Veterans Health Information Systems and Technology Architecture. This
system was designed and developed to support a high-quality medical care environment
for the military veterans in the United States. The VistA system is in production
today at hundreds of VA medical centers and outpatient clinics across the country.
VistA has a proven track record of supporting a large variety of clinical settings
and medical care delivery systems. Facilities range from small clinics that
provide solely outpatient care to large medical centers with significant inpatient
populations and their associated specialties, such as surgical care or dermatology.
These systems focus on clinically relevant record keeping that improves patient
care by improving clinical and administrative decision-making. Versions of this
system are in active use in the U.S. Department
of Defense Military Health System, the U.S. Department of Health and Human Services Indian
Health Service, and internationally as well, e.g., Mexico – Instituto Mexicano del Seguro Social, and National Cancer Institute of Cairo
University in Egypt.
The costs associated with the acquisition and support of an EHR can
be a barrier to improving the quality of health care provided by
limiting the availability of timely and accurate access to electronic
patient information. Part of the solution is to lower the cost of
acquiring an EHR by using a software stack consisting of open-source,
free software such as VistA. VistA is public domain and freely
available through the US Freedom
of Information Act (FOIA).