VistA Non-EHR Modules
by Peter Groen
Introduction
People who are interested=2 0in the
VistA health information system tend to focus primarily on the
clinical applications and the Computerized Patient Record System
(CPRS) in particular. However, there are numerous other modules
within VistA that might be of interest to the user and vendor
communities, e.g. Police & Security, Library, Incident Reporting,
Nursing Education, Engineering, Dentistry, etc. This paper attempts
to bring some of these lesser known non-clinical care VistA software
modules to your attention for consideration.
Background
In 1982, the Veterans Health
Administration (VHA) committed to building an electronic health care
architecture called the Decentralized Hospital Computer Program
(DHCP). The focus was the of software applications easily integrated
into a complete hospital information system. VA selected the ANSI
Standard ‘M’ as the primary language for DHCP, and began developing
applications using VHA internal programmers who directly with user
groups in software prototyping environments.
By 1990, VHA had upgraded computer
capacity at all medical facilities and began implementing complex
integrated software s olutions across the national health care
delivery system. 1996, the VHA DHCP system was renamed and evolved
into the Veterans Health Information Systems and Technology
Architecture (VistA).
VistA is built on a client-server
architecture, which ties together workstations and personal computers
with graphical user interfaces at VA facilities, as well as software
developed by local medical staff. VistA also includes the links that
allow commercial off-the-shelf software and products to be used with
existing and future technologies.
A key component of VistA is the
Computerized Patient Record System (CPRS). It is a true longitudinal
health record that follows the patient through all VA treatment
settings, outpatient, inpatient, and long care. CPRS has been
installed and used at all VA Medical Centers since 1997.
Other noteworthy applications are VistA
Imaging and Bar Code Medication Administration (BCMA). VistA Imaging
facilitates medical decision-making by delivering complete multimedia
patient information to the clinician’s desktop in an integrated
manner. Images and associated text data are available at all times
anywhere in the hospital. BCMA provides a real-time point-of-car e
solution to ensure that the right drug, the right dose, goes to the
right patient at the right time.
In total, Vista includes over 130
administrative, clinical, and technical software modules (see
Appendix or visit http://www.va.gov/VISTA_MONOGRAPH/ ).
Selected Examples of Non-EHR VistA
Modules
Patient Representative
The purpose of the Patient
Representative module is to ensure that medical centers are more
responsive to patient needs. The software tracks and trends
compliments and complaints and measures the facilitys types of
complaints as they relate to the Customer Services Standards and the
National Patient Satisfaction Survey. This package supports the
Patient Advocate with the collection and categorization of complaints
and compliments that give the medical center an opportunity to meet
and exceed the customers expectations.
Engineering
Engineering, also known as Automated
Engineering Management System/Medical Equipment Reporting System
(AEMS/MERS), facilitates the management of information needed to
effectively discharge key operational responsibilities normally
assigned to VA engineering organizations, such as:
Equipment Management
Work Control
Space/Facility Management
* Selected Features
* Uses bar codes for equipment
inventory and preventive maintenance. Completed work orders are
automatically posted to equipment histories.
* Tracks and controls work orders,
maintaining annotated repair histories for medical and non-medical
equipment. There is a separate menu option for display of incomplete
work orders.
* Identifies building features (square
footage, floor coverings, window types, etc.) and keeps track of
locks and keys.
Nursing System
The Nursing application is a comprised
of multiple modules (i.e., Administration, Education, Clinical, and
Quality Assurance).
Selected Features:
The nursing software includes the
following functionalities:
Tracks staff information.
Accumulates daily statistics on the
number of patients treated.
Generates daily, monthly, quarterly,
and yearly management reports.
Support nurse educators by providing
data/information for the tracking of mandatory
programs and staff education.
Includes nationally developed
standard nursing care plans for initiating patient care plan
generation.
Allows nurses to generate a patient
care plan based on patient problems, identified goals, and specified
nursing interventions.
Police and Security
The Police and Security module supports
the VA Police in their responsibilities of crime prevention,
preliminary investigation of crimes, apprehension, legally correct
handling of suspected offenders, and the transfer of suspected
offenders to appropriate authorities.
Selected Features:
* Serves as the repository file for the
names, addresses, and other demographic data of persons who come in
contact with the Police and Security staff.
* Allows for the retrieval and display
of stored information for a selected person.
* Stores electronic data normally
entered on the VA Police Uniform Offense Report, Investigative Notes,
Case Log, and other documentation assembled during an investigation.
* Contains all violation information on
U.S. District Court Violations Notices and Courtesy Warnings issued
by Police Officers.
* Assembles selective data into a
standardized report format documenting the numbers and types of
criminal incidents that are occurring at the site.
* Records information necessary for the
Vehicle Registration program.
* Records any data pertinent to
individuals currently under any type of criminal proceedings or other legal restraining document.
Conclusions & Recommendations
VistA is a comprehensive system
containing more than just clinical applications tied to the EHR. It
has quite a few other administrative, management and technical
software applications that can stand alone and be used for other
purposes. The Engineering system could be used by almost any
organization to keep track of its equipment, offices, maintenance
records, and associated work orders. The Nursing Education module
could be used by any Nursing school or department to track and keep
records on credentials and training received. There are modules to
track customer complaints, track volunteer hours, motor vehicles,
library holdings, and much more. The open source software development
community ought to seriously consider creating the GUI front end to
these modules and tailoring them to meet the needs of many medical
and non-medical organizations. For more information on the many VistA
software modules, visit https://www.va.gov/vdl/documents/Monograph/Monograph/VistA_Monograph_0421_REDACTED.pdf.