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 facility’s 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 customer’s 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.
