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HP and VISTA
Claudine Beron, PMPJune 2004
page 26/18/2004 HP Copywrite 2004
HP’s History with VISTA
•HP and its Compaq and Digital Equipment Corporation heritage have been providing VistA solutions and support to the Department of Veterans Affairs for over 20 years.
•HP has collaborated with VA on:– DHCP Environment (now VistA)– VistA Imaging– Bar Code Medical Administration (BCMA)– Federal Health Information Exchange (FHIE)– VistA Outside the VA
page 36/18/2004 HP Copywrite 2004
HP’s Relationship with VA
• HP is a partner with the Dept. of Veterans Affairs to move its HIS system (VistA) outside the VA into State level hospitals and clinics as well as across commercial enterprises through the HealthePeopleinitiative
• HealthePeople’s goals are: – Adopt national data, communications and architecture standards for
health information systems. – Make high performance health information systems (electronic health
records) more affordable, available and interoperable generally and, as appropriate, provide health information system software to other public organizations and to private sector organizations who serve the poor and near poor at as close to no cost as is possible.
– Make personal health record systems available to people and their health care providers that enables people to access and share their health records, access trusted health information and access keysupportive services, including prescription drugs and appointments.
page 46/18/2004 HP Copywrite 2004
VistA Implementations
page 56/18/2004 HP Copywrite 2004
VistA Stages of Success
1) Educate the Customer2) Consult with Customer if necessary 3) Analyze the Environment thoroughly (Assessment)4) Deploy Pilot site (sub-stages exist here)5) Train6) Deploy Disaster Recovery Site (sub-stages exist here)7) Train8) Deploy Additional sites (sub-stages exist here)9) Train10) Provide support
page 66/18/2004 HP Copywrite 2004
VISTAINFORMATION
SYSTEM
USERSECURITY
MAILMAN
DEVICE MANAGER
MENU MANAGER
RPCBROKER
INTEGRATED DATABASE
PATIENTS
WARDS
DRUGS
PERSONS
INVENTORYPRESCRIPTIONS
IMAGES
LAB RESULTS
VISTA SOFTWARE PACKAGES
SCHED-ULING
INPATIENTPHARMACY
LABORATORY
SURGERY
MEDICINE
SOCIAL WORK
DENTAL
ENGINEERING
INTEGRATED FUNDS CONTROLACCOUNTING &PROCUREMENT
ADMISSIONDISCHARGETRANSFER
DIETETICS
MENTALHEALTH
HEALTHSUMMARY
NURSING
LIBRARY
PATIENTFUNDS
MEDICALRECORDSTRACKING
ACCOUNTSRECEIVABLE
VOLUNTARYSERVICE
REHABMEDICINE
RADIOLOGY
ONCOLOGY
COMPUTERIZEDPATIENT RECORDSYSTEM(CPRS)
KERNELTASKMANAGER
VA FILEMAN
TEXTINTEGRATIONUTILITIES (TIU) OUTPATIENT
PHARMACY
CLINICAL PATIENT RECORD
AUTHORIZATION SUBSCRIPTIONUTILITY (ASU)
BAR CODEMEDICATIONADMINISTRATION
WOMEN’SHEALTH
BLOOD BANK PROBLEM LIST
VistAIMAGING
CONSULTS /RESULTTRACKING
CLINICALREMINDERS
MEDICAL CARECOST RECOVERY
Sites of Care•Clinics•Hospitals•Nursing Homes•Domiciliaries•Home/Workplace
page 76/18/2004 HP Copywrite 2004
VISTA Versions
• There are two major varieties of VistA
• FOIA VistA –– Minor changes to code required to implement– Customers: SL Dept of Veterans Affairs
• VA support, patch stream and training long term
• OpenVistA– Major changes to code– Customers: Commercial & SL Medical Facilities
• Commerical Organization will have to support
page 86/18/2004 HP Copywrite 2004
VistA Assessment
• Size of the organization• Number of modules using currently• Number of modules interested in• Number of SME’s provided• Number of IT staff provided• Number of integrations • Number of migrations• Number of individual to be trained
page 96/18/2004 HP Copywrite 2004
VISTA Integrations
• There are hundreds of integration packages that may be required in a given hospital/clinic environment:
– United Max – MDS– AccuCare- AccuMed– McKesson Precision 2000 or Other Patient Account System – IDX PACS: – Amelior EDIS – Puritan Bennet CliniVision– GE/Marquette Muse EKG System – Roche Diagnostic DataCare Blood Gas Monitory – 3M Encoder – MediWare HemoCare Bloodbank Systems – Data Innovations – McKesson Robot Pharmacy – Pyxis Med Stations – GE QMI/QS Fetal Monitoring system – Orsoss Scheduling Surgery – Pharmacy Rx
page 106/18/2004 HP Copywrite 2004
VISTA Migrations
• There are multitudes of migrations of legacy data that may also be required in a given hospital/clinic environment:
– Legacy Billing Systems– Master Patient Index– Legacy Pharmacy– Encounter History
page 116/18/2004 HP Copywrite 2004
VISTA Change Management
• Before any of the work starts, it is important to understand the Change about to occur
– Executive Leader Support– Ownership by MDs and RNs
• Changes to occur– Standard Operating Procedures– Moving from Pen to Computer– Organization Hierarchy and Ownership– Managing the Change Process in each module
page 126/18/2004 HP Copywrite 2004
VISTA Configurations
page 136/18/2004 HP Copywrite 2004
VISTA Configurations
• Configuration Used by HP• IA32/IA64 with Linux & InterSystems Cache• IA32/IA64 with Windows OS & InterSystems Cache• Alpha/Itanium with OpenVMS & InterSystems Cache
• Other Configurations • IA32/IA64 with Linux & Sanchez G.TM• IA32/IA64 with Windows OS & Oracle
page 146/18/2004 HP Copywrite 2004
HP Linux Architecture – Open Source Middleware
Par
tner
/Vi
stA
Valu
e-ad
d/co
mpl
eter
sFo
unda
tion
DistributionDistribution
System softwareSystem software
ManagementManagement
High AvailabilityHigh Availability
Backup/RestoreBackup/Restore
Middleware Middleware stackstack
ApplicationApplication
softwaresoftware
Hardware platformHardware platform
kernel featuresagents and drivers
Java virtual machine
HP OpenViewHP OpenView
HP HP ServiceguardServiceguard
HP ProLiant and HP Integrity ServersHP ProLiant and HP Integrity Servers
HP Data ProtectorHP Data ProtectorHP Data Protector
page 156/18/2004 HP Copywrite 2004
HP Microsoft Architecture – Commercial Middleware
Par
tner
/Vi
stA
Valu
e-ad
d/co
mpl
eter
sFo
unda
tion
DistributionDistribution
System softwareSystem software
ManagementManagement
High AvailabilityHigh Availability
Backup/RestoreBackup/Restore
Middleware Middleware stackstack
ApplicationApplication
softwaresoftware
Hardware platformHardware platform
HP OpenViewHP OpenView
HP HP ServiceguardServiceguard
HP ProLiant and HP Integrity ServersHP ProLiant and HP Integrity Servers
HP Data ProtectorHP Data ProtectorHP Data Protector
page 166/18/2004 HP Copywrite 2004
HP OpenVMS Architecture – Commercial Middleware
Par
tner
/Vi
stA
Valu
e-ad
d/co
mpl
eter
sFo
unda
tion
DistributionDistribution
System softwareSystem software
ManagementManagement
High AvailabilityHigh Availability
Backup/RestoreBackup/Restore
Middleware Middleware stackstack
ApplicationApplication
softwaresoftware
Hardware platformHardware platform
HP OpenViewHP OpenView
HP HP ServiceguardServiceguard
HP Alpha Servers HP Alpha Servers
HP Data ProtectorHP Data ProtectorHP Data Protector
HP OpenVMSHP OpenVMS
page 176/18/2004 HP Copywrite 2004
VISTA Outside the VA
page 186/18/2004 HP Copywrite 2004
VISTA at Oklahoma Dept of VA (ODVA)
page 196/18/2004 HP Copywrite 2004
ODVA Solution Topology
page 206/18/2004 HP Copywrite 2004
ODVA Solution Integration Model
– Standardization– Documentation– Incremental Efficiencies
Enterprise Assessment
Core Setup
Standard Setup
Core Training
Standard Training
Additional Modules, Customizations & Migrations
Norman + Infrastructure (26 weeks)
Ardmore(10 weeks)
Lawton(10 weeks)
Clinton(10 weeks)
Sulphur(6 weeks)
Claremore(8 weeks)
Talihina(6 weeks)
October 2003 June 2004
July 2004
October 2005
March 2005
Phase 1
Phase 2
– ODVA Involvement– Training– Collaboration
page 216/18/2004 HP Copywrite 2004
Grants for VISTA(reference)
page 226/18/2004 HP Copywrite 2004
Agency for Healthcare Research & Quality
Scott Young, M.D.Center for Primary Care540 Gaither RoadRockville, MD 20850301-427-1580syoung@ahrg.gov
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-011.html
Domestic for-profit and non-profit organizations/institutions, state and local governments, tribes and tribal gov’ts and faith-based organizations
THQIT Implementation Grants
Scott Young, M.D.Center for Primary Care540 Gaither RoadRockville, MD 20850301-427-1580syoung@ahrg.gov
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-010.html
Domestic for-profit and non-profit organizations/institutions, state and local governments, tribes and tribal gov’ts and faith-based organizations
THQIT Planning Grants
Eduardo Ortiz, M.D., M.P.H. Senior Advisor for Clinical Informatics 540 Gaither RoadRockville, MD 20850301-427-1585eortiz@ahrg.gov
http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-04-012.html
Domestic organizations, institutions, and state/local governments including non-profit organizations, universities, hospital, and clincs; tribe or tribal organizations; faith-based or community-based organizations; and unit of state or local gov’t
Demonstrating the Value of Health Information Technology
ContactLinkEligible GroupsGrant Name
page 236/18/2004 HP Copywrite 2004
Dept. of Veterans Affairs
Margaret Coopey, RN, MGA, MPS Center for Practice and Technology AssessmentAHRQ6010 Executive Bld,Rockville, MD 20852301-594-4022mcoopey@AHRQ.gov
http://grants.nih.gov/grants/guide/pa-failes/PA-02-066.html
AHRQ: Domestic and foreign public and private non-profit institutions such as universities and clinics, state and local gov’t, eligible agencies of the Federal gov’t and faith-based organizations. VA Pls and co-Pls must hold a minimum of 5/8ths VA paid appointment although non-PI investigators who collaborate on the project do not need to hold a VA appointment.
TRIP
ContactLinkEligible GroupsGrant Name
page 246/18/2004 HP Copywrite 2004
Agency for Healthcare Research & Quality and NIH
David Lanier, MD Center for Primary CareAHRQ540 Gaither RoadRockville, MD 20850301-427-1567dlanier@AHRQ.gov
http://grants1.nih.gov/grants/guide/pa-files/PAR-04-041.html
Domestic public or private non-profit institutions, such as universities, colleges, hospitals, clinics and professional associations, units of state and local gov’t, eligible components of agencies of the Federal gov’t, tribes and tribal organizations, faith-based or community based organizations are eligible.
Practice-based Research Networks (PBRNs) and the Translation of Research into Practice
ContactLinkEligible GroupsGrant Name
page 256/18/2004 HP Copywrite 2004
Health Resources and Services Administration
Michelle Pray-Gibson, MHSProgram AnalystOffice of Rural Health Policy5600 Fishers Lane, Rm9A-55Rockville, MD 20857301-443-0835mpray@hrsa.gov
http://www.hrsa.gov/grants/preview/rural.htm#hrsa04003
Applicants must be a public or non-profit entity that represents a network that includes at least three or more healthcare providers. In addition, the grantee must meet at least one of the 3 following 1) located in a rural area or in rural zip code 2) exists exclusively to provide services to migrant and season farm workers 3) federal recognized Tribe or quasi-tribal entity on reservations.
Rural Health Network Development Planning Grant Program
Susan Lumsdent301-594-4488SLumsden@hrsa.gov
http://www.hrsa.gov/grants/preview/primary.htm#hrsa04029
Applications for ISDI Planning and Development of Managed Care Network funds are limited to currently funded health centers. Practice Management Networks are limited currently funded section 330 health centers. Application for SIMIS and ICT funds are limited to section 330(e) health centers and section 330 primary care associations.
ISDI
Luigi S. Procopio301-443-0262Lprocopio@hrsa.gov
http://www.hrsa.gov/grants/preview/hivaids.htm#hrsa04046
Public or private non-profit agencies. Faith-based and community-based organizations are eligible to apply
TRCCP
ContactLinkEligible GroupsGrant Name
page 266/18/2004 HP Copywrite 2004
National Institute of Health/National Library of Medicine
Same as abovehttp://www.nim.nih.gov/ep/GrantInfoSys.html
US public and private, non-profit institutions engaged in health administration, education, research, promotion and/or clinical care are eligible to apply
Information System Grants
Same as abovehttp://www.nim.nih.gov/ep/GrantlADL.html
US public and private non-profit health-related organizations are eligible to apply. Health-related includes medicine, dentistry, nursing, pharmacy, and other activities related to the promotion of health and prevention and treatment of disease.
IADL
Valerie Florance, Ph.D.Extramural programsNational Library of MedicineRockledge 1, Suite 301Rockledge DriveBethesda, MD 20892301-594-4882Floranv@mail.nlm.nih.gov
IAIMS program: http://www.nlm.nih.gov/pubs/factsheets/iaims.htmlPlanning Grant: http://www.nlm.nih.gov/ep/iaims-plan.htmlOperations Grant: http://www.nlm.nih.gov/ep/iaims-ops.htmlPilot Study Grant: www.nlm.nih.gov/ep/iaims-test.html
Various depending on which grant application is for
IAIMS: Planning, Operations, Pilot Study and Testing & Evaluation Grants
ContactLinkEligible GroupsGrant Name
page 276/18/2004 HP Copywrite 2004
NIH, CDC and FDA
Ms. Jo Anne GoodnightNIH SBIR/STTR ProgramCoordinator6705 Rockledge DriveBethesda, MD 20892301-435-2688sbir@od.nih.gov or jg128w@nih.gov
http://grants.nih.gov/grants/funding/sbirsttr1/index.pdt
For profit US businesses with 500 or fewer employees that are at least 51% US-owned and controlled by one of more individuals and independently operated. In addition, for SBIR grants, the principle investigator’s primary employment must be with the small business for the duration of the project.
Small business innovation research and small business technology transfer
ContactLinkEligible GroupsGrant Name
page 286/18/2004 HP Copywrite 2004
Terms
• Government Computer-based Patient Record (GCPR) – original name for effort for DoD & VA to share information; also included Indian Health Service (IHS)
• Federal Health Information Exchange (FHIE) – new name for GCPR effort; primary focus is on making DoD patient information available to VA
• HealthePeople (Federal) – joint efforts by VA, DoD & HHS/IHS with respect to data standardization, joint build/procurement, sharing software & potential software convergence
• HealthePeople – joint efforts under HealthePeople (Federal) as well as those efforts with other federal, public & private sector organizations with respect to national standards, high performance systems & sharing information (when appropriate/authorized)
page 296/18/2004 HP Copywrite 2004
HP & WorldVista
• How do we communicate more and work together with the WorldVista community?
• Thoughts/Comments/Suggestions, contact us:
Claudine Beron – Claudine.Beron@hp.comDavid Shull – David.Shull@hp.comAugie Turano – AugieT@hp.comDonna Mastin – Donna.Mastin@hp.com
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