HP and VistA - FINALworldvista.sourceforge.net/.../HP_and_VistA_-_FINAL.pdf6/18/2004 HP Copywrite 2004 page 2 HP’s History with VISTA •HP and its Compaq and Digital Equipment Corporation

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


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.


VistA Implementations


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


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


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


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


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


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


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


VISTA Configurations


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


HP Linux Architecture – Open Source Middleware

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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


HP Microsoft Architecture – Commercial Middleware

Par

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softwaresoftware




HP ProLiant and HP Integrity ServersHP ProLiant and HP Integrity Servers



HP OpenVMS Architecture – Commercial Middleware

Par

tner

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Valu

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softwaresoftware




HP Alpha Servers HP Alpha Servers


HP OpenVMSHP OpenVMS


VISTA Outside the VA


VISTA at Oklahoma Dept of VA (ODVA)


ODVA Solution Topology


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


Grants for VISTA(reference)


Agency for Healthcare Research & Quality

Scott Young, M.D.Center for Primary Care540 Gaither RoadRockville, MD [email protected]

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 [email protected]


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 [email protected]


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


Dept. of Veterans Affairs

Margaret Coopey, RN, MGA, MPS Center for Practice and Technology AssessmentAHRQ6010 Executive Bld,Rockville, MD [email protected]

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



Agency for Healthcare Research & Quality and NIH

David Lanier, MD Center for Primary CareAHRQ540 Gaither RoadRockville, MD [email protected]

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



Health Resources and Services Administration

Michelle Pray-Gibson, MHSProgram AnalystOffice of Rural Health Policy5600 Fishers Lane, Rm9A-55Rockville, MD [email protected]

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 [email protected]

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. [email protected]

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



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 [email protected]

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



NIH, CDC and FDA

Ms. Jo Anne GoodnightNIH SBIR/STTR ProgramCoordinator6705 Rockledge DriveBethesda, MD [email protected] or [email protected]

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



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)


HP & WorldVista

• How do we communicate more and work together with the WorldVista community?

• Thoughts/Comments/Suggestions, contact us:

Claudine Beron – [email protected] Shull – [email protected] Turano – [email protected] Mastin – [email protected]

Documents

HP and VistA - FINALworldvista.sourceforge.net/.../HP_and_VistA_-_FINAL.pdf6/18/2004 HP Copywrite 2004 page 2 HP’s History with VISTA •HP and its Compaq and Digital Equipment Corporation