Abstract
The U.S. Department of Veterans Affairs ( VA  ) has developed and successfully implemented a comprehensive, integrated healthcare information system known as VISTA in its 173 hospitals and more than 600 clinics across the country. The software was also acquired and implemented in the hundreds of U.S. Department of Defense military healthcare facilities around the world, as well as in the U.S. Indian Health Service and its hundreds of healthcare facilities. Over the last 20 years, the VISTA integrated healthcare information system has been made available in an "as is" state under a Freedom Of Information Act (FOIA) release, and copies of it are also available in the Public Domain from other sources, e.g. www.hardhats.org . The package is dynamic and is ever growing in capability and application. Enhancements are being added all the time by the government and other interested parties. Some of the most notable enhancements made to VISTA over the past five years include a graphical user interface (GUI), the Computerized Patient Record System (CPRS), and a Master Patient Index (MPI). The VA has also interfaced many COTS (Commercial Off The Shelf) software products to VISTA where appropriate, e.g. Laboratory instruments, ICU software, etc. The VISTA system has been running in VA hospitals for almost two decades where it has proven its worth. It is a dynamic and scalable system used in both large and small inpatient and outpatient facilities. All patient data is available to those who have been granted rights to access the applications and associated patient data. Nothing is hidden from the health-care provider unless specifically excluded. The system is remarkably secure and patient confidentiality can be well maintained. Other countries or organizations have also successfully implemented VISTA. For example, the Finnish Government converted VISTA to Finnish and they have been using the Department of Veterans' Affairs software for over 15 years. They have been exporting this software to African clinics in Nigeria where VISTA has also been implemented. VISTA has been successfully implemented in four Egyptian hospitals as part of a U.S. AID effort as well as in the National Cancer Institute in Cairo. VISTA was translated into Arabic as part of this effort. The system has also been translated into German and is running in a number of hospitals and medical schools in Germany. VISTA has also been implemented in several mental health hospitals in Washington State, at the LBJ Hospital in Samoa, and in other organizations and locations around the world. The VA VistA healthcare system software has been available to in the public domain for many years and can be readily obtained from the VA though a Freedom Of Information Act (FOIA) request to the Department. Making the VistA software readily available to other organizations is just one minor component of a new long range collaborative VA strategy referred to as HealthePeople. HealthePeople is aimed at increasing availability and use of (a) high performance health systems and (b) high performance, interoperable health information systems to greatly improve health for people in the U.S. and in other nations. One of the goals is to pursue collaborative partnerships with organizations in the public and private sector to help put into place an open health information system with a common architecture and standardized data and communications elements. HealthePeople has the potential of bringing together a wide range of health care provider organizations, commercial companies, consumer groups, and federal and state government agencies in a collaborative and constructive partnership. |