HP And VistA - FINAL - Welcome To The WorldVistA Homepage

HP and VISTAClaudine Beron, PMPJune 2004

HP’s History with VISTA HPand its Compaq and Digital Equipment Corporationheritage have been providing VistA solutions andsupport to the Department of Veterans Affairs for over 20years. 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 VA6/18/2004HP Copywrite 2004page 2

HP’s Relationship with VA HPis a partner with the Dept. of Veterans Affairs to move its HISsystem (VistA) outside the VA into State level hospitals and clinics aswell as across commercial enterprises through the HealthePeopleinitiative HealthePeople’s goals are:Adopt national data, communications and architecture standards forhealth information systems.– Make high performance health information systems (electronic healthrecords) more affordable, available and interoperable generally and,as appropriate, provide health information system software to otherpublic organizations and to private sector organizations who serve thepoor and near poor at as close to no cost as is possible.– Make personal health record systems available to people and theirhealth care providers that enables people to access and share theirhealth records, access trusted health information and access keysupportive services, including prescription drugs and appointments.–6/18/2004HP Copywrite 2004page 3

VistA Implementations6/18/2004HP Copywrite 2004page 4

VistA Stages of Success1) Educate the Customer2) Consult with Customer if necessary3) 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 support6/18/2004HP Copywrite 2004page 5

CLINICAL PATIENT RECORDVISTA SOFTWARE ADMISSION TRACKINGNURSINGINTEGRATED NDSDRUGSMAILMANWARDSMENUMANAGERBAR ES (TIU)Sites of Care Clinics Hospitals Nursing Homes Domiciliaries OD ORDSYSTEMACCOUNTSRECEIVABLE LIBRARYREHABMEDICINERPCBROKERSOCIAL SCHEDULINGAUTHORIZATIONSUBSCRIPTIONUTILITY (ASU)INTEGRATEDFUNDS CONTROLACCOUNTING &PROCUREMENTCLINICALREMINDERSHP Copywrite ECOSTRECOVERYMENTALHEALTHONCOLOGY NSULTS /RESULTTRACKINGVISTAINFORMATIONSYSTEMpage 6

VISTA Versions Thereare two major varieties of VistA FOIAVistA –––Minor changes to code required to implementCustomers: SL Dept of Veterans Affairs VA support, patch stream and training long term OpenVistA––Major changes to codeCustomers: Commercial & SL Medical Facilities Commerical Organization will have to support6/18/2004HP Copywrite 2004page 7

VistA Assessment Sizeof 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 trained6/18/2004HP Copywrite 2004page 8

VISTA Integrations Thereare hundreds of integration packages that may berequired in a given hospital/clinic �–––6/18/2004United Max – MDSAccuCare- AccuMedMcKesson Precision 2000 or Other Patient Account SystemIDX PACS:Amelior EDISPuritan Bennet CliniVisionGE/Marquette Muse EKG SystemRoche Diagnostic DataCare Blood Gas Monitory3M EncoderMediWare HemoCare Bloodbank SystemsData InnovationsMcKesson Robot PharmacyPyxis Med StationsGE QMI/QS Fetal Monitoring systemOrsoss Scheduling SurgeryPharmacy RxHP Copywrite 2004page 9

VISTA Migrations Thereare multitudes of migrations of legacy data thatmay also be required in a given gacy Billing SystemsMaster Patient IndexLegacy PharmacyEncounter HistoryHP Copywrite 2004page 10

VISTA Change Management Beforeany of the work starts, it is important tounderstand the Change about to occur––Executive Leader SupportOwnership by MDs and RNs Changes––––6/18/2004to occurStandard Operating ProceduresMoving from Pen to ComputerOrganization Hierarchy and OwnershipManaging the Change Process in each moduleHP Copywrite 2004page 11

VISTA Configurations6/18/2004HP Copywrite 2004page 12

VISTA Configurations ConfigurationUsed by HPIA32/IA64 with Linux & InterSystems Cache IA32/IA64 with Windows OS & InterSystems Cache Alpha/Itanium with OpenVMS & InterSystems Cache OtherConfigurationsIA32/IA64 with Linux & Sanchez G.TM IA32/IA64 with Windows OS & Oracle 6/18/2004HP Copywrite 2004page 13

HP Linux Architecture– Open Source MiddlewarePartner/VistABackup/RestoreHP DataData ProtectorProtectorHPHigh AvailabilityHP ApplicationMiddlewarestackManagementSystem softwareJava virtual machineagents and driverskernel featuresDistributionHardware platform6/18/2004HP OpenViewHP ProLiant and HP Integrity ServersHP Copywrite 2004page 14

HP Microsoft Architecture– Commercial MiddlewarePartner/VistABackup/RestoreHP DataData ProtectorProtectorHPHigh AvailabilityHP ApplicationMiddlewarestackManagementSystem softwareDistributionHardware platform6/18/2004HP OpenViewHP ProLiant and HP Integrity ServersHP Copywrite 2004page 15

HP OpenVMS Architecture– Commercial MiddlewarePartner/VistABackup/RestoreHP DataData ProtectorProtectorHPHigh AvailabilityHP ApplicationMiddlewarestackManagementHP OpenVMSSystem softwareDistributionHardware platform6/18/2004HP OpenViewHP Alpha ServersHP Copywrite 2004page 16

VISTA Outside the VA6/18/2004HP Copywrite 2004page 17

VISTA at Oklahoma Dept of VA (ODVA)6/18/2004HP Copywrite 2004page 18

ODVA Solution Topology6/18/2004HP Copywrite 2004page 19

ODVA Solution Integration ModelOctober 2003Norman Infrastructure (26 weeks)Standard SetupPhase 1EnterpriseAssessmentCore SetupCore TrainingJuly 2004Phase 2–––6/18/2004Standard TrainingAdditional Modules,Customizations & MigrationsArdmoreLawtonClinton(10 weeks)(10 weeks)(10 weeks)SulphurClaremoreTalihina(6 weeks)(8 weeks)(6 weeks)StandardizationDocumentationIncremental Efficiencies–––June 2004March 2005October 2005ODVA InvolvementTrainingCollaborationHP Copywrite 2004page 20

Grants for VISTA(reference)6/18/2004HP Copywrite 2004page 21

Agency for Healthcare Research & QualityGrant NameEligible GroupsLinkContactDemonstrating the Value ofDomestic organizations, institutions, http://grants.nih.gov/grants/ Eduardo Ortiz, M.D.,Health Information Technology and state/local governments including guide/rfa-files/RFA-HS-04M.P.H. Senior Advisor fornon-profit organizations, universities, 012.htmlClinical Informaticshospital, and clincs; tribe or tribal540 Gaither Roadorganizations; faith-based orRockville, MD 20850community-based organizations; and301-427-1585unit of state or local gov’teortiz@ahrg.govTHQIT Planning GrantsDomestic for-profit and non-profithttp://grants.nih.gov/grants/ Scott Young, M.D.organizations/institutions, state and guide/rfa-files/RFA-HS-04Center for Primary Carelocal governments, tribes and tribal 010.html540 Gaither Roadgov’ts and faith-based organizationsRockville, MD 20850301-427-1580syoung@ahrg.govTHQIT Implementation Grants Domestic for-profit and non-profithttp://grants.nih.gov/grants/ Scott Young, M.D.organizations/institutions, state and guide/rfa-files/RFA-HS-04Center for Primary Carelocal governments, tribes and tribal 011.html540 Gaither Roadgov’ts and faith-based organizationsRockville, MD 20850301-427-1580syoung@ahrg.gov6/18/2004HP Copywrite 2004page 22

Dept. of Veterans AffairsGrant NameTRIP6/18/2004Eligible GroupsLinkContactAHRQ: Domestic and foreign public http://grants.nih.gov/grants/ Margaret Coopey, RN,and private non-profit institutions such guide/pa-failes/PA-02MGA, MPSas universities and clinics, state and 066.htmlCenter for Practice andlocal gov’t, eligible agencies of theTechnology AssessmentFederal gov’t and faith-basedAHRQorganizations. VA Pls and co-Pls must6010 Executive Bld,hold a minimum of 5/8ths VA paidRockville, MD 20852appointment although non-PIinvestigators who collaborate on the301-594-4022project do not need to hold a VAmcoopey@AHRQ.govappointment.HP Copywrite 2004page 23

Agency for Healthcare Research & Quality and NIHGrant NamePractice-based ResearchNetworks (PBRNs) and theTranslation of Research intoPractice6/18/2004Eligible GroupsDomestic public or private non-profitinstitutions, such as universities,colleges, hospitals, clinics andprofessional associations, units ofstate and local gov’t, eligiblecomponents of agencies of theFederal gov’t, tribes and tribalorganizations, faith-based orcommunity based organizations ts David Lanier, MD/guide/pa-files/PAR-04Center for Primary Care041.htmlAHRQHP Copywrite 2004540 Gaither RoadRockville, MD 20850301-427-1567dlanier@AHRQ.govpage 24

Health Resources and Services AdministrationGrant NameEligible GroupsLinkContactTRCCPPublic or private non-profit agencies. http://www.hrsa.gov/grants Luigi S. ProcopioFaith-based and 0262organizations are eligible to apply046Lprocopio@hrsa.govISDIApplications for ISDI Planning andhttp://www.hrsa.gov/grantsDevelopment of Managed Care/preview/primary.htm#hrsa0Network funds are limited to currently 4029funded health centers. PracticeManagement Networks are limitedcurrently funded section 330 healthcenters. Application for SIMIS andICT funds are limited to section 330(e)health centers and section 330primary care associations.Applicants must be a public or non- http://www.hrsa.gov/grantsprofit entity that represents a network /preview/rural.htm#hrsa040that includes at least three or more03healthcare providers. In addition, thegrantee must meet at least one of the3 following 1) located in a rural areaor in rural zip code 2) existsexclusively to provide services tomigrant and season farm workers 3)federal recognized Tribe or quasitribal entity on reservations.Rural Health NetworkDevelopment Planning GrantProgram6/18/2004HP Copywrite 2004Susan Lumsdent301-594-4488SLumsden@hrsa.govMichelle Pray-Gibson,MHSProgram AnalystOffice of Rural HealthPolicy5600 Fishers Lane, Rm9A-55Rockville, MD 20857301-443-0835mpray@hrsa.govpage 25

National Institute of Health/National Library of MedicineGrant NameEligible GroupsIAIMS: Planning, Operations,Pilot Study and Testing &Evaluation GrantsVarious depending on which grantapplication is forIADLUS public and private non-profithealth-related organizations areeligible to apply. Health-relatedincludes medicine, dentistry, nursing,pharmacy, and other activities relatedto the promotion of health andprevention and treatment of disease.Information System GrantsUS public and private, non-profitinstitutions engaged in healthadministration, education, research,promotion and/or clinical care areeligible to apply6/18/2004LinkContactIAIMS program:Valerie Florance, Ph.D.http://www.nlm.nih.gov/pub Extramural programss/factsheets/iaims.htmlNational Library ofPlanning Grant:Medicinehttp://www.nlm.nih.gov/ep/Rockledge 1, Suite 301iaims-plan.htmlRockledge DriveOperations Grant:http://www.nlm.nih.gov/ep/ Bethesda, MD h.govPilot Study nim.nih.gov/ep/ Same as aboveGrantlADL.htmlhttp://www.nim.nih.gov/ep/ Same as aboveGrantInfoSys.htmlHP Copywrite 2004page 26

NIH, CDC and FDAGrant NameSmall business innovationresearch and small businesstechnology transfer6/18/2004Eligible GroupsLinkContactFor profit US businesses with 500 or http://grants.nih.gov/grants/ Ms. Jo Anne Goodnightfewer employees that are at least 51% funding/sbirsttr1/index.pdt NIH SBIR/STTR ProgramUS-owned and controlled by one ofCoordinatormore individuals and independently6705 Rockledge Driveoperated. In addition, for SBIRBethesda, MD 20892grants, the principle investigator’sprimary employment must be with the301-435-2688small business for the duration of thesbir@od.nih.gov orproject.jg128w@nih.govHP Copywrite 2004page 27