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Vist. A - Wikipedia. This article is about the health information system developed by the US Department of Veterans Affairs. For other uses, see Vista (disambiguation). Department of Veterans Affairs (VA). VISTA consists of over 1. Congress has mandated the VA keep the veterans health record in a single, authoritative, lifelong system in VISTA.

Over 6. 5% of all physicians trained in the U. S. The most significant is a graphical user interface for clinicians known as the Computerized Patient Record System (CPRS), which was released in 1. In addition, Vist. A includes computerized order entry, bar code medication administration, electronic prescribing, and clinical guidelines. CPRS provides a client–server interface that allows health care providers to review and update a patient's electronic medical record. This includes the ability to place orders, including those for medications, special procedures, X- rays, nursing interventions, diets, and laboratory tests.

CPRS provides flexibility in a wide variety of settings so that a consistent, event- driven, Windows- style interface is presented to a broad spectrum of health care workers. Clinical Functions. Transmission (PAIT)Patient Assessment Documentation Package (PADP)Patient Care Encounter (PCE)Patient Record Flags. Pharm: Automatic Replenish / Ward Stock (AR/WS)Pharm: Bar Code Medication Administration (BCMA)Pharm: Benefits Management (PBM)Pharm: Consolidated Mail Outpatient Pharmacy.

Pharm: Consolidated Mail Outpatient Pharmacy. Pharm: Controlled Substances. Pharm: Data Management (PDM)Pharm: Drug Accountability.

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Pharm: Inpatient Medications. Pharm: Outpatient Pharmacy. Pharm: Prescription Practices (PPP)Prosthetics. Quality Audiology and Speech Analysis and Reporting (QUASAR)Radiology / Nuclear Medicine. RAI/MDSRemote Order Entry System (ROES)Social Work. Spinal Cord Dysfunction.

Standards & Terminology Services (STS)Surgery. Traumatic Brain Injury (TBI)Virtual Patient Record. Vist. A Imaging System. Vist. AWeb. Visual Impairment Service Team (VIST)Vitals / Measurements. Women's Health. Financial- Administrative Functions. Kennedy School of Government at Harvard University in July, 2. The Vist. A electronic medical records system is estimated to improve efficiency by 6% per year, and the monthly cost of the EHR is offset by eliminating the cost of even a few unnecessary tests or admissions.

The VA currently runs a majority of Vist. A systems on the proprietary Inter. Systems. Cach. Although initially separate releases, publicly available Vist. A distributions are now often bundled with the GT. M database in an integrated package. This has considerably eased installation. The free, open source nature of GT.

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M allows redundant and cost- effective failsafe database implementations, increasing reliability for complex installations of Vist. A. Database projections. For the Cach. Both of these have allowed development of the MUMPS database environment (by programmers) using modern object- oriented tools.

M2. Web is an open source web gateway to MUMPS for use with Vist. A. A free open source module from M/Gateway called MGWSI has been developed to act as a gateway between GT. M, Cache, or M2. 1 MUMPS databases and programming tools such as PHP, ASP. NET, or Java, in order to create a web- based interface. Patient Web Portal.

This also allows veterans to port their health records to institutions outside the VA health system or keep a personal copy of their health records, a Personal Health Record (PHR). Vist. A Imaging. This type of integration of information into a medical record is critical to efficient utilization. The results have spurred a national impetus to adopt electronic medical records similar to Vist. A nationwide. Vist.

A Web collectively describes a set of protocols that in 2. VHA to transfer data (from Vist. A) between hospitals and clinics within the pilot project. This is the first effort to view a single patient record so that Vist. A becomes truly interoperable among the more than 1. Vist. A today. BHIE enables real- time sharing of electronic health information between Do.

D and VA for shared patients of allergy, outpatient pharmacy, demographic, laboratory, and radiology data. This became a priority during the Second Iraq War, when a concern for the transition of healthcare for soldiers as they transferred from active military status to veteran status became a national focus of attention. Bidirectional real time exchange of computable pharmacy, allergy, demographic and laboratory data occurred in phase 1. Phase 2 involved additional drug–drug interaction and allergy checking.

Initial deployment of the system was completed in March 2. El Paso, Augusta, Pensacola, Puget Sound, Chicago, San Diego, and Las Vegas facilities. The combination of Vist. A and the interoperable projects listed above in the VA/Do.

D systems will continue to expand to meet the objectives that all citizens will have an electronic record by 2. Because of the success of these programs, a national move to standardize healthcare data transmission across the country was started.

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Text- based information exchange is standardized using a protocol called HL7 (Health Level 7), which is approved by the American National Standards Institute. DICOM is an international image communications protocol standard. Vist. A is compliant with both. Vist. A has been interfaced with commercial off- the- shelf products, as well. Standards and protocols used by VA are consistent with current industry standards and include HL7, DICOM, and other protocols. Tools for CCR/CCD support have been developed for Vist.

A, allowing Vist. A to communicate with other EHRs using these standardized information exchange protocols. Public- domain Vist. A derivatives are also expected to be able to use NHIN Connect. The Vist. A EHR has been used by the VA in combination with Telemedicine to provide surgical care to rural areas in Nebraska and Western Iowa over a 4. Vist. A has since been adapted by companies such as Blue Cliff, DSS, Inc., Medsphere, and Sequence Managers Software to a variety of environments, from individual practices to clinics to hospitals, to regional healthcare co- ordination between far- flung islands. In addition, Vist.

A has been adopted within similar provider environments worldwide. Universities, such as UC Davis and Texas Tech implemented these systems. A non- profit organization, World. Vist. A, has also been established to extend and collaboratively improve the Vist.

A electronic health record and health information system for use outside of its original setting. Vist. A (and other derivative EMR/EHR systems) can be interfaced with healthcare databases not initially used by the VA system, including billing software, lab databases, and image databases (radiology, for example). Vist. A implementations have been deployed (or are currently being deployed) in non- VA healthcare facilities in Texas. Public Health Service (NCHSR& D/PHS).

Navy's clinic at the Brunswick Naval Air Station had used an early version of the system software to develop an operational, automated, clinic- management and medical- record system that was . Department of Commerce, the National Bureau of Standards (NBS, reorganized in 1. National Institute of Standards and Technology), to turn the systems- technology strategy into a systems- architecture design. Under the farsighted leadership of the VA's Chief Medical Director, Dr. John Chase, the VA's Department of Medicine and Surgery (now known as the Veterans Health Administration (VHA)), then agreed to deploy the system at the largest medical system of that time, the VA hospitals.

Both Dr. Robert Kolodner (National Health Information Technology Coordinator). The program was named the Decentralized Hospital Computer Program (DHCP) in 1. The physicians in VA Medical Centers, with leadership from the National Association of VA Physicians (NAVAP, renamed NAVAPD in 1. Dentists were added) and its Executive Director, Dr. Paul Shafer, made sure that the VA understood the importance of clinician- directed development and refinement of this new clinical- information system. In December 1. 98.

Congressman Sonny Montgomery of Mississippi arranged for the Decentralized Hospital Computer Program (DHCP) to be written into law as the medical- information systems development program of the VA. VA Administrator Robert P. Nimmo signed an Executive Order in February 1. DHCP was to be organized and managed within the VA's Department of Medicine and Surgery. In consultation with F. Whitten Peters and Vincent Fuller of the Williams and Connolly law firm, it was established at the beginning of the 1. VA (derived from the PHS projects) was legally in the public domain and must be made available without proprietary or other restrictions to other government and private- sector organizations for their use.

In conjunction with the VA's DHCP development, the (IHS) Indian Health Service deployed a system built on and augmenting DHCP throughout its Federal and Tribal facilities as the Resource and Patient Management System (RPMS). This implementation emphasized the integration of outpatient clinics into the system, and many of its elements were soon re- incorporated into the VA system (through a system of technology sharing). Subsequent Vist. A systems therefore included elements from both RPMS and DHCP. Health IT sharing between VA and IHS continues to the present day. The U. S. Department of Defense (Do. D) then contracted with Science Applications International Corporation (SAIC) for a heavily modified and extended form of the DHCP system for use in Do.

D healthcare facilities, naming it the Composite Health Care System (CHCS). Meanwhile, in the early 1. Finland. Department of Veterans Affairs (VA), Dr. Ken Kizer, renamed what had previously been known as the Decentralized Hospital Computer Program (DHCP). The four major adopters of Vist. A – VA (Vist. A), Do. D (CHCS), IHS (RPMS), and the Finnish Musti consortium – each took Vist.

A in a different direction, creating related but distinct .

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