WorldVistA

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WorldVistA
EstablishedMarch 18, 2002; 18 years ago (2002-03-18)[1]
Founded atCalifornia, USA[1]
Legal status501(c)(3) charitable organization[1]
Focusmedical information technology
Director, President & CMO
Nancy E. Anthracite[2]
Chair, Joseph Dal Molin
Websiteworldvista.org

WorldVistA is an not-for profit that provides the WorldVistA EHR, an open source implementation of the Veteran Administration's Electronic Health Record system intended for use in health care facilities outside the VA.[3][4]

Background[edit]

The US Veterans Administration developed the most widely distributed electronic health record used in the US, the Veterans Health Information Systems and Technology Architecture (VistA). In an effort to make the system widely available to institutions outside the Veterans Administration health system, the software code was placed in the Public Domain under the Freedom of Information Act.

The not-for-profit organization WorldVistA was formed to extend and collaboratively improve the VistA electronic health record and health information system for use outside of its original setting. WorldVistA EHR was originally developed as part of the VistA-Office project, a collaborative effort funded by the United States Centers for Medicare and Medicaid Services (CMS), an agency of the US Department of Health and Human Services (DHHS).

WorldVistA EHR VOE/ 1.0 is based on and compatible with the U.S. Department of Veterans Affairs' (VA) world-renowned EHR, Veterans Health Information Systems and Technology Architecture (VistA). A fully open-source (GPL v2 licensed) project, WorldVistA EHR has also developed software modules (such as pediatrics, obstetrics, and other functions) not used in the veterans' healthcare setting.

In 2006, WorldVistA EHR VOE/ 1.0 was the only open source EHR that met Certification Commission for Healthcare Information Technology (CCHIT) ambulatory electronic health record (EHR) criteria,[5] and in January 2008, it was released with full CCHIT EHR, as mentioned on the same website.

As a free (gratis and libre) product developed in co-operation with the US government, WorldVistA EHR is not marketed in a similar fashion to commercial EHRs.

Customizable functions[edit]

The structure of WorldVistA EHR is modular, and a wide variety of customization is possible. Because it is fully open source, this can be done without restriction (although CCHIT certification is granted only to the officially maintained package).

  • ability to interface to existing practice management / billing systems, lab services and other applications
  • scanning and inclusion of scanned documents into the medical record
  • prescription finishing and faxing
  • clinical quality measure reporting capabilities
  • support for disease management, using clinical reminders
  • templates for obstetrics/gynecology (OB/GYN) and pediatrics care

Server platforms[edit]

Linux[edit]

For Linux-based servers, the WorldVistA EHR server uses the (free open source) Fidelity GT.M MUMPS database, available as an integrated package along with WorldVistA EHR Server. This software is part of the VistA Public Domain software, and does not require licensing. The YottaDB software is backwards compatible to GT.M, and can also be used as a software base for WorldVistA EHR.

VistA from the VA, as well as WorldVistA EHR has been implemented on Linux servers with the Caché MUMPS database which requires a database license and software from Intersystems Corporation.

MS Windows[edit]

For Windows-based servers, WorldVistA EHR has been implemented used the commercial Caché MUMPS database, which requires a database license and software from Intersystems Corporation.

Mac OS[edit]

For Mac OS-X-based servers, a development effort ported GT.M (and the Server software) to the Mac OS platform.

Client platforms[edit]

The Client software is an implementation of CPRS, which is Windows-based. This allows Windows terminals to access the central server database. This software is part of the VistA Public Domain software, and does not require licensing.

For Linux terminals, CPRS can be run as a Wine package or from within a virtual machine. CodeWeavers has made changes to Wine that enhances this work.

A separate (Windows-based) module is available to capture and view vital signs as well as graphing of other clinical data. This is meant to be used on client PCs.

A separate (Windows-based) module allows the scanning, capture and integration of paper documents as part of an individuals medical record. It can also be used to add a variety of non-diagnostic quality images to the medical record. This is meant to be used on client PCs.

Development history[edit]

WorldVistA EHR is developed by a series of physicians (and other medical professionals) and software professionals that donate their efforts as volunteers. This group is organized around the Hardhats mailing-list, and loosely refer to themselves as Hardhats following the traditions of the VA Hardhats and continues to do so. The name of the project was officially changed to WorldVistA EHR.

WorldVistA has developed and distributes a "toaster" version of WorldVistA EHR, which is a self-contained software package that integrates both the MUMPS database (GT.M version) and the VistA software.[6]

In 2009, the self-installing Linux toaster version was enhanced with a GUI-based patient registration module, web interface, and other enhancements, and incorporated into a self-installing package for both Debian/Ubuntu and Red Hat Linux. This freely available version of WorldVistA is known as Astronaut VistA. This version is packaged with both an enhanced GUI as well as a web interface (which allows connection through an intranet or through the Internet). An introduction to this package is here in a PDF slide presentation.[dead link]

A similar package for Windows-based servers is in alpha (early development) stage.[when?]

OSEHRA was instrumental in putting a copy of VistA onto the github.com platform. A similar github repository exists for WorldVistA EHR as well.

A docker image for WorldVistA EHR version 3.0 was created in 2018 and is available for use with the Docker program from hub.docker.com.

Adoption[edit]

  • Arizona-based Clinica Adelante implemented the open source version of VistA for its 30,000 member community health clinic, and has testified before the US Congress regarding its success.[7]
  • Oroville Hospital is installing the WorldVistA version into a co-ordinated hospital and clinic system.[citation needed]
  • Central Regional Hospital in North Carolina, is a psychiatric hospital that first adopted VistA in the early 2010s, and uses the WorldVistA EHR system as its base system, with local modifications.

References[edit]

  1. ^ a b c "About WorldVistA". WorldVistA. Retrieved 19 June 2016.
  2. ^ "Executive Team". WorldVistA. Retrieved 19 June 2016.
  3. ^ "Distributions of VistA". Open Source Electronic Health Record Alliance. Retrieved 19 June 2016.
  4. ^ "Welcome to the WorldVistA homepage". WorldVistA. Retrieved 19 June 2016.
  5. ^ "WorldVistA EHR VOE/ 1.0". Certification Commission for Healthcare Information Technology. Archived from the original on 17 October 2007.
  6. ^ "Four Slice Toaster". VistApedia. 28 November 2012.
  7. ^ "Statement of Matthew King, M.D., Chief Medical Officer, Clinica Adelante, Inc, Surprise, Arizona: Testimony Before the Subcommittee on Health of the House Committee on Ways and Means". House Committee on Ways and Means. 24 July 2008. Archived from the original on 7 January 2010.

External links[edit]