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HP and VISTA

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					HP and VISTA




Claudine Beron, PMP
June 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


6/18/2004                    HP Copywrite 2004              page 2
 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 HealthePeople
   initiative
 • 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 key
        supportive services, including prescription drugs and appointments.

6/18/2004                            HP Copywrite 2004                       page 3
                                VistA Implementations



6/18/2004   HP Copywrite 2004                           page 4
 VistA Stages of Success

 1) Educate the Customer
 2) Consult with Customer if necessary
 3) Analyze the Environment thoroughly (Assessment)
 4) Deploy Pilot site (sub-stages exist here)
 5) Train
 6) Deploy Disaster Recovery Site (sub-stages exist here)
 7) Train
 8) Deploy Additional sites (sub-stages exist here)
 9) Train
 10) Provide support


6/18/2004                  HP Copywrite 2004                page 5
                                                  CLINICAL PATIENT RECORD


                                                      VISTA SOFTWARE PACKAGES
                                                    VOLUNTARY      REHAB          ACCOUNTS
                                                    SERVICE        MEDICINE       RECEIVABLE LIBRARY
                                        MEDICAL
                 VistA
                                         RECORDS                                                   NURSING
                 IMAGING
                               ADMISSION TRACKING
                               DISCHARGE                   INTEGRATED DATABASE
                               TRANSFER                                                                 RADIOLOGY

                        PATIENT                                             PERSONS
                                                                                                            BLOOD BANK       PROBLEM
                        FUNDS                 PATIENTS
                                                                                              DRUGS                          LIST
                                                                              RPC                            SOCIAL WORK
                                                                MAILMAN
                     LABORATORY                                               BROKER
   COMPUTERIZED                                                                        DEVICE                       MENTAL
   PATIENT                                            TASK                                                          HEALTH
                DENTAL                WARDS           MANAGER        KERNEL           MANAGER
                                                                                                LAB
   RECORD
   SYSTEM                                                                            USER       RESULTS       ENGINEERING
                       SURGERY                             MENU                    SECURITY
   (CPRS)                                                  MANAGER
                                                                          VA                                   ONCOLOGY HEALTH
                         BAR CODE                                      FILEMAN                                               SUMMARY
                         MEDICATION
                                             PRESCRIPTIONS                             INVENTORY            DIETETICS
                         ADMINISTRATION

                                                                                                        INPATIENT
             TEXT                 MEDICINE                           IMAGES                             PHARMACY
             INTEGRATION
                                        WOMEN’S                                               OUTPATIENT
             UTILITIES (TIU)            HEALTH                              INTEGRATED
                                                             MEDICAL                          PHARMACY
                                                  SCHED-     CARE           FUNDS CONTROL
Sites of Care                                     ULING      COST           ACCOUNTING &
                                                                            PROCUREMENT                CONSULTS /
                                                             RECOVERY
•Clinics                                                                                               RESULT
                                    AUTHORIZATION
                                                                                                       TRACKING
                                    SUBSCRIPTION
•Hospitals
•Nursing Homes
                                    UTILITY (ASU)                    CLINICAL
                                                                     REMINDERS
                                                                                                                                 VISTA
•Domiciliaries                                                                                                      INFORMATION
•Home/Workplace                                                                                                          SYSTEM
 6/18/2004                                                    HP Copywrite 2004                                                        page 6
 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


6/18/2004                             HP Copywrite 2004         page 7
 VistA Assessment

      of the organization
 • Size
 • 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




6/18/2004                  HP Copywrite 2004   page 8
 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
     –
6/18/2004
            Pharmacy Rx                 HP Copywrite 2004             page 9
 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




6/18/2004                            HP Copywrite 2004        page 10
 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




6/18/2004                              HP Copywrite 2004   page 11
                                VISTA Configurations


6/18/2004   HP Copywrite 2004                          page 12
   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




6/18/2004                    HP Copywrite 2004       page 13
        HP Linux Architecture
        – Open Source Middleware

               Application
 Partner/




               software
  VistA




               Middleware
               stack


                                                 HP Data Protector
                                                 HP Data Protector
 completers
 Value-add/




               Backup/Restore

               High Availability                   HP Serviceguard

               Management                            HP OpenView

                                                 Java virtual machine
                                                  agents and drivers
  Foundation




               System software                      kernel features

               Distribution

               Hardware platform   HP ProLiant and HP Integrity Servers

6/18/2004                            HP Copywrite 2004                    page 14
   HP Microsoft Architecture
   – Commercial Middleware

               Application
 Partner/




               software
  VistA




               Middleware
               stack


                                                 HP Data Protector
                                                 HP Data Protector
 completers
 Value-add/




               Backup/Restore

               High Availability                   HP Serviceguard

               Management                            HP OpenView
  Foundation




               System software

               Distribution

               Hardware platform   HP ProLiant and HP Integrity Servers

6/18/2004                            HP Copywrite 2004                    page 15
   HP OpenVMS Architecture
   – Commercial Middleware

               Application
 Partner/




               software
  VistA




               Middleware
               stack


                                               HP Data Protector
                                               HP Data Protector
 completers
 Value-add/




               Backup/Restore

               High Availability                 HP Serviceguard

               Management                          HP OpenView



                                                       HP OpenVMS
  Foundation




               System software

               Distribution

               Hardware platform               HP Alpha Servers

6/18/2004                          HP Copywrite 2004                page 16
                                VISTA Outside the VA



6/18/2004   HP Copywrite 2004                          page 17
 VISTA at Oklahoma Dept of VA (ODVA)




6/18/2004            HP Copywrite 2004   page 18
 ODVA Solution Topology




6/18/2004            HP Copywrite 2004   page 19
 ODVA Solution Integration Model
                   October 2003    Norman + Infrastructure (26 weeks)                                June 2004


                                                  Standard Setup                 Standard Training
 Phase 1                    Enterprise
                           Assessment                                         Additional Modules,
                                         Core Setup       Core Training   Customizations & Migrations
            July 2004                                                                                    March 2005


                        Ardmore                       Lawton                        Clinton
                        (10 weeks)                    (10 weeks)                   (10 weeks)

 Phase 2
                                  Sulphur         Claremore               Talihina      October 2005
                                   (6 weeks)          (8 weeks)           (6 weeks)



 –   Standardization                                       –   ODVA Involvement
 –   Documentation                                         –   Training
 –   Incremental Efficiencies                              –   Collaboration



6/18/2004                                      HP Copywrite 2004                                                 page 20
                                Grants for VISTA
                                  (reference)


6/18/2004   HP Copywrite 2004                      page 21
 Agency for Healthcare Research & Quality

       Grant Name                      Eligible Groups                            Link                     Contact

 Demonstrating the Value of    Domestic organizations, institutions, http://grants.nih.gov/grants/ Eduardo Ortiz, M.D.,
 Health Information Technology and state/local governments including guide/rfa-files/RFA-HS-04-      M.P.H. Senior Advisor for
                               non-profit organizations, universities, 012.html                      Clinical Informatics
                               hospital, and clincs; tribe or tribal                                 540 Gaither Road
                               organizations; faith-based or                                         Rockville, MD 20850
                               community-based organizations; and
                               unit of state or local gov’t                                          301-427-1585
                                                                                                     eortiz@ahrg.gov
 THQIT Planning Grants         Domestic for-profit and non-profit      http://grants.nih.gov/grants/ Scott Young, M.D.
                               organizations/institutions, state and guide/rfa-files/RFA-HS-04-      Center for Primary Care
                               local governments, tribes and tribal 010.html                         540 Gaither Road
                               gov’ts and faith-based organizations
                                                                                                     Rockville, MD 20850
                                                                                                     301-427-1580
                                                                                                     syoung@ahrg.gov
 THQIT Implementation Grants Domestic for-profit and non-profit    http://grants.nih.gov/grants/ Scott Young, M.D.
                             organizations/institutions, state and guide/rfa-files/RFA-HS-04-    Center for Primary Care
                             local governments, tribes and tribal 011.html                       540 Gaither Road
                             gov’ts and faith-based organizations
                                                                                                 Rockville, MD 20850
                                                                                                 301-427-1580
                                                                                                 syoung@ahrg.gov




6/18/2004                                                HP Copywrite 2004                                                 page 22
 Dept. of Veterans Affairs

        Grant Name         Eligible Groups                          Link                    Contact
 TRIP                AHRQ: Domestic and foreign public http://grants.nih.gov/grants/ Margaret Coopey, RN,
                     and private non-profit institutions such guide/pa-failes/PA-02- MGA, MPS
                     as universities and clinics, state and 066.html                 Center for Practice and
                     local gov’t, eligible agencies of the                           Technology Assessment
                     Federal gov’t and faith-based                                   AHRQ
                     organizations. VA Pls and co-Pls must
                     hold a minimum of 5/8ths VA paid                                6010 Executive Bld,
                     appointment although non-PI                                     Rockville, MD 20852
                     investigators who collaborate on the                            301-594-4022
                     project do not need to hold a VA                                mcoopey@AHRQ.gov
                     appointment.




6/18/2004                                   HP Copywrite 2004                                              page 23
 Agency for Healthcare Research & Quality and NIH

       Grant Name                      Eligible Groups                              Link                     Contact

 Practice-based Research        Domestic public or private non-profit    http://grants1.nih.gov/grants David Lanier, MD
 Networks (PBRNs) and the       institutions, such as universities,      /guide/pa-files/PAR-04-       Center for Primary Care
 Translation of Research into   colleges, hospitals, clinics and         041.html                      AHRQ
 Practice                       professional associations, units of
                                state and local gov’t, eligible                                       540 Gaither Road
                                components of agencies of the                                         Rockville, MD 20850
                                Federal gov’t, tribes and tribal                                      301-427-1567
                                organizations, faith-based or                                         dlanier@AHRQ.gov
                                community based organizations are
                                eligible.




6/18/2004                                                HP Copywrite 2004                                                   page 24
 Health Resources and Services Administration

        Grant Name                  Eligible Groups                           Link                       Contact

 TRCCP                        Public or private non-profit agencies. http://www.hrsa.gov/grants Luigi S. Procopio
                              Faith-based and community-based        /preview/hivaids.htm#hrsa04301-443-0262
                              organizations are eligible to apply    046                        Lprocopio@hrsa.gov




 ISDI                         Applications for ISDI Planning and      http://www.hrsa.gov/grants   Susan Lumsdent
                              Development of Managed Care             /preview/primary.htm#hrsa0   301-594-4488
                              Network funds are limited to currently 4029                          SLumsden@hrsa.gov
                              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.
 Rural Health Network         Applicants must be a public or non- http://www.hrsa.gov/grants       Michelle Pray-Gibson,
 Development Planning Grant   profit entity that represents a network /preview/rural.htm#hrsa040   MHS
 Program                      that includes at least three or more    03                           Program Analyst
                              healthcare providers. In addition, the                               Office of Rural Health
                              grantee must meet at least one of the                                Policy
                              3 following 1) located in a rural area
                              or in rural zip code 2) exists                                       5600 Fishers Lane, Rm
                              exclusively to provide services to                                   9A-55
                              migrant and season farm workers 3)                                   Rockville, MD 20857
                              federal recognized Tribe or quasi-                                   301-443-0835
                              tribal entity on reservations.                                       mpray@hrsa.gov
6/18/2004                                             HP Copywrite 2004                                                     page 25
 National Institute of Health/National Library of Medicine

        Grant Name                     Eligible Groups                             Link                    Contact

 IAIMS: Planning, Operations,   Various depending on which grant         IAIMS program:             Valerie Florance, Ph.D.
 Pilot Study and Testing &      application is for                       http://www.nlm.nih.gov/pub Extramural programs
 Evaluation Grants                                                       s/factsheets/iaims.html
                                                                                                    National Library of
                                                                         Planning Grant:            Medicine
                                                                         http://www.nlm.nih.gov/ep/
                                                                                                    Rockledge 1, Suite 301
                                                                         iaims-plan.html
                                                                                                    Rockledge Drive
                                                                         Operations Grant:
                                                                         http://www.nlm.nih.gov/ep/ Bethesda, MD 20892
                                                                         iaims-ops.html             301-594-4882
                                                                         Pilot Study Grant:         Floranv@mail.nlm.nih.gov
                                                                         www.nlm.nih.gov/ep/iaims-
                                                                         test.html
 IADL                           US public and private non-profit         http://www.nim.nih.gov/ep/ Same as above
                                health-related organizations are         GrantlADL.html
                                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.

 Information System Grants      US public and private, non-profit        http://www.nim.nih.gov/ep/ Same as above
                                institutions engaged in health           GrantInfoSys.html
                                administration, education, research,
                                promotion and/or clinical care are
                                eligible to apply




6/18/2004                                                HP Copywrite 2004                                               page 26
 NIH, CDC and FDA

       Grant Name                    Eligible Groups                          Link                    Contact

 Small business innovation     For profit US businesses with 500 or http://grants.nih.gov/grants/ Ms. Jo Anne Goodnight
 research and small business   fewer employees that are at least 51% funding/sbirsttr1/index.pdt NIH SBIR/STTR Program
 technology transfer           US-owned and controlled by one of                                  Coordinator
                               more individuals and independently
                               operated. In addition, for SBIR                                    6705 Rockledge Drive
                               grants, the principle investigator’s                               Bethesda, MD 20892
                               primary employment must be with the                                301-435-2688
                               small business for the duration of the                             sbir@od.nih.gov or
                               project.                                                           jg128w@nih.gov




6/18/2004                                             HP Copywrite 2004                                              page 27
 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)




6/18/2004                                HP Copywrite 2004                               page 28
 HP & WorldVista

 • How  do we communicate more and work together with
   the WorldVista community?
 • Thoughts/Comments/Suggestions, contact us:


            Claudine Beron – Claudine.Beron@hp.com
            David Shull – David.Shull@hp.com
            Augie Turano – AugieT@hp.com
            Donna Mastin – Donna.Mastin@hp.com




6/18/2004                            HP Copywrite 2004   page 29

				
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