Funding reductions and concerns over the method of implementation have prompted the Veterans Health Administration to revise the plans for its next-generation health IT system, now being called HealtheVistA.
The agency now plans to field the initial HealtheVistA capability in 2008 and complete the transition to the new system by 2012, through a phased implementation, said Cyndi Kindred, deputy director of VHA’s Health Program Management Office. She spoke at the Health IT Day program organized by the Bethesda, Md., chapter of the Armed Forces Communications and Electronics Association.
Kindred traced the changes in plans for the modernized system to a 2005 program review undertaken by the Software Engineering Institute at VHA’s request. “They didn’t really feel we would be successful” with the plans as drawn up, she said. In particular, the SEI reviewers said the plans for the transition to the new system were too risky, she said.
“We were…forced to step back and take a [new] look” at the program, especially after Congress cut $50 million from the program’s 2006 budget, Kindred said.
The new plan, still being developed, calls for implementing one or two new applications at a time, she said. As a result, as many as six versions of a given application may be running simultaneously in various locations during the transition. With the new architecture, the applications can run independently of one another.
“It does help us avoid that Big Bang” of a sudden implementation of the new system, Kindred said.
She said VHA also is focusing on standardizing its terms. Because the current VistA system operates to some extent independently at each VA hospital and clinic, different locations use different terms. For example, aspirin is called acetyl salicylic acid in some medical centers, and ASA in others, as well as being called aspirin in a third set of centers.
Although the current VistA system, developed mostly in the 1980s, is considered one of the world’s most advanced, Kindred said it lacks the ability to render a complete health record for a veteran who gets care at more than one medical center. It also cannot it produce overviews of the population being cared for. For example, it is unable to readily report how many patients with diabetes the VA treated last year.
“It’s not the most secure system in the world,” said Marcia Insley, director of VHA’s Standards and Terminology Services program. Insley, who spoke at the same event, said programmers can make changes to VistA relatively freely. The new system will be managed more centrally, the speakers said.
Mike Hendry, another program management office official, said the new pharmacy and e-prescribing system will be developed using a hybrid approach of some in-house development and some development by contractors.
Kindred said the agency expects to know by mid-2007 what development work it will contract out for the new system.
From the battlefield to the home front: Managing medical data
Government Health IT presents Col. Claude Hines Jr., program manager for the Defense Health Information Management System, in this recent InSight eSeminar. Col. Hines discusses the health information technology and tactical challenges faced by the military medical community in Iraq, Afghanistan and other areas of conflict. In doing so, he describes the current information technology solutions for transferring clinical data between battlefield care givers to health care personnel at military treatment facilities worldwide.
