Next week, the CMS will hold a meeting with information technology vendors interested in using a proposed version of the Department of Veterans Affairs' comprehensive computerized electronic record and IT system -- the Veterans Health Information Systems Technology Architecture, or Vista -- modified for use in physician offices.
The CMS/VA effort aims to bring the Vista Office Electronic Health Record, a proven, affordable version of an electronic medical records system, to the small-group office practice, where EMR penetration rates are lowest due to system costs.
The vendors meeting on the Vista-Electronic Health Records project is scheduled for Oct. 20 in Washington, D.C.
At the meeting, CMS and VA officials will gauge the level of vendor interest in the project as well as raise awareness of the initiative, according to Capt. Cynthia Wark, an officer in the Public Health Service and deputy director of the information systems group in the CMS' Office of Clinical Standards and Quality.
"We just want to figure out if we put this out on the street, are any of the vendors going to pick up on it," said Wark. "We're trying to gauge the interest. The other thing is to let people know what we're doing."
Wark is a registered nurse with certification in medical informatics from the American Nurses Association. She comes to the job from the Indian Health Service, which uses a modified version of the VA clinical IT system.
Under CMS' Physician Focused Quality Initiative, the federal agency has joined with the VA in a plan to scale the massive Vista program to office size.
"One of our goals is to help physician offices get over the impediment of an investment in a software product -- and why not do it (with Vista) since the government has invested a lot of money in a product that without too much modification physicians can use in their office," Wark said.
Vista, which comprises about 100 program modules -- including programs to run activities as far-ranging as an inpatient pharmacy or an out-patient mental health service -- also includes a module called Computerized Patient Record System, or CPRS, which is an electronic medical record system. The Vista CPRS has already been adapted to the office practices by several private consultants working independently of CMS. (See the current Health IT Strategist.)
Copies of the Vista software are available free under the Freedom of Information Act, but the VA provides no support for installation and maintenance of Vista by outside users. License fees also are required for the Cache database and computer language on which the system runs on the server side, and for Windows for some applications that have a graphical user interface on the provider side.
The Pacific Telehealth and Technology Hui, based in Hawaii, a joint venture of the VA and the Defense Department, has ported Vista to the open-source Linux operating system and GT.M database. Their aim was make the system more broadly available by reducing licensing fees. The software can be downloaded for free on the Internet at the Web site of WorldVista, a not-for-profit organization of Vista supporters.
CMS' Vista Office EHR will run on the Cache database and the Windows operating system, according to Dennis Stricker, CMS' director of the information systems group in CMS' Office of Clinical Standards and Quality.
Vista is the IT backbone of the VA's vast healthcare system that provides care to more than 7 million people at 1,300 care sites, including more than 800 out-patient clinics and more than 150 hospitals.