Gordon, Thank you for this information! Would you be able to share the presentation with this embryonic group that is gelling around this project? Better still would you be interested in lending a hand when you can and participating in any other way?
I will set up a "sub-project" on the WorldVistA sourceforge site where documents and code and be shared and managed...as well as a project specific discussion list. Joseph On Tue, 2004-09-21 at 14:22, Gordon Moreshead wrote: > In my former life in the VA, as a holder of the title "Master Architect" for > VistA, until I left in 1996, I was advocating a structure internal to VistA > that would house what would have been the basis for a portable EHR. (I > still have copies of my power point presentations that talk about this > concept.) Whether it is internal or external to the current FOIA VistA, > probably does not matter, however, since it can be done either way. It is > basically a clinical data repository that could accommodate data extracted > from VistA files and/or fed from external sources of clinical data that > would be relevant for the "portable EHR". From this, many options exist for > storage and/or transport of the individual patient's EHR. I think that this > is a very achievable project to create such a capability. > > Of course, with any such repository, when there are multiple sources of > clinical data, the data must be treated with care in honoring the context of > the source of that data. The absence of and/or weakness of standards is > still a factor. This could be accommodated within the database so that the > data sources could be indicated and in some cases, relevant context > information may also have to be stored. > > Gordon Moreshead > > -----Original Message----- > From: [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] On Behalf Of Bill > Walton > Sent: Monday, September 20, 2004 9:52 AM > To: [EMAIL PROTECTED] > Subject: Re: Exporting and Accessing VistA health records (was) > Re:[Hardhats-members] EsiObjects, and Open Source, etc. > > Hi Joseph, > > Joseph Dal Molin wrote: > > > Thanks Bill...we will add you to the > > list of potential volunteers for whatever > > emerges in the next few weeks...:-) > > In all seriousness, if what emerges involves implementing the import / > export capability, you can count me in. I'm not an M programmer, but I'll > contribute however I can. > > > VistA has all the architectural prerequisites to > > export an emergency health record, continuity > > of care record or whatever the latest label > > for this is today. The MyHealtheVet demo/ > > implementation does this now...perhaps not > > the way the community might choose to do it > > but it works. > > Could you elaborate on the MyHealtheVet capabilities please? I have an > upcoming meeting with the Director of the NLM and some of his senior staff. > He's invited me to Bethesda to propose an open source public-private > partnership to extend the capabilities of the ClinicalTrials.gov site. I > believe strongly that an extended version of ClinicalTrials.gov could become > a key driver for the accelerated adoption of EHR systems by community-based > physicians. The import / export capabilities are fundamental requirements > for any EHR system in this model though. I would love to be able to say > that VistA (in whatever form) had these capabilities and thus would be a > viable candidate for those physicians. My current (prior to your comments) > understanding of VistA and belief vis-a-vis its viability in the > community-based healthcare context is, on both counts, precisely the > opposite. I'd love to find out I was wrong. > > > What would be really helpful would be a > > tutorial or white paper comparative analysis > > of the various alternatives, their pros and > > cons and the various api's and interfaces that > > are available. If anyone knows whether this > > already exists please let us know. > > Most helpful, indeed. And an extremely worthwhile undertaking if it does > not already exist. > > > Making it easy to understand how to open > > up VistA for other uses etc. would be a > > very effective strategy for establishing it as > > health computing "platform" much like Linux > > is a platform for thousands of applications > > today... > > I think it's safe to make this statement even more strongly. "Making it > easy..." is *necessary.* Not sufficient. But definitely necessary. > > > you cannot hide the value of something > > that keeps getting better all the time. > > "Value" and "better" are very context-sensitive concepts. It's clear that > VistA keeps getting better within the context wherein patients receive all > their care within a closed system. It's not clear at all that it's even > remotely applicable (applicable meaning "could be used") to the > community-based healthcare context. It's important, IMO, to get some > clarity on this question. Thanks in advance for your help. > > Best regards, > Bill > > > On Mon, 2004-09-20 at 08:34, Bill Walton wrote: > > > Nancy Anthracite wrote: > > > > > > > > It would seem this might be something we > > > > could use to create the equivalent of > > > > MyHealtheVet, the code for which is not > > > > yet available and from what I was told, > > > > will contain proprietary elements when and > > > > if it is released. My HealtheVet essentially > > > > allows veterans web access to their health > > > > records, and with the HHS's firm > > > > recommendation that patients be able to > > > > access their doctors' electronic medical records, > > > > I think EsiObjects could provide one > > > > solution. > > > > > > I've tried to imagine the use of the MyHealtheVet model in the example > of > > > the little girl with lukemia that the President used in his April > speech. > > > But every scenerio I've been able to envision that satisfies the > requirement > > > that every new physician she sees has access to all her existing medical > > > records is more complicated, more expensive, less secure, and will take > much > > > longer to put into actual use than one where her Dad just hands the new > doc > > > a CD (or whatever). > > > > > > The ability to export / import patient records in electronic form is a > > > fundamental requirement for any EHR system's viability as a solution to > the > > > problem the President has put before us. A project to give VistA that > > > capability would be one I'd want to participate in. Not as cool as the > one > > > you're talking about, I know. But much more important. > > > > > > Best regards, > > > Bill > > > > ------------------------------------------------------- > This SF.Net email is sponsored by: YOU BE THE JUDGE. Be one of 170 > Project Admins to receive an Apple iPod Mini FREE for your judgement on > who ports your project to Linux PPC the best. Sponsored by IBM. > Deadline: Sept. 24. 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