VistA® News
Editor, Roger A. Maduro, LxIS
July 18, 2006. Vol. 1, No. 1



*       VA Honored As Innovator For Medical Records: Paperless System Brings 
$100,000 Prize
*       VA health care chief to leave government  
*       The Best Medical Care In The U.S: How Veterans Affairs transformed 
itself -- 
and what it means for the rest of us
*       Technology has transformed the VA
*       VistA users from Mexico steal show at WorldVistA conference
*       England's healthcare IT project mired in delays
*       Texas Tech Health Sciences Center Selects DSS, Inc. to Implement VistA
*       VA-LSU partnership advances toward New Orleans hospital
*       Federal health services choose VA imaging standard
*       DOD to adopt VA medical imaging system
*       Bridging the gap: The VA and DOD are delivering a real-world example of 
cross-agency electronic health records sharing

Editorial Policy Statement
Subscription and Contact Information 


Welcome to the inaugural issue of VistA® News. I have been a strong advocate 
of the need for a newsletter that brings together news and views across the 
wide and growing spectrum of communities of interest in the transformation of 
VistA® – the Veterans Health Information Systems and Technology Architecture 
– from being primarily an in-house application/platform that runs all the 
medical facilities of the United States Department of Veterans Affairs to 
becoming the platform of choice for electronic medical and health records for 
the rest of the world. With encouragement from many,  I have started this 
publication to provide the VistA® community with news and updates.  Your 
comments, suggestions, and news items are sought, and are always welcome. 
-Roger A. Maduro


The last three weeks have been very significant for VistA®. There are four 
major stories featured in this issue of VistA® News. The first is the 
decision by Harvard University to honor the Department of Veterans Affairs 
and the VistA® system with its Innovation in Government Award. Second is a 
series of articles on the great medical care provided at VA hospitals and the 
role that VistA® has played in this success. Third is a report on the 13th 
VistA Community Meeting held at Robert Morris University in Pittsburgh, PA, 
June 28-July2. The fourth centers on the increasing collaboration between the 
Department of Veterans Affairs (VA) and the Department of Defense (DoD) on 
health IT issues.

The VA is one of only seven recipients of the Innovation in Government Award 
given annually by Harvard University's Ash Institute For Democratic 
Governance and Innovation. More than 1,000 government programs competed for 
the award. The VA has created a web site to handle the inquiries from the 
story as well as to provide more in depth information on VistA® 
<www.innovations.va.gov>. There is an excellent video of VistA® on the web 
site as well as more extensive background information. This news, however, is 
tempered by the announcement that VHA Undersecretary, Dr. Jonathan Perlin, 
will step down from his position for a job in the private sector. Dr. Perlin 
has been one of the major driving forces in recent years behind the success 
of the Veterans Health Administration and VistA® system and he will be 
greatly missed.

Shortly after the Harvard University announcement Business Week published a 
feature story on the VA and VistA® titled "The Best Medical Care In The U.S: 
How Veterans Affairs transformed itself -- and what it means for the rest of 
us" by Catherine Arnst. Available in the July 17 print edition, and through 
their web site, this is one of the best documented stories in the press. If 
reading the web version of the story, make sure to look at the graphics. The 
hyperlinks are hard to find but the data tables are worth the effort. In 
addition to this feature story, we also cite an earlier story on VistA® that 
appeared in the May 15 issue of Fortune magazine.

We also have one article that is a cautionary tale. It's from Healthcare IT 
News on the problems that Britain's National Health Service (NHS) is having 
developing a national electronic health record. The $11.7 billion project is 
reportedly in serious trouble and many industry experts are publicly warning 
that it may end up as the greatest failure of an IT project in history. The 
curious thing is that the functionality that NHS is paying billions of 
dollars to develop in England, is only a subset of the functionality that 
already exists in VistA®. For a fraction of the money they have already 
spent, NHS could have implemented VistA® as their platform and adapted it for 
the specific needs of Great Britain.

Many other countries are taking a wiser course of action. In the past four 
years, over 50 countries have sent national  delegations to the Department of 
Veterans Affairs to meet the leadership of the VA, study VistA®, and have 
hands-on demonstrations and  tours of the VA hospital complex in Washington, 
DC. More than 30 of these countries are now either implementing VistA®, 
carrying out pilot deployments, or conducting feasibility studies. Mexico is 
a case in point. Mexico's social security administration (Instituto Mexicano 
del Seguro Social-IMSS) has implemented VistA® in 24 of their hospitals in 
the past two years. They have plans to implement VistA® in 140 of their 
secondary and tertiary care institutions. Details of their existing 
deployments and future plans were presented by an IMSS delegation at the 
recent WorldVistA conference in Pittsburgh. Below we cite an article from 
Joseph Conn in Modern Healthcare on the conference. The article focuses on 
the presentation from Mexico. In addition to this presentation, there were 
many other presentations on successful VistA® deployments, including a 
presentation on the implementation of VistA® at the Midland Memorial Hospital 
in Midland, Texas by its Chief Information Officer, David Whiles.  Whiles' 
presentation included not only a discussion of VistA®, but also an 
explanation of the reasons why he used Linux as the operating system of 
choice for the VistA® deployment. The next issue of VistA® News will have 
more in-depth coverage of the WorldVistA conference and several of the 

Last but not least, Texas Tech University Health Sciences Center in El Paso, 
Texas, has selected DSS, Inc. <www.dssinc.com> to implement VistA® for their 
entire campus. They are a flourishing health sciences center and medical 
school with outpatient clinics located in East, West, Central, and Northeast 
El Paso. VistA® will be used to connect all facilities and share patient 
information to provide a continuum of care to all of their patients. This is 
the first of what is expected to be a large number of  medical schools in the 
U.S. to commit to a full implementation of VistA®. More than 125 medical 
schools in the U.S are affiliated with the Department of Veterans Affairs and 
their students as well as faculty regularly practice at VA hospitals. Between 
70 and 85 percent of all doctors and nurses graduating from medical schools 
in the U.S. today have used VistA® during their rotations at VA hospitals. -- 
Roger A. Maduro


VA Honored As Innovator For Medical Records: Paperless System Brings Agency 
$100,000 Prize
Washington Post, Christopher Lee, July 11, 2006

When Hurricane Katrina swamped New Orleans last year, the Department of 
Veterans Affairs medical center there was lost -- but medical records for 
40,000 veterans were not.

That is because since 1998, VA medical records have been computerized, stored 
and tracked electronically, rather than on paper. That allowed VA doctors in 
far-flung locations such as Houston, Jackson, Miss., and the District to 
immediately access records for New Orleans area VA patients who relocated, 
ensuring that they continued to receive the care and prescriptions they 

It was just one reason that the VA health information system won an award 
yesterday for innovative government from Harvard University. The award was 
one of seven handed out by the Ash Institute for Democratic Governance and 
Innovation at Harvard's John F. Kennedy School of Government, each carrying a 
$100,000 prize. The annual awards are administered in partnership with the 
Washington-based Council for Excellence in Government.

"This is a proud day for us," VA Secretary Jim Nicholson said. "The VA is now 
at the forefront of America's health-care industry."

VA health care chief to leave government   
Associated Press, Jul 12, 2006

The top Veterans Affairs official in charge of health care is leaving for a 
job in the private sector, the Department said Wednesday. Jonathan Perlin, 
VA's Undersecretary for health, will step down on Aug. 11, 2006. Dr. Perlin, 
who has been with the VA since 1999 and has held the top health post since 
2004, will become a senior vice president and chief medical officer at HCA 
Inc., a Nashville, Tenn.-based hospital company.

The Best Medical Care In The U.S: How Veterans Affairs transformed itself -- 
and what it means for the rest of us
Business Week, Catherine Arnst, July 17, 2006

..."Every day some 1,400 patients pass through the Buffalo VA's 
unprepossessing entrance, into what many might assume is a hellish 
health-care world, understaffed, underfunded, and uncaring. They couldn't be 
more wrong. According to the nation's hospital-accreditation panel, the VA 
outpaces every other hospital in the Buffalo region. "The care here is 
excellent," says Roemer. "I couldn't be happier, and my friends in the POW 
group I belong to all feel the same."

Roemer seems to have stepped through the looking glass into an alternative 
universe, one where a nationwide health system that is run and financed by 
the federal government provides the best medical care in America. But it's 
true -- if you want to be sure of top-notch care, join the military. The 154 
hospitals and 875 clinics run by the Veterans Affairs Dept. have been ranked 
best-in-class by a number of independent groups on a broad range of measures, 
from chronic care to heart disease treatment to percentage of members who 
receive flu shots. It offers all the same services, and sometimes more, than 
private sector providers."

Technology has transformed the VA
Veterans' hospitals used to be a byword for second-rate care or worse. Now, 
thanks to technology, they're national leaders in efficiency and quality.
Fortune, David Stires, May 11, 2006

...”The seamless integration of science, information, and compassion is the 
dream of modern health care. Scenes like these are not fantasies, however, 
but daily realities at the Veterans Health Administration, the federal agency 
that is the most wired and cost-effective health system in the land.

By making medical information both more centralized and easier to access, 
wiring health facilities can reduce the errors that the Institute of 
Medicine, a nonprofit research group that is part of the National Academy of  
Sciences, says cause at least 44,000 deaths a year. A national 
health-information network could also save $140 billion a year, estimates the 
U.S. Department of Health and Human Services.”

VistA users from Mexico steal show at WorldVistA conference
Modern Healthcare, Joseph Conn, July 10, 2006

The biggest stars of the WorldVistA community meeting this year were from 

The 13th Conference of WorldVistA was held June 29 through July 2 this year at 
Robert Morris College near Pittsburgh. It showcased healthcare organizations 
that have adopted and are now using using the VistA clinical software system 
in their healthcare 
facilities both in the U.S. and abroad   

According to Joseph Dal Molin, Vice President of Business Development for the 
not-for-profit WorldVistA organization, adopters of various versions of the 
VA's public-domain software were honored invitees at this year's conference. 

Among the welcomed speakers representing the VistA user community, were David 
Whiles, CIO of Midland (Texas) Memorial Hospital, a 230-bed system that last 
year began installing a VistA-based system developed by Medsphere Systems 
Corp. of Aliso Viejo, California.  Also speaking was Marcus Werners, who 
spearheaded the use of a VistA system at the German Heart Institute in Berlin 
back in 1992 that is still in use. 

But it was  the delegation from Mexico -- with their Spanish-translated core 
elements of the VistA system already deployed in about 24 hospitals within 
the government-run Instituto Mexicano del Seguro Social, or IMSS -- wowed the 
attendees of the conference, according to Dal Molin, a Toronto-based 
healthcare IT consultant.

England's healthcare IT project mired in delays
Healthcare IT News, Caroline Broder, July 1, 2006

A project in England to create electronic health records for 50 million 
National Health Service patients is not going as smoothly as officials had 
hoped. The plan is at least 2 1/2 years behind schedule and doctors are now 
calling for a review of the project.  

The project, which was set to begin last year, will not be implemented until 
late 2007 at the earliest. Phil Sissons, a supplier liaison who worked for 18 
months with the NHS’ Connecting for Health project, said the $11.7 billion 
plan to create an electronic medical network has been plagued by a number of 
problems. Many of the products that IT contractors sold to the government 
turned out to be vaporware, according to Sissons, who spoke to attendees in 
May at the Towards the Electronic Patient Record conference. Sissons is now a 
private consultant. 

Texas Tech Health Sciences Center Selects DSS, Inc. to Implement VistA
Business Wire, July 11, 2006

JUNO BEACH, Fla.--(BUSINESS WIRE)--July 11, 2006--Document Storage Systems, 
Inc. (DSS) announced today that the Texas Tech University Health Sciences 
Center in El Paso, TX has selected them for campus wide implementation of the 
VistA Electronic Health Record (EHR) system. "We're elated that Texas Tech 
has chosen us," said Mark Byers, President of DSS. "This is our first major 
vxVistA customer outside of the Veterans Health Administration and we're 
looking forward to building a great relationship with them as we have with 
the VHA."

The contract calls for an Alpha site clinic to be live and running the basic 
features of the EHR software within 8 months. Other project milestones 
include three additional months to go live with basic features in all El Paso 
clinics, and an additional 9 months to go live with advanced features, 
including multi-formulary capabilities at all of their over 20 clinics 
providing EHR functionality to 300 plus providers and students.

VA-LSU partnership advances toward New Orleans hospital
Army News Service, June 16, 2006

BATON ROUGE (Army News Service, June 16, 2006) – To provide state-of-the-art 
medical care for veterans in metropolitan New Orleans, the Department of 
Veterans Affairs (VA)and Louisiana State University took a major step June 15 
toward creating a shared, VA-LSU medical complex in downtown.

“Both our institutions would benefit from savings and efficiencies by working 
together,” said the Honorable R. James Nicholson, Secretary of Veterans 
Affairs. “Most importantly, Louisiana veterans would receive world-class 
medical care in a modern, conveniently located site.”

Officials from VA announced the results of an intensive four-month study of 
the feasibility of the two organizations collaborating on new medical 
facilities. Both VA and LSU operated hospitals in New Orleans that were 
destroyed last year by the floods spawned by Hurricane Katrina.

Federal health services choose VA imaging standard
The major federal health services may standardize on the VA’s VistA system 
Government Health IT, Bob Brewin, July 10, 2006

Two major federal health services expect to standardize on a medical imaging 
system that the Department of Veterans Affairs developed and already uses. 
The Indian Health Service will test the VA’s medical imaging system this 
summer in its Portland, Ore., area office before deploying it nationwide, top 
IHS officials said.

The Defense Department announced last month that it would adopt the VA’s 
medical imaging system as its standard. Carl Hendricks, chief information 
officer for the Military Health System, said DOD intends to use the VA’s 
Veterans Health Information Systems and Technology Architecture (VistA) 
Imaging system in its 70 hospitals and 411 clinics worldwide.

DOD to adopt VA medical imaging system
Government Health IT, Bob Brewin, June 15, 2006

WASHINGTON, D.C. –- The Defense Department’s Military Health System (MHS) has 
decided to adopt the Department of Veterans Affairs’ medical imaging system 
for use in its electronic health care program, said Carl Hendricks, MHS’ 
chief information officer, speaking at FCW Events’ Government Health IT 

Hendricks said the decision represents an increasing convergence of e-health 
systems operated by the two departments, which run the largest health care 
systems in the country. It made sense for MHS to adopt a “great VA imaging 
system,” he said.

Hendricks said MHS wants to use as much code as possible from the VA’s imaging 
system, which meets DOD standards. 
DOD will also work with the VA to improve the system, he added.

Bridging the gap: The VA and DOD are delivering a real-world example of 
cross-agency electronic health records sharing
Government Health IT, Brian Robinson, April 17, 2006 

The Defense and Veterans Affairs departments are considered leaders in 
implementing electronic health records. Some experts have even touted the 
Veterans Health Information Systems and Technology Architecture (VistA) as a 
model for a national EHR system.

Now the two departments are becoming champions of the kind of interoperability 
that the Bush administration and medical organizations say is needed if a 
National Health Information Network is ever to see the light of day.


August 15, 2006. San Francisco, CA
Rise in Healthcare IT Spending Spells Opportunity for IT Managers, Profit for 
Open Source Vendors
OSDL to Host First Ever Full-Day Event Dedicated to Healthcare IT at 
LinuxWorld San Francisco
Medsphere CEO Kenneth W. Kizer to Deliver Keynote

August 21–23, 2006. Nashville, TN
Veterans Affairs E-Health Conference & Exposition 2006
A Decade of Impact on Healthcare for Veterans


VistA Software Alliance (www.vistasoftware.org )
WorldVistA (www.worldvista.org )
VA VistA Innovations Site (www.innovations.va.gov )
VistA Monograph Home (www.va.gov/vista_monograph )


While the underlying basis for publishing this newsletter is the publisher’s 
belief in the potential of VistA to vastly improve the quality of healthcare 
in the US and its potential to make affordable healthcare IT technology 
available to the developing world, the editorial policy is to be independent 
and, to this end, the newsletter will not promote vendor products or 
services.  As an expression of its independence, the newsletter may, from 
time to time, include information that may reflect negatively on VistA. The 
newsletter may include information about future events that the editor feels 
are relevant to the communities for which the newsletter is intended but such 
information in no way endorses such events. 

Opinions expressed in the newsletter and the identity of the person or 
organization expressing such opinions will either be clear from the context 
or will be explicitly stated.

Note: VistA® is a registered trademark of the Department of Veterans Affairs. 
It stands for “Veterans Health Information Systems and Technology 

Roger A. Maduro is a leading expert in the application of open source software 
and concepts to improve information technology systems. In the past 5 years 
he has focused on solutions in healthcare, in particular the migration of 
VistA® from an application specific to the Department of Veterans Affairs to 
one that can run everywhere from the private sector clinics and hospitals to 
national health systems. He is one of the founders of the VistA Software 
Alliance (VSA) and currently a board member. He is also a member of the 
WorldVistA organization.


If you wish to subscribe to this newsletter, please send an email to 
[EMAIL PROTECTED] If you wish to cancel a subscription, please send an 

phone: (571) 217-6921


VistA® News| P.O. Box 6201 | Leesburg | VA | 20178

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