VA Revamps VistA EHR with New User Interface, Functions

The Department of Veterans Affairs, eyeing improved population health management, is developing substantial new capabilities for its VistA electronic health records system with initial rollouts starting later this year and in 2016.

Advances in care delivery models have “dramatically changed from physician-dominated practice to team-based, patient-centered care,” the department notes in a 2016 funding request to Congress. “To meet current and future needs, HIT systems must respond to these changes with expanded standards for data, tools for electronic health record interoperability, and new functionality for clinical decision making, teamwork and patient goals. This budget request is designed to ensure that the HIT solutions developed or purchased meet the current and future needs of the VHA healthcare teams at the time of deployment.”

The initiative, under which the ASM Research Unit of Accenture Federal Services received a $162 million contract in mid-2014, also will support advances in knowledge for such routine treatments as cholesterol management as well as “previously unimaginable” treatments such as genomics and advanced prosthetics, according to the department.

Also See: VA EHR System to Get Major Overhaul

The EHR enhancement effort, called the VistA Evolution program, will introduce an Enterprise Health Management Platform (eHMP) a set of new modular-based components, to replace the Computerized Patient Record System, or CPRS, which is the existing user interface that clinicians use while delivering care. The new eHMP platform also will enable the VA to meet many of the 2014 Edition meaningful use certification criteria for HIT components.

Functions expected in eHMP include entry of structured data to support immunizations, family history, occupational history, women’s health and other specialized care, more user-friendliness to increase productivity and facilitate clinician recruitment, and a common plan of care. Also on tap are development of new rules and other content for clinical decision support and workflow management, as well as analytics to assess if HIT investments are supporting business goals.

VA has more incremental fixes of VistA scheduled in late 2016 and early 2017 to collect structured clinical data “to support ‘lean-style’ management of clinical micro-processes,” according to the funding request. “Clinical micro-processes are the decisions and actions that clinicians and Veterans undertake. Many of these are currently recorded in free text notes or not captured at all, and therefore cannot be managed.”

The department intends to substantially complete eHMP functionality by September 2016 and certify components of the new VistA system, called VistA 4, starting in late 2015 and ending in 2017, with complete retirement and decommission of the current CPRS user interface during 2017 and 2018.

VA also notes to Congress that the initiative supports its commitment to interoperate with the new electronic health records system that the Department of Defense is expected to announce in the near future. Both departments previously pledged to implement the same EHR, and then both backed down. More information on VistA 4 is available here.

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