Web Strategies 2005 - Healthcare Technology Network


VistA-Office EHR

CAPT Cynthia Wark

Deputy Director, Information Systems Group

Office of Clinical Standards and Quality

Centers for Medicare and Medicaid Services

July 15, 2005


Session Topics

• Project Background

• VistA-Office EHR: Where We Are Today and Where We’re Headed Tomorrow


Framework for Strategic Action

• Released July 21, 2004.

• 10-year plan to build a national health information infrastructure including electronic health records for all


• IT in health care lags behind IT in other industries – Use of EHRs reported to be 14-28 percent in physician offices

• Plan identified needed actions including federal leadership, accelerated efforts by Federal Agencies, and incentivizing EHR adoption

• VistA-Office EHR listed in the CMS project inventory


Certification Commission for

Health Information Technology

• The mission of CCHIT is to accelerate the adoption of robust, interoperable HIT throughout the US healthcare system, by creating an efficient, credible, sustainable mechanism for the certification of HIT products.

• CMS plans to pursue certification of the VistA-

Office EHR when ambulatory standards are published.


Quality Improvement


• The Office of Clinical Standards and Quality

(OCSQ) administers the Health Care

Quality Improvement Program (HCQIP) and provides data for analysis to individual QIOs to facilitate quality improvement for

Medicare beneficiaries.


QIO IT Infrastructure

• As part of CMS' mission to ensure the provision of quality care to Medicare beneficiaries, CMS has sponsored the development of various systems to collect clinical, cost and other beneficiary and provider information to determine and assess the quality of care provided. As part of this effort, the QIO community uses the Standard Data Processing

System (SDPS).


QualityNet Exchange

• Designed and developed by CMS and entered production in August, 2002

• CMS-approved site for secure communications and data exchange between Quality Improvement

Organizations (QIOs), Hospitals, Performance

Measurement System vendors, End Stage Renal

Disease (ESRD) networks, ESRD facilities, and CMS

• Provides tools to perform data exchange and import of data to the QIO Clinical Warehouse


Doctor’s Office Setting: Quality

Improvement Efforts

• The Doctor’s Office Quality Information Technology (DOQ-

IT) is a “special study” in the QIO 7 th SOW that includes four participating states: California, Utah, Arkansas,


– The DOQ-IT work is aimed at promoting information technology to improve care in small-to-medium sized physician offices.

– QIOs are providing assistance to physician offices by educating offices on EHR system solutions and providing implementation assistance.

• DOQ-IT does not endorse any particular product or service.

VistA-Office EHR is one option that offices may consider using.


The DOQ-IT Model


QIO EHR Vendor


VistaOffice EHR will…

• Promote health information technology adoption in the ambulatory care setting by providing government developed software that is publicly available at low cost by August 1, 2005

• Support quality of health care services by enabling the exchange of clinical quality data

• Be based upon and stay in alignment with the current

Veteran’s Health Administration VistA spending government resources wisely to produce software which will be compatible with future system updates



• The Centers for Medicare and Medicaid Services (CMS) in the

Department of Health and Human Services (DHHS)

– Iowa Foundation for Medical Care

• Daou Systems, Inc.

• WorldVista

• The Veterans Health Administration (VHA) of the Department of

Veterans Affairs (VA)

• The Indian Health Service (DHHS/IHS)

• The Health Resources and Services Administration



VistA-Office EHR Development


• Modular approach to modifications with 3 phased releases in February, April and June

• Usability Testing

• Field Testing

• Independent Testing

• Acceptance Testing

• Class I Testing


Modifications to VistA

• Registration changes to support general practice in non-VA environment

• Templates added for pediatric and OB/GYN care

• Addition of printing and faxing of prescriptions

• Laboratory interface training package and implementation guide

• Measure reporting to QIO clinical warehouse

• Disease management reminders

• Interface to accept data from practice management/billing application(s)

• Improved installation procedures


VistA-Office EHR Vendor Support

Organization (VVSO)

• VVSO will provide training to vendors

• Contract awarded to WorldVistA May 6, 2005

• Training sessions to be held in locations across the country

• Website to be launched July 22

• Will post list of Qualified VOE Vendors

• Tests will include successful completion of scenarios

(installing the system, configuring the system, entering data, building templates, etc.)

• Conference late September in DC area


VistA-Office EHR Applied to the

DOQ-IT Model


QIO EHR Vendor





Communication Channels

• Change Control Board

• Feedback and suggestion box at: vista@ifmc.org

• Information posted on the CMS website at: http://www.cms.hhs.gov/quality/pfqi.asp

– VistA-Office EHR Information Sheet

– Version 1.0 Requirements

– Fact Sheet

– Questions and Answers

– VistA-Office EHR Presentation

• Software distribution will be available through VistA-Office.org

• List of qualified VOE vendors available at WorldVistA.org