Difference between revisions of "CHC Corner"

Latest revision as of 00:05, 7 July 2012

From: Matthew King <mking@clinicaadelante.com>

The Community Health Centers in AZ are forming the Arizona Integrated 
Network (AIN) to formally integrate information technology services, 
financial management, and clinical initiatives. We are have included 
VistA Office in our EHR evaluation.

From: John Leo Zimmer <jlzimmer@cbchc.com>

The Council Bluffs Community Health Center is assembling the hardware
and software to implement VistA Office or FOIA VistA in this one small
center. We hope to participate in an open development process that tailors
VistA to community health centers' special needs.

From Hardhats Listserve:

Here are some recurrent questions us nontechies have about VistA:

1) Is Mumps a serious limitation to complete EHR functionality, code maintainence, HL7, or PMS interfacing?

2) What is the fundamental difference between a relational database and a hierarchical database and how does that effect the end-user? (Should we even care? If so why?)

3) How hard is it for non-Mumps IT personnel to learn Mumps/VistA and are there enough experienced VistA programmers (or former VistA programmers) to consult or be hired to non-VA projects?

4) What other concerns should we have regarding adopting VistA?

5) Are any Community Health Centers currently utilizing VistA?

@@ Line 1: / Line 1: @@
-  From: "Matthew King" <mking@clinicaadelante.com>
+  From: [[Matthew King]] <mking@clinicaadelante.com>
   The Community Health Centers in AZ are forming the Arizona Integrated
@@ Line 6: / Line 6: @@
   VistA Office in our EHR evaluation.
-  From: "John Leo Zimmer" <jlzimmer@cbchc.com>
+  From: [[John Leo Zimmer]] <jlzimmer@cbchc.com>
   The Council Bluffs Community Health Center is assembling the hardware
@@ Line 13: / Line 13: @@
   VistA to community health centers' special needs.
-'''From: Hardhats Listserve:'''
+==From Hardhats Listserve:==
 Here are some recurrent questions us nontechies have about VistA:
-'''1) Is Mumps a serious limitation to complete EHR functionality, code maintainence, HL7, or PMS interfacing?'''
+[[1) Is Mumps a serious limitation to complete EHR functionality, code maintainence, HL7, or PMS interfacing?]]
-      There are several major commercial EHRs that use MUMPS.  In fact,
+[[2) What is the fundamental difference between a relational database and a hierarchical database and how does that effect the end-user? (Should we even care? If so why?)]]
-      the language was developed expressly FOR the health care
-      environment. There are far more limitations (and serious ones at
-      that) in most other languages and especially strict SQL
-      Absolutely not.  I will go one step further than Cameron.
+[[3) How hard is it for non-Mumps IT personnel to learn Mumps/VistA and are there enough experienced VistA programmers (or former VistA programmers) to consult or be hired to non-VA projects?]]
-      I have heard that M is the #1 language used for EHR's.
-      Epicare, which just contracted for EHR for Kaiser, is based
-      on M, for example.
-'''2) What is the fundamental difference between a relational database and a hierarchical database and how does that effect the end-user? (Should we even care? If so why?)'''
+[[4) What other concerns should we have regarding adopting VistA?]]
-     While MUMPS has been characterized as "hierarchical", the
+[[5) Are any Community Health Centers currently utilizing VistA?]]
-     DBMS that VistA uses, VA FileMan, provides what is more accurately
-     characterized as a polymorphic view of the database.  One can
-     readily use relational projections (indeed there are commercial
-     add-ons that give a strict SQL view of the database).  The more
-     advantageous view through VA FileMan is more like an object view
-     of the data with abstract data types being highly specialized for
-     optimal use and performance.  End users usually need not care
-    (except that performance of VA FileMan is demonstrably superior
-    (there are published reports) to SQL on the same hardware and
-     configuration.)
-     Another difference is the way the data is stored.  M data is stored
-     in b-trees, as compared to flat tables (I believe).  This leads to
-     faster data acess, and less CPU power needed.
-     Also, the database in M is called by some a "sparce array."  This
-     means that there are no "blank spaces" left for data to be later
-     filled into.  So with M, if there is no data present, then no space
-     is wasted.  I find this to lead to many many fields being defined
-     for a given file.  With a traditional database, having all these
-     fields with empty/wasted space, would lead to huge database files.
-     But with M, one can can store years of patient information on a
-     relatively small disk.
-'''3) How hard is it for non-Mumps IT personnel to learn Mumps/VistA and are there enough experienced VistA programmers (or former VistA programmers) to consult or be hired to non-VA projects?'''
-      Learning MUMPS is as simple as learning BASIC.  Learning about all
-      the utilities and capabilities of the common services in VistA is
-      a years long process.  And learning the functionality and setup
-      for the clinical and administrative functions in VistA would
-      probably take several life-times. Are there enough experienced
-      programmers and application consultants?  So far I believe you'll
-      currently pay more for a Java programmer.
-      I am a physician and have taught myself M.  It is a very simple
-      language.  I consider it to be a scripting language.  But it gets
-      the job done, and has run hospitals safely for decades.
-      There are many people on the list that would like work as
-      programmers, so I don't think there will be any limitation there.
-      And when CMS releases VistAOffice, there should be even more
-      interest and consultants available.
-'''
-) What other concerns should we have regarding adopting VistA?'''
-      Expect a long learning curve.  Get help.
-      I think a factor here is how much you want to put into the system.
-      It is not turn key at this point, although there are installers
-      who can do the work for you.  It is not going to have all the
-      bells and whistles that commercial EMR's want you to pay for.
-      It is not currently integrated with a billing system or a system
-      for appointments.

Difference between revisions of "CHC Corner"

Latest revision as of 00:05, 7 July 2012

From Hardhats Listserve:

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