Difference between revisions of "User:Hydenseek/Here"

Revision as of 20:07, 16 August 2009

As a new user and proponent of the WorldVistA Electronic Health Record, I will document on this page my personal experience using the software on a test system in my home.

How I became interested:

I suppose I am like the majority of people, I have always been in good health, had medical insurance and had very limited contact with the Health Care System, yet assumed I knew "how it all worked" if I did need to use it.

A recent health issue left me reeling with disbelief with regard to the lack of patient health information being readily available to the very health care providers who needed it. Every visit to a hospital, doctor, or clinic seemed as though I were visiting an island known only to itself. I would fill out the same paperwork over and over: Name, address, wife's name, allergies, past surgeries, and on and on. Most places did not use a computer but relied on a paper record system to keep track of my information. I thought to myself this is the most inefficient system I have ever seen. I mean we live in an age where I can buy a widget at WalMart in Syracuse, fly to Chicago and the WalMart clerk there can tell me what I bought, where I bought it and how much I paid for it in seconds.

This prompted me to begin searching for the reason things were the way they were. I came across Google Health and immediately began a health record for myself. If I went to a new doctor I printed out my Google Health record and they were amazed at what I had done in so short a time. But the health record information is for them to gather not me,(fortunately I was still healthy enough to be able to build the record) so I looked further and soon found WorldVistaEHR.

Now here was a free piece of software that ran the VA, one of the largest health care systems in the world and I became an immediate fan. But why wasn't everyone using it? It turns out that WorldvistA is too good, too complete, and too not Windows. Everyone wants a point and click interface and WV is far from that, except for CPRS of course.

I have known for a long time that a piece of software will never learn how you want it to behave, you MUST learn how it behaves so I set about learning how it functions. Enter HardHats, a dedicated group of individuals whose goal is to further the acceptance of VistA and its derivatives in applications outside the VA. If not for these HardHats, VistA would be dead and buried never to see life outside the VA. What they are trying to accomplish is akin to moving a mountain, they number perhaps a few hundred strong yet have turned the heads of many people.

How I began:

Initially I was overwhelmed with the capability of the program from what I read. I wanted to learn a program that would help the small clinic or doctor's office, not run St. Judes Hospital. But the more I read the more I realized that this program could scale to any level of complexity with its modular architecture. I decided to download the demo from the Worldvista.org website to kick the tires a bit. Installation was straight forward and the demo ran flawlessly. After a week I decided to try a client server test setup using Ubuntu Jaunty and Windows Vista HP. It seemed that the Astronaut Installer was the quickest and most reliable way to setup the system. It was a breeze to install both server and TMG-CPRS with Astronaut. Now the fun begins.....

My first hurdle was to log on to the server. To do this required changing the Access/ Verify codes for an existing doctor, in my case Doctor,One

Follow these steps to do this:

Open a terminal

enter choice 3 in Vista Commander

VA FileMan 22.0

Select OPTION NAME: Select OPTION NAME:1 ENTER OR EDIT FILE ENTRIES

INPUT TO WHAT FILE: REMOTE PROCEDURE// 200 NEW PERSON

                                         (74 entries)

EDIT WHICH FIELD: ALL// Access CODE Want to edit ACCESS CODE (Y/N) THEN EDIT FIELD: verify

    1   VERIFY CODE  Want to edit VERIFY CODE (Y/N)
    2   VERIFY CODE never expires

CHOOSE 1-2: 1 Want to edit VERIFY CODE (Y/N) THEN EDIT FIELD:

Select NEW PERSON NAME: DOCTOR,ONE

You are then at Doctor, One's entry and can change his login codes. As soon as he logs in he will have to change to a new access and verify code for security reasons.

You can now login using CPRS (Computerized Patient Record System) as Doctor,One

To make the system more realistic go back to a terminal and press 3 as before.

then press 1 when asked for the Option Name

INPUT TO WHAT FILE: 200 NEW PERSON//

EDIT WHICH FIELD: ALL//

Select NEW PERSON NAME: DOCTOR,ONE

Now press enter until you get down to the e Sign entry and enter a new e sign code for the good doctor. This will let you sign orders etc. for patients, just like a real doctor!!

Time to PuTTY:

I discovered that it was a pain to keep running into the other room where the server is located to open a terminal and use the roll and scroll interface. To use one computer just download the PuTTY terminal emulator to your windows machine and use it to connect to a terminal on the server--much more convenient