Ignacio Valdes Implementation Log/Episode5

Patient picture?

Ignacio Valdes Date: Thu, 17 Jul 2008 15:50:23 -0500

Does VistA support addition of a patient picture to the record? This is necessary at Intracare for many reasons. -- IV

Hartsel Date: Thu, 17 Jul 2008 14:51:00 -0700 (PDT)

I am a Clinical Applications Specialist for a State Hospital in WV and we use Medsphere Systems Corporation's OpenVista CPRS. It supports adding a patient photo in the chart. Once the image has been scanned into the product, you see a thumbnail image in the upper left corner of the Cover Sheet, which you can then click on to view full-size.

Chris Richardson Date: Thu, 17 Jul 2008 22:02:35 -0700

Ignacio;

It should not be difficult to do, but it is not part of the general release. It would make a lot of sense.

Nancy Anthracite View profile Date: Fri, 18 Jul 2008 05:35:03 -0400

I think VOE Solutions has taken a look at this and maybe made a object??? Hopefully they will see this and jar my memory. -- Nancy Anthracite

Ben Mehling Date: Fri, 18 Jul 2008 07:12:31 -0700

Both our existing (and I'm afraid, not open-able) OpenVista CPRS and new AGPL'd CIS applications include the patient photo feature. You can see a screenshot of the patient header bar or demo it here: http://medsphere.org/

- Ben

David Whitten CTO WorldVistADate: Fri, 18 Jul 2008 10:26:38 -0500

Ben,

Is there a RPC call that is associated with the photo feature? If someone wanted to make a corresponding change to the open source CPRS, is there some "lessons learned" or "de facto" implementation that should be kept in common, for the good of the community?

David

Ben Mehling Date: Fri, 18 Jul 2008 08:59:12 -0700

Hi David-

The Patient Photo enhancement was a part of the 'desktop imaging' work done to allow directly attached images to be associated with TIU documents.

A design goal was to use existing "MAG" related work where we could. Some RPCs were added as necessary. Our implementation uses RPCs to associate images and fetch image locations. The actual image upload is handled via a secure WebDAV link and image fetching uses HTTPS. The RPC used to fetch the patient photo is "MSCGMAG PAT PHOTOS" and is available in our distribution if you'd like to take a look.

- Ben

I, Valdes Date: Mon, 21 Jul 2008 05:35:50 -0700 (PDT

Since this is a log I am going to think out loud:

I am faced with a dilemma: Abandon WVEHR and change over to OpenVistA which has the picture function now but does not have CCHIT certification and is said to not be VA patch-stream compatible or wait an indeterminate amount of time for the picture function to appear in WVEHR? -- IV

st...@stevenowen.com Date: Mon, 21 Jul 2008 08:45:24 -0400

As Nancy mentioned, I took a look at the COM object functionality of CPRS and created a very simple CPRS plug-in that will display a the patient photo just after the the patient selection is made in CPRS. It uses existing MAG RPC's. I'll upload to the source to file section this evening.

Ben Mehling Date: Mon, 21 Jul 2008 07:07:20 -0700

Ignacio-

I'm not certain I understand the "VA patch-stream" compatible comment. While I haven't looked in depth at patch stream used for any of the other VistA-based distributions, if the system in question fixes bugs or enhance functionality inside any VA packages, then some care will need to be taken before applying vanilla VA patches. OpenVista most certainly has both fixes to VA bugs and enhancements that would mean the patches from the VA would need to be analyzed before application -- this is a process we periodically perform to update our own distribution.

I would make the assumption this is true of other distributions as well.

- Ben

David Whitten CTO WorldVistA Date: Mon, 21 Jul 2008 10:04:16 -0500

I agree with Ben.

Any person who is currently using any VistA variant (WorldVistA EHR, Medsphere OpenVista, RPMS from IHS, Hui OpenVista) will need to install VA patches on a regular basis. Contrary to the name, patches rarely fix deficiencies in the system, and usually enhance the capabilities of a package or bring it into compliance with new regulatory requirements. Anyone who does doesn't install patches ends up having to do all that work on their own, with the concomitant costs of development, testing, and deployment.

Part of the process of installing a patch into a VistA system requires an evaluation of the impact of any patch. After evaluation, the patch can be installed directly if it doesn't overlap any local modifications to code or data. If it does, then the patch must be recreated taking them into account, or a new patch must be created to put the local modifications back into the system after the patch is installed. I know this process is a priority of WorldVistA and part of the software services we work on.

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