VistA Community Meeting Q2 2006

Please use the sections below to enter your suggestions for the next meeting. = Venue = The VistA Community Meeting is currently planned for the second quarter of 2006. (Sometime in May we hope) LOCATION: George Mason University, Fairfax, VA (Washington, DC area)

= Tracks = Enter tracks of interest:

1. Introduction to VistA

2. International Adopters

3. VistA Programming

= Sessions = Enter sessions you would like:

a) VistA for Beginners VistA Loadfest - bring your laptop and leave with VistA installed!

b) VistA Programming Standards and Conventions

c) Advanced VistA Programming

d) Workshop on the Anatomy and Physiology of CPRSChart.exe (Including compiling from source)

e) Workshop on Web2M

f) VistA and disaster / terrorism preparedness: a) remote backup, b) connectivity to pharmacies, near and far, c) data-driven Point of Care (POC) information about uncommon presentations, d) POC access to guidelines of disaster / terrorism care, e) POC to remote data monitoring for clusters of unusual presentations, f) facilitated access to unusual pharmaceuticals and supplies needed in some disasters (e.g., Prussian Blue), g) VistaWeb....

g) VistA and disaster recovery: Can Charity Hospital, University Hospital and the New Orleans VA be rebuilt with a common IT infrastructure linked to Vista-Office in New Orleans community primary care practices?

H) VistA and outline views of data: Can a customized TreeView control be linked to an outliner for data viewing (e.g., the annotated problem list) and data input (e.g., the annotation of the problem list)?

I) VistA and the National Debt: Can VistA be used to dramatically alter medication errors, duplication of services, Application of clinical guidelines, access to very low cost pharmaceuticals, access to cost-effective nutraceuticals, team care, self-care education, preventive medicine, cost-effectiveness research....?

J) VistA and the patient history: Can VistA be linked to a customizable questionnaire driver to collect patient history data important for clinical diagnosis, need-based education, prevention and cost-effective followup?

K) VistA and smart searching for content: Can VistA be linked to a semantic network (e.g., MEDCIN), semantic network software (e.g., WordWeb) and clinical content to assist staff in identifying clinically relevant content at the POC?

M) VistA and primary care medical education: Can VistA be linked to the education of undergraduate "medical assistants" and medical student study of basic clinical skills to enhance the entry of allopathic medical school students into primary care, including, especially, rural primary care? Can VA's and office practices using Vista-Office be increasingly used as training centers for facile and cost-effective use of an EMR?

= Speakers = Enter speaker suggestions here:

1. Cynthia Wark

Basic bio info - feel free to improve details with updated or more concise descriptions.

(http://www.fcw.com/article84607-11-21-04-Print) Nov. 22, 2004 Capt. Cynthia Wark, a Public Health Service nurse who is the acting deputy director of the information systems group at CMS' Office of Clinical Standards and Quality

(http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=106562)October 25, 2004 A group of four federal health care agencies will establish a change control board to keep current the Department of Veteran Affairs' proposed VistA Office Electronic Health Record system...

2. Rob Kolodner, MD, Chief Information Officer, Veterans Health Administration

3. Sen. Chuck Hagel (former Deputy Administrator of the Veterans Administration, 1981)

4. Technical representative from Intersystems, presenting info on upgrades to Cache and/or using Ensemble to integrate Applications.

5. Beyond Drilldown: Are rich internet Applications the answer for list, outline, network.... processing of data in VistA by the care team?
 * TIBCO - http://www.tibco.com guru -: We do HIPAA and HL-7 now.
 * Ray Ozzie & Chuck Hatton: Why the new Groove + LPA Prolog (WinProlog) is the answer.
 * http://www.lpa.co.uk
 * SAJAX, Leo, Buzz and UMLisp / Debian Medical gurus: Why not use python and lisp as very productive languages for text, list, outline, network, pubmed....database processing at the Point of Care? You too can do it in Linux, python and lisp.
 * SAJAX - http://www.modernmethod.com/sajax/
 * Python - http://www.python-in-business.org/ep2005/
 * Leo - http://leo.sourceforge.net/ - Richard K. Ream
 * Buzz - http://buzz.sourceforge.net/ - Charles Nofsinger MD
 * UMLisp http://umlisp.b9.com/start.html
 * Allegro Common Lisp & Store - http://www.franz.com
 * Debian Medical and UMLisp - http://b9.com Dr. Kevin Rosenberg
 * Patrick Dumas - http://www.kartoo.com -: We do flashy hyperlinked information processing now.
 * Latenitelabs - http://www.latenitelabs.com - guru: We do very flashy transactional database processing and displays using Intersystems Cache as our speedy database and Macromedia's Flash for our eye popping displays. You will see your experiments explode if you mix the wrong chemicals.
 * Macromedia Labs - http://labs.macromedia.com guru -: We are coming out with the flashiest toolkit for rich internet Application programming you could ever want to use.
 * WebIdeaTree - http://www.webideatree.com - originator (Christophe Guibert): Combine at least some of the above with WebIdeaTree and the care team can transactionally cooperate with the patient to create and maintain a "patient-centered" medical Record that patients can carry with them while they (the medical Records) are being remotely backed up.

6. Association of Professors of Medicine and Rural Medical Educators representatives to discuss medical education and Vista-Office:

A Assemble a Group interested in writing a grant proposal

B Target a proposal that has the primary goal of creating a means of certifying medical students as Honorary Clinical Scholars

C Create Processes in the proposal that "fit the future".

A Include in the Group:

a Experts in Motivational Interactions to include those skilled in teaching Motivational Interviewing

b Experts in Symptom Diagnosis & Point of Care Testing

c Experts in N of 1 & Cost-effectiveness Research in Primary Care

d Experts in Electronic Medical Record customization to reinforce educational goals

e Experts in Process customization for cohorts, context, complication prevention and coinage

f Experts in Emergency Medicine, Family Practice, Pediatrics, OB-Gyn and Psychiatry as those fields apply to adult primary care, especially in "resource poor" environments.

B Clinical Scholar certification should be:

a An honor that can be achieved by the end of the third year of medical school

b A means of commanding increased reimbursement in practice, assuming ongoing recertification based on practice and teaching outcomes

c Something that can be leveraged in the forth year of medical school for Prolonged Prestigious International Rotations that emphasize care using limited resources and tons of ingenuity

d A means of increasing future practice reimbursement in proportion to participation in an ongoing manner in providing care to patients in “resource poor” environments (both local and international) and teaching students in those environments.

C Processes that "fit the future" should include:

a Taking the ICD-10 coding system available from the WHO and interfacing it with teaching scenarios in primary care

b Taking the HHS/CMS Vista-Office EMR and customizing it so that it is very efficient and effective in assisting clinicians in the care of Medicare, Medicaid, underinsured, Native American, Veteran, Military Retiree and immigrant patients; AND it is efficient and effective in reinforcing primary care teaching goals; AND it is part of the process of measuring primary care teaching outcomes

c Creating a system of teaching primary care that encourages the sharing of teaching, clinical research and outcome successes using transactional techniques at the Point of Care.

= Topics = Enter topics of interest:

Building the business case for VistA

GUI Registration and Cashiering alternatives

Is there a Role for VistA in Disaster Preparedness?

Cache' on Linux, VOE on Linux

Rich Internet Application Programming