Projects lists

Projects

Welcome to the WorldVistA "Brainstorming" Projects Page The Projects page is the working directory of WorldVistA project ideas. All project concept are welcome - new and old.

The Process

1. Project ideas and description will be collected and published on this page. 2. High-level benefit analysis will be applied. 3. Suggestions will be reviewed, prioritized and endorsed by the WorldVistA leadership. 4. Funding will be sought and teams will be organized for projects that are determined to be of high value and show promise of successful completion.

Brainstorming Rules:

1. Offer and collect as many ideas as possible. 2. All ideas are valuable, the more the better. One crazy idea spawns three rational ideas. 3. Don't spend time discussing details during brainstorming phase. Ideas submitted will be analyzed and deconstructed at length later... 4. Do not be critical of ideas, it stifles the process and make creative thinkers go back into the box. 5. Build on other ideas. Linking one idea to another is powerful. 6. Capture all ideas and make them visible. 7. Set a time limit. This iteration closes on 07/06/2007.

Project Details requested

Please supply the following: • Project title • Brief description • Benefit provided • Your name (so we know who to ask for clarification -- anonymous posts are accepted.) • Email address (optional) • link to projects.worldvista.org Project page if exists (If you would rather submit your project ideas via email -- send them to webmaster@members.worldvista.org with the subject line: WorldVistA Projects) Please add your project suggestion(s) here:

List of Projects

Training Ideas - Tools, Teachers, and Techniques

by Chris Richardson (to be detailed)

I18N (Internationalization) - Issues and Answers

by Chris Richardson (to be detailed)

Transport of Medical and Health Records

by Chris Richardson (to be detailed)

Post-Traumatic Stress Disorder - Developments and Impacts

by Chris Richardson (to be detailed)

New Organizations, MDC (new) and VDC (even newer)

by Chris Richardson (to be detailed)

Ontologies and how VistA fits in with them.

by Chris Richardson - David Whitten is also interested in this (to be detailed)

Title: LabCorp Interface

Description:Working with LabCorp to make their interface for VistA with the VA generally available. Benefits: Very fast hookups to LabCorp anywhere in the US Status: A programmer is working on making it easy to import the LabCorp Compendium into VistA and to take in unsolicited results. This will be an HL7 interface NOT utilizing Mirth because it is already virtually completely built to interface with VistA as is. Name: Nancy Anthracite

Title: Mental Health Assistant

Benefits:Mental Health Assistant provides for the administration and scoring of Mental Health tests both by staff and by patients. This has become particularly important because public mental health hospitals and programs are taking a big interest in using VistA and because of the push to have the public sector help to support the returning veterans with PTSD Description: Mental Health Assistant does not currently fully function with VistA. It will take a little more work to get everything working properly and it may mean waiting for the next iteration to be released in the future. However, we are making progress. Name: Nancy Anthracite

Title: Demographic and Insurance Information Improvement Project

Description: Identifying and creating an appropriate place for all of the data that various types of practices need to collect for demographics and insurance and trying to reach a consensus as to where everything should be mapped to. Benefit: Increase ease of adoption and use for everyone interested in VistA Name: Nancy Anthracite

Title: Open Source Practice Management Interfaces

Description: Collecting and perhaps collectively hiring folks to make interfaces with practice management systems that will allow the interface to be open source Benefit: Ease of adoption and lower cost per practice if the programming work is paid for collectively Name: Nancy Anthracite

Title: Open Source Lab Interfaces

Description: Collecting and collectively creating lab interfaces to be used with Mirth for those la Benefit: Ease of adoption and lower cost per practice if the programming work is paid for collectively or done by volunteers Name: Nancy Anthracite

Title: Template, Reminder and Object Repository

Description: A source and hopefully some sort of rating system to point out the best of the best templates and objects for VistA Benefit: Improved functionality for all users of VistA Name: Nancy Anthracite

Title: Spread Sheet/Flow Sheet capability for VistA

Description: The VA is working to include this is VistA. It may be some time before it is ready and we could use it now. Hopefully we could accomplish this without stepping on what they are doing Benefit: Allowing improved functionality for VistA in several areas, especially in ICU, OB, and long term care Name: Nancy Anthracite

Title: VistA for Nursing Homes

Description: There is a new MDS and data collection instrument coming out of CMS. This would integrate the data collection for those things necessary into the work flow of VistA so the separate tools are not needed to provide this functionality Benefit: Nursing Homes are poorly funded and could use the increased safety, etc., that could be provided by VistA. Integrating this functionality into VistA could increase the ease of adoption. Nursing homes usually need to purchase this software. Better they utilize VistA with the additional capabilities it has instead.

Title: Biosense for VistA

Description: CDC has a program to collect real time data to support recognition of epidemics and terrorist attacks Benefit: Provide nationwide, opt-in reporting capability to increase the ability of the CDC to pick up a problem. Also, to provide the same capability to the states that are taking an interest in doing their own statewide surveillance and for those world-wide who might like to do the same. Name: Nancy Anthracite

Title: Pediatric Growth Charts for VistA

Description; Integration of the ability to display, initially the CDC growth charts, but eventually WHO and growth charts for diverse ethnicities and world locations in VistA Benefits: Needed by pediatricians everywhere. CDC level capability needed for CCHIT certification. Name: Nancy Anthracite

Title: VistA Education Server

Description: Demo installations of VistA offered to Universities for Education. Mock patient data and may be entered, etc. Server to be hosted by Hewlett Packard beginning June 26, 2006. Benefit: Colleges have multiple uses for a training EMR from class simulations to demonstrations of the functionality of medical record systems. It will also raise the awareness of this open source record system.

Title: CPRS for Linux

Description: Getting CPRS written with Borland Delphi running on Wine for Linux. Kevin Toppenberg is currently working on this with the Codeweavers helping with the wine end. Kevin is incorporating TFireFox to replace TWebBrowser to help. Benefit Provided: Much lower cost for deployment of VistA particularly in developing countries.

Title: CPRS Enhancement

Description: Now that we have had to modify CPRS in order to pass CCHIT, it has made it practical to consider further enhancements to CPRS. The drawback is that they will need to be maintained which may be expensive in time and money. George Welch and Kevin Toppenberg have been working on this Benefit: Improved functionality for CPRS Name: Nancy Anthracite

Project Title: Vital Signs Enhancement and Standardization

Description: Gather and then try to standardize new vital signs needed. Contacting the VA to see if they are following any standard other then their own, finding out about IHS measurement file, and finding out what others are needed in the community, then harmonizing them all to make something suitable, hopefully for all but maybe just for WV-EHR Name: Nancy Anthracite

Project Title: Postal Codes for non-US countries

Description: Developing a Method for handling the Postal Code files considering that non-US countries have other systems. This project is well underway and being tested. More testers welcome. Name: Nancy Anthracite

Project Title: Billing Interfaces

Description: Interfaces with various billing services that can be made open source built and donated to the open source community. Pooling of resources may allow several practices to fund the construction of the interface that would be made available to all who wish to use it. Also, perhaps the billing companies could be persuaded to help defray the costs of development or be convinced to accept the current output from VistA. Benefit Provided: Easier adoption of VistA Name: Nancy Anthracite

Project; Interface between FreeB and VistA

Description: FreeB is open source billing software written by Fred Trotter. Funding and help is needed to complete and interface between FreeB and VistA. I believe Fred and Dave Whitten are already working on this and could use some help. Name: Fred Trotter, Nancy Anthracite

= Project: Scheduling GUI

Description; Interface between Fred Trotter's open source scheduling software and VistA. I believe Fred and Dave Whitten are already working on this and could use some help. Name: Fred Trotter, Nancy Anthracite

Project Title: Vital Signs Enhancement and Standardization

Description: Gather and then try to standardize new vital signs needed. Contacting the VA to see if they are following any standard other then their own, finding out about IHS measurement file, and finding out what others are needed in the community, then harmonizing them all to make something suitable, hopefully for all but maybe just for WV-EHR Name: Nancy Anthracite

Project Title: Postal Codes for non-US countries

Description: Developing a Method for handling the Postal Code files considering that non-US countries have other systems. This project is well underway and being tested. More testers welcome. Name: Nancy Anthracite

Project Title: Pedi Project

Description: To Implement the suggestions of the HL7 Pediatric SIG and others for improving Pediatrics for VistA Name: Nancy Anthracite

Project Title:OB-GYN project

Description: OB-GYN enhancements for VistA including Hollister like flow charts Name: Nancy Anthracite

Project: Scheduling GUI

Description; Completion of the scheduling GUI started by George Welch written in Delphi. Name: George Welch, Nancy Anthracite

Project title: Scaleable interoperability and portability

Brief description: Develop a viable alternative to the current namespace framework Benefit provided: The current framework of allocating 2-4 character namespaces and corresponding numberspaces to each project and adopter does not scale well to a world where VistA is widely adopted (and leads to less than transparent code). We need a new framework, one that can grow with VistA while maintaining backward compatibility Your name: Greg Woodhouse

Project title: Next steps in standardization

Brief description: Develop a set of semantically driven tools for developing standards based interfaces Benefit provided: At present, standards such as HL7 are supported through ad hoc mechanisms, such as developing message based interfaces that are product specific and closely tied to specific use cases or scenarios. There is very little support for generic tools, much less a framework to support semantically driven interface development. This project would develop tools and techniques that will reduce the amount of effort that must be expended on repetitive (and non-reusable) tasks through development of appropriate tools. A second aspect of the project (and they cannot really be separated) is developing a suitable language for describing concrete realizations of standards. Current work is generally hobbled by the lack of general concepts and tools, wit the result that projects become labor intensive and error prone, essentially starting from the beginning with each new project Your name: Greg Woodhouse

Project title: HL7v3

Brief description: Develop an implementation of HL7 version 3 Benefit provided: At present, VistA only supports HL7 v 2.x. That has worked well for the way HL is used now, but factors such as scale, interoperability, and new developments in medicine are likely to make adoption of v3 increasingly important. Even now, thr CDA (and therefore the CCD) is v3 based. Your name: Greg Woodhouse

Project title : Peds Growth Charts

Peds Growth Charts and expansion of vitals package to include OB and Peds parameters by Matthew King

OB flow sheets (ACOG style)

by Matthew King OB Flow sheets- See ACOG (American College of OB) paper charts: These are the standard. Apparently, in the VA, there are some Nursing Flow Sheets for ICU. These might be adaptable. Otherwise, you could pull data from the patient record and build it using XML and a Web server, like the approach they are taking for the Peds charts.

Prescription Autofinish

Use Microsoft Windows Printers

Reconfigure prescription autofinish to pipe data to windows printer instead of VistA drivers. This is dependent upon the version MUMPS used (Cache or GT.M)

True Fax functionality

Fax service in autofinish nearly unusable. The Pharmacy Directory should be maintained in the windows fax software, so non-techies at each site can maintain their own lists.

Additional Vitals Measurments

Need Head Circumference
Need Fundal height
(See IHS vitals)

by Matthew King

=== Peds functionality

OB functionality

Intelligent Database of VISTA Global and Routine Documentation

from Charles Volkstorf Brief description: Allows you to: 1. Print Global documentation for any given global. 2. Describes what is at a given global, subscript and piece. 3. Lists the globals that contain a given field. 4. Finds a field based on knowing a given value e.g. “Blue Cross” or its format. 5. List all places (routine, tag, offset) where a given field is used, set, read, edited, deleted.

Program Execution Simulator

from Charles Volkstorf Brief description: Give it a MUMPS routine as a starting point, and it simulates the execution. 1. Diagnose bugs e.g. an undef would be traced back to where the variable was last set or killed. 2. Give it integrity constraints e.g. A is a number, and it stops when it is first violated, the source of the problem. 3. Test live programs without changing live globals – all global changes are simulated only. 4. Make sure all code is tested – tells you what lines were never executed and logical paths to get to them to test them. 5. Improve efficiency e.g. variables set to the same value repeatedly in a loop. 6. Diagnose infinite loops – tells you the range of code being executed and the FOR or GOTO that repeats. 7. Tells you the net result of a subroutine (writes, global sets, local variables passed) to create documentation. 8. Reruns using the input entered at reads to repeat tests after you make changes to the MUMPS routines.

Project title - CAM Enhancements toVistA - Chiropratic & Accupunture Modules

from Charles Volkstorf

A brief description - For VistA to remain at the forfront of EHR systems, it needs to encompass Complementary and Alternative Medicine (CAM) modules. CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Patients are increasingly turning to complementary and alternative medical (CAM) in order to enhance their health and well-being. CAM includes acupuncture, chiropractic medicine, osteopathic medicine, use of herbal remedies and other practices as an augmentation to more conventional medical treatments. The marketplace reflects this growing acceptance of complementary medicine by many patients and a small, but growing number of health care providers. By gathering and integrating health care information associated with the application of CAM procedures into a patient's electronic health record (EHR), more accurate measurement of outcomes can be generated. Best practices can then emerge showing which complementary medical practices are most effective when coupled with conventional medical treatments of specific disorders.

In a recent report on Complementary and Alternative Medicine (CAM) in the United States (2005), the Board on Health Promotion and Disease Prevention states that the total visits to CAM providers exceed total visits to all primary-care physicians. Out-of-pocket costs for CAM are estimated to exceed $27 billion, which shows that CAM is now big business. That does not include those therapies or treatments covered by insurance. Hospitals, managed care plans, and conventional practitioners are now incorporating CAM therapies into their practices. Medical schools, nursing schools, and schools of pharmacy are teaching their students about CAM.

It's hard to get an exact handle on the market for CAM, however, according to a recent article published on the Investors.Com web site, consumers snapped up about $54 billion worth of CAM services and dietary supplements in 2003. Of that figure, they claim that $34 billion went to all types of alternative services such as chiropractic, naturopathy, osteopathy and massage therapy, up from $25.5 billion in 1999. The U.S. market for dietary supplements isn't far behind, generating sales of $19.8 billion in 2003, up from $16.5 billion in 1999.

Benefit provided - It will enhance the capabilities and reputation of VistA in the world marketplace. It will include modules of CAM practices/treatment that patients and provider organizations are embracing whole heartedly. It will capture patient care information that is not being captured. It will allow providers to generate more revenue by charging for these CAM treatments. I suggest starting with the chirpratic and accupuncture modules. • Your name (so we know who to ask for clarification -- anonymous posts are accepted.) - Peter Groen