1. Collaboration Expedition April 18, 2006

2. page 2 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Institute of Medicine on VistA “VHA’s integrated health information system, including its framework for using performance measures to improve quality, is considered one of the best in the nation.” Institute of Medicine (IOM) Report, Leadership by Example: Coordinating Government Roles in Improving Health Care Quality (2002)

3. page 3 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Veterans Health Administration $27.4 Billion Annual Budget Largest Network of Hospitals and Clinics in the US. – 163 Hospitals – Over 850 Community and Facility-based Clinics – 135 Nursing Homes – Over 193,500 Health Care Professionals – Over 5.1 million patients per year Most comprehensive and advanced health care system—VistA Billions of dollars in R&D invested in VistA over 20 years.

4. page 4 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Highlights of VistA Fully integrated health care information system that meets inpatient and outpatient needs. Facility-based electronic health record system. Health e Vet program will make VistA a patient-centric EHR. Comprehensive—clinical, financial, administrative. Modular system—over 100 software application packages, e.g. Laboratory, Pharmacy, Nursing, etc. Continuing development by VA Related development by other agencies, private corporations, foreign government agencies, and open source VistA community. Applications, source code, and documentation available from the VA.

5. page 5 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Clinical Functionality Complete laboratory system. Pharmacy and bar-coded medication administration. Radiology and Clinical Imaging. Progress notes & Discharge Summaries. Physician order entry. Surgical, Medical, Dental, Nursing…

6. page 6 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Benefits of VistA Extensively deployed Fully functional, fully integrated Very scalable Hardware and O/S independent Source code is license free VA is continually enhancing Electronic Health Record (EHR) that can be shared Standards based Content

7. page 7 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Versions of VistA Federal Government FOIA Vista (Veterans Administration)-The gold standard from which all other versions come from. VistA Office EHR (HHS/CMS) RPMS – Indian Health Service NASA – Derivative of RPMS CHCS – Department of Defense Hui VistA - Pacific Hui

8. page 8 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Versions of VistA Private Sector Hui VistA – Open Source. Developed by Pacific Hui. OpenVistA – Medsphere Systems Corporation VxVistA – DSS, Inc. WorldVistA – WorldVistA/Community Foreign Countries MUSTI/FixIT– Finland MINPHIS – Nigeria Mexico Egypt Malaysia Brazil

9. page 9 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Collaboration Models Apache Software Foundation Eclipse Foundation Open Source Development Labs (Linux) Free Standards Group (Linux Standards Base) KDE SELinux

10. page 10 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Governance Issues Governance and Collaboration Model Organizational Structure Open Source Licenses Code Contribution Licenses Funding

11. page 11 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Architectural and Collaboration Requirements Define several VistA architectural alternatives, e.g. Open Source, COTS (VMS/NT/Cache…), etc. Help develop new software modules, e.g. ObGyn, Pediatrics, Billing, … Improve VistA system documentation Open Software development process for VistA Help establish VistA software enhancement process Establish Patch management process Certification processes for software, training, support, etc. Standards compliance Shared VistA software tools and utilities

12. page 12 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Education and Training Development of Technical Training Courses & Materials Development of Clinical Training Courses & Materials Development of online VistA Courses & Training Materials Certify VistA Training Programs by Vendors Develop a library of VistA Promotional Materials Success stories Cost/Benefit Studies

13. page 13 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting Contact Information Roger A. Maduro VistA Software Alliance 7315 Wisconsin Ave. Suite 400E Bethesda, MD 20814. (571) 217-6921 ramaduro@vistasoftware.org

14. page 14 April 18, 2006 Roger A. Maduro -- Collaboration Expedition Meeting