VistApedia - User contributions [en]

Projects

2007-07-05T16:30:52Z

GregWoodhouse: HL7v2 enhancemewnts

Below find the unedited and unprioritized project idea submissions. The project is in process and open for new submissions. This iteration of project submissions will close on 07/06/2006.

== 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 and Greg Woodhouse are 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: Mailman email encryption using a widely accepted standard ===
Purpose: To allow transmission of patient related information securely via
email between VistA and other medical record system and between providers and
patients
Name: Nancy Anthracite

===Project: Enhancing CPRS===
'''Description''': Enhancing CPRS including working with providers and the system
architect to decide what enhancements should be made/incorporated in the WV
EHR gold standard CPRS and which might be optional for local modifications.
This includes developing a method for maintaining and integrating these
enhancements with future versions of CPRS from the VA. We have recently had
an increase in the number of volunteers interested in working on CPRS so that
this project has a much improved chance of success.
'''Name''': Nancy Anthracite

===Project: Genomics Project===
'''Description''': Prepare VistA to take in Genomic Data for patients.
'''Benefit''': This data will soon be something that patients have for use in
helping to make treatment decisions as well as for research. Research
companies and universities are looking at WV EHR as a place to gather the
date from their research subjects for subsequent analysis and for the
necessary record keeping.
'''Contact''': Nancy Anthracite

===Chiropractic Support additions to VistA===
'''Description''': Research and develop the additions to VistA that will support
the practice of chiropractics
'''Benefit''': Chiropractics is being incorporated into many traditional medical
practices and a need to provide for those practitioners is growing.
'''Contact''': Nancy Anthracite

===Acupuncture Support additions to VistA===
'''Description''': Provide support for acupuncture practitioners in VistA
Benefit: Acupuncture is being added to some traditional medical settings and
there is a growing need to provide support for gathering data for care and
research for those providers and their patients.
'''Contact''': Nancy Anthracite

===Update the race and ethnicity file according to standards===
'''Description''': Enhance the current race and ethnicity file with a standards
based file that makes sense from a medically and takes into consideration
making changes in the future as the science advances.
'''Benefit''':The race an ethnicity file has virtually no medically beneficial
elements to it at this time. It more closely tracks political designations
than those that might be helpful for the patient and the providers. ASTM and
perhaps HL7 are both tackling this in a way that should help with this and,
in my opinion, enhancing the system with one of these standards is needed. As
genomics advances, we should be advancing with it .
'''Name''': 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''': [[User:GregWoodhouse|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''': [[User:GregWoodhouse|Greg Woodhouse]]

=== HL7v2 enhancements ===
'''Brief desciption''': Provide an expanded framework for HL7v2 development

'''Benefit provided''': VistA HL7 focuses primarily on ''message transport'', providing only minimal support to developers. In this sense, it is more
analogous to an MTA like sendmail or qmail to a development framework. Although it is possible to off-load quite a bit of work to an interface engine
(like Mirth), not everyone will be able to (or want to) use the same product, and even then development work is still required on the VistA end when
creating new interfaces. Areas for improvement include better message parsing and generation capabilities, more HL7 knowledge, support for entire
transactions (not just individual messages), the ability to auto-generate the relatively large amount of repetitive code that has to be crafted by hand
today (or, as an alternative, a run-time processing engine), template capabilities and more support for datbase integration.

'''Your name''': [[User:GregWoodhouse|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''': [[User:GregWoodhouse|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

=== 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.

#Diagnose bugs e.g. an undef would be traced back to where the variable was last set or killed.
#Give it integrity constraints e.g. A is a number, and it stops when it is first violated, the source of the problem.
#Test live programs without changing live globals – all global changes are simulated only.
#Make sure all code is tested – tells you what lines were never executed and logical paths to get to them to test them.
#Improve efficiency e.g. variables set to the same value repeatedly in a loop.
#Diagnose infinite loops – tells you the range of code being executed and the FOR or GOTO that repeats.
#Tells you the net result of a subroutine (writes, global sets, local variables passed) to create documentation.
#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

=== Internationalization ===
Brief description: Provide language, date, currency, and support resources for non-English speaking users, both domestic and international. This would include an interface translation process for VistA and WorldVistA EHR systems, client interface translations, documentation translation, and organise a team of foriegn language speakers to communicate with and support non-English speaking users.
 
Benefit: Extend the reach of VistA and WorldVistA user population. Provide an effordable electronic health care to emerging countries.
 
by Peter Bodtke
(support foreign languages, i.e. Spanish)
Kevin Toppenberg (kdtop)
* Multiple language support (I am working on this)

=== Patch stream updating system ===
Brief description: As WorldVistA is now the steward of the WorldVistA EHR code a system needs to be designed to incorporate enhancements from the VA and the VistA community. The process requires an evaluation step, integration and testing. Finally, the system requires stable equipement to host the resources.
by Peter Bodtke (to be detailed)

What does this project need assistance to get started?

=== Marketing and Public Relations ===
by Peter Bodtke (to be detailed)
: WorldVistA organization and WorldVistA EHR VOE V1.0 software package

=== Installers (WorldVistA EHR VOE w/Registration GUI, VistA/G.TM/Linux) ===
Brief description: Develop a suite of installers/set-up files, to assist in copying VistA, WorldVistA EHR files and clients to servers and desktops. This is a multiple stage development effort. First step - define installer types/classes(production, educational, demostration), standardize deployment directories, learning installer tools and records clean-up (VistA). Second step - design and develop basic GUI wizards to localize/customize implimentations, establish large scale resource hosting. Third step - design and develop advance GUI wizards to localize/customize implimentations and provide adminstrative support interfaces for tasks such as journaling management and database back-up.

by Peter Bodtke

=== Achieve United Nations NGO status ===
Brief description: complete any outstanding tasks or application steps to achieve recognized United Nations Non-governmental Organization status. Below are the published requirements:

What are the Criteria for NGOs to become associated with DPI? The NGO must support and respect the principles of the Charter of the UN and have a clear mission statement that is consistent with those principles; • The NGO must be recognized nationally or internationally; • The NGO should operate solely on a non-for-profit basis and have tax-exempt status; • The NGO must have the commitment and the means to conduct effective information programmes, with its constituents and to a broader audience about UN activities; • The NGO should have an established record of continuity of work for a minimum of three years and should show promise of sustained activity in the future; • The NGO should have a satisfactory record of collaboration with UN Information Centres/Services or other parts of the UN System prior to association; • The NGO should provide an audited annual financial statement, conducted by a qualified, independent accountant; • The NGO should have statutes/by-laws providing for a transparent process of making decisions, elections of officers and members of the Board of Directors.

Benefits: Raise the status and credibility of WorldVistA on an international level. NGO status will hopefully open doors to foreign governments and provide opportunities to collaborate with the World Health Organization.
by Peter Bodtke (to be detailed)

=== Standard Development Architect and Tools ===
by Peter Bodtke (to be detailed)

=== VistA Documentation Repository ===
by Peter Bodtke (to be detailed)

=== Educational materials / training materials / book ===
by Peter Bodtke (to be detailed)

=== VistA Demo Appliance V1.2 ===
(next iteration, including "VistA link", Vitals, Patient Registration GUI)
by Peter Bodtke (to be detailed)

=== Community surveys ===
* members skills and needs
* adopters registry
* integrators registry
by Peter Bodtke (to be detailed)

=== OpenForum (not sure what this project team had in mind) ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)

=== Billing Package ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== Configuration and Installation ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== Ambulatory Care Data Capture ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== WorldVistA EHR / VOE FAQs need to be updated ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== An information / press kit ===
* needed with key articles, links to demos, etc.
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== WorldVistA.org links to software need to be edited ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== Combine and edit SourceForge sites ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
combine (VOE project, WorldVistA EHR, WorldVistA, and VistAOutreach)
=== Add abstract/index and improve naming conventions for software ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)

Kevin Toppenberg (kdtop)
* Server data "Save As"... i.e. ability to export site-specific data, for import into another installation. This would make VistA analogous to Word, which could open, close, transfer, share etc. data sets.
* Better installation and configuration tools
* Enable CPRS to run on Linux

=== User Directory Registration ===
by Bob Olmedo
- a page where users can document who they are, what they are doing, lessons learned, contact info, etc.
 
(This functionality is supplied by http://members.worldvista.org , take a look at your account features. - PB)

=== Documentation - VistA for Dummies. ===
by Bob Olmedo
I think, we as technical people, assume the abilities of who is doing this.

=== Skype - use this tool as a support line. ===
by Bob Olmedo
For example, we travel all over Palm Beach County. My users have Skype accounts, we all have wireless cards, so when our users need us (wherever we are) they can ask for help. This same setup can be used to support users that can purchase a Platinum, Gold, Silver or Bronze support contract from WV (with volunteers on line).

Does anyone know who owns the Skype accout "'''worldvista'''"? (PB)

=== Newsletter ===
by Bob Olmedo
I know that there are several groups, including Ignacio's, but the WV needs a marketing venue.

=== Web-site advertising board ===
by Bob Olmedo
(generates revenue) $100/month (or what you decide) for a consultant to post their availability, this could be part of membership dues to be able to access this site, the person that hires the consultant can fill a "How did he do?" form that can help maintain the quality of service and consultants that are provided.

=== WebEx courses ===
I bought a 10 user unlimited WebEx account for $39.95/mo. and I'm using it to provide weekly classes that 10 users can register for. You can charge $25 a class - good return on the investment.
by Bob Olmedo

=== Corporate support ===
by Bob Olmedo
- leverage the CCHIT to contact different companies (Dell, IBM, etc). I am using Rackspace and trying to get a group discount for using them as a VistA ASP.

=== Grants ===
by Bob Olmedo
There are billions available in grant funding and we can send these out to our registered membership as a service. We can also offer grant writing as a service (there are grant writers out there that charge $5 - $10K).

=== WorldVistA Business Development ===
by Bob Olmedo
- create a business development group. Contact VAR's. (BO)
there is a fab wv biz dev group...of one. expand/grow the biz dev is closer to the need.
wv is in contact with many vendors, many of them are develpoment partners and will become the leading vars for wv ehr. are you thinking of a particular angle? (PB)

=== Develop training CD's ===
by Bob Olmedo
we are using a product called TurboDemo to create training CD's for our members. (DW)
i think he is talking about developing training content, not the need or choice in a tool (PB)

=== Develop a self installing CD for WV EHR for both Cache and GT.M ===
by Bob Olmedo
(it's not clear what Bob means as these exist already)(DW)
(I believe he is interested in production grade installers, WorldVistA EHR has not been released as of this writing...) (PB)

=== Interview groups that are using VistA ===
by Bob Olmedo
Contact groups that are using VistAin their clinics and interview them to gather information on what their experience. Build a reference list from this group and also add them to the User Directory.
=== CPRS - Clinical enhancements ===

A brief description: Extending CPRS to a more useful product, not only to include VA omissions necessary for non-VA use (as I understand WV is already doing, like billing and pediatrics); but to make it more relevant and supportive for clinicians. For example, CPRS has no flow-sheeting capabilities; these would be useful in a variety of settings; but particularly for in-patient care. Also a way to help with major management issues; out-patient anticoagulation for example, or diabetes management, or childhood growth charts, etc. I have made some of these to add onto the Portland VA’s CPRS system, so could provide some screen shots, etc. In this vein, I would like to see a members section for clinicians as WV rolls out, to discuss and prioritize enhancements to the product. The VA is slow to respond to these needs, WV should be more receptive, perhaps developing and testing in cycles to correspond to certification (which if I remember correctly, it was every 3 years), so that the product could grow and remain certified. Also, as you get more experienced with certification, you might get a feel for what minor enhancements can be made between cycles.

I originally thought these changes would (or could) be done by the venders, but both the certification issue, and the ability to make these changes available to the whole subscription base (as well as a source of revenue), it might be better to be part of WV operation.

If WV develops a team of programmers to do this, and to respond quickly to these needs, the product will be untouchable in the marketplace. The VA cannot do this due to their complex bureaucratic structure.
<ul>
<li>Benefit provided
<li>Better product
<li>Source of revenue
<li>Marketing tool; customers (especially the early adopters) will have input into product’s features.
</ul>
Your name: Robert Felder

===Wiki Expansion===
'''Brief description''': Expand scope of Wiki to cover informatics topics that are not (obviously) VistA-specific

'''Benefit provided''': Much of the material on the Wiki today is narrowly focused on VistA applications, APIs and such. It is understandable to want to keep the scope of the Wiki narrowly focused, but there are problems with being too narrowly focused. For example, important topics of general interest to the community (network administration, data modeling and database design, programming topics, ontologies, interfrace design, etc., are either not included at all or (more likely) treated incompletely with information scattered throughout the Wiki where it is difficult to find. Restructuring the Wiki and encouraging a more systematic treatment of informatics topics could enhance it's usefulness.

'''Your name''': [[User:GregWoodhouse|Greg Woodhouse]]

===Interoperable health data exchange===

''Description'':
In the futuristic movie Demolition Man, the only restaurant was Taco Bell. In our experience, we are seeing that Epic is looking to be the Taco Bell of electronic health records. One of the key issues we have faced with potential clients of the VistA is interoperability with local hospitals and providers who are using Epic and other EHRs. We can establish agreements to provide access to patient health data to local emergency rooms and hospitals using the read only functionality. We can’t, conversely, electronically access patient data of care rendered from other proprietary EHRs for continuity of care purposes. We need to establish a mechanism for health data exchange, including a master patient index and clinical data warehouse.
''Benefit provided'': Continuity of care, data standardization
''name'': Khadijah Rashada

===Patient Portal===
'''A brief description''' Bring the MyHealtheVet functionality to WorldVistA EHR
<ul>
<li>Obtain electronic copies of key portions of their electronic health records
<li>Have confidence that their health information is stored in a secure and private web environment
<li>Add structured medical information
<li>Track personal health metrics, such as blood pressure, blood sugar, weight, heart rate, and cholesterol
<li>Access a Health Education Library and health assessment tools
<li>Grant access to all or some of their health information to others, such as family other healthcare providers
<li>Send and receive electronic communication between patient and provider
</ul>
''Benefit provided ''
<ul>
<li>Patient has electronic access clinical data as well as provider interaction
<li>Your name (so we know who to ask for clarification -- anonymous posts are accepted.)
</ul>
''Name'': Khadijah Rashada

===GUI Interface===

'''Description''': All new development projects should be done with GUI interfaces. Existing roll & scroll interfaces should be converted to GUI interfaces as-soon-as possible

'''Benefit Provided''': GUI Interfaces will help WorldVista better compete with commercial EMR applications and help WorldVista gain more market share. It is also better for the end-user physicians and their staffs.

'''Name''': Ed Salvador

Queueing Reports~

2007-07-04T17:11:44Z

GregWoodhouse: Queueing Reports~ moved to Queuing Reports

#REDIRECT [[Queuing Reports]]

TLC~

2007-07-04T17:09:55Z

GregWoodhouse: TLC~ moved to TLC

#REDIRECT [[TLC]]

HB~

2007-07-04T17:08:38Z

GregWoodhouse: HB~ moved to HB

#REDIRECT [[HB]]

Thrombus~

2007-07-04T17:06:06Z

GregWoodhouse: Thrombus~ moved to Thrombus

#REDIRECT [[Thrombus]]

AGC~

2007-07-04T17:04:51Z

GregWoodhouse: AGC~ moved to AGC

#REDIRECT [[AGC]]

ADD~

2007-07-04T17:03:40Z

GregWoodhouse: ADD~ moved to ADD

#REDIRECT [[ADD]]

AHI~

2007-07-04T17:01:59Z

GregWoodhouse: AHI~ moved to AHI

#REDIRECT [[AHI]]

$~

2007-07-04T17:00:21Z

GregWoodhouse: $~ moved to $

#REDIRECT [[$]]

DG~

2007-07-04T16:57:20Z

GregWoodhouse: DG~ moved to DG

#REDIRECT [[DG]]

MUMPS Overview

2007-07-04T15:46:34Z

GregWoodhouse: add diacritical to Caché

There is a good article on Wikipedia about MUMPS:
http://en.wikipedia.org/wiki/MUMPS

=== Implementations and Vendors ===

It is important for new people to know the difference between the language and the implementation of the language. Vendors sell implementations of MUMPS. In the process, they are allowed to add commands, functions, and special variables to their implementation of the language. This does not increase what is in the language, but simply in their product.

Currently there are several active Vendors of MUMPS, and MUMPS-like languages.

A partial list includes:

{| cellpadding="2" border="1"
|+ MUMPS implementations
! Vendor
! Implementation
|-
| Intersystems
| Caché
|-
| Fidelity
| GT.M
|-
|}

* [[Common MUMPS Errors and What they Mean]]

* [[Ed de Moel]] has a good description of MUMPS language elements in his [http://www.jacquardsystems.com/Examples/index.htm MUMPS By Example] page.

If we think we need more details, we should add them here.

MUMPS Overview

2007-07-04T15:44:41Z

GregWoodhouse: fix table

There is a good article on Wikipedia about MUMPS:
http://en.wikipedia.org/wiki/MUMPS

=== Implementations and Vendors ===

It is important for new people to know the difference between the language and the implementation of the language. Vendors sell implementations of MUMPS. In the process, they are allowed to add commands, functions, and special variables to their implementation of the language. This does not increase what is in the language, but simply in their product.

Currently there are several active Vendors of MUMPS, and MUMPS-like languages.

A partial list includes:

{| cellpadding="2" border="1"
|+ MUMPS implementations
! Vendor
! Implementation
|-
| Intersystems
| Cache
|-
| Fidelity
| GT.M
|-
|}

* [[Common MUMPS Errors and What they Mean]]

* [[Ed de Moel]] has a good description of MUMPS language elements in his [http://www.jacquardsystems.com/Examples/index.htm MUMPS By Example] page.

If we think we need more details, we should add them here.

User:GregWoodhouse

2007-07-04T15:08:54Z

GregWoodhouse: adding category

Greg Woodhouse studied mathematics, where he received a bachelor's degree, with highest honors (1984), and a master's degree (1987) from the University of California, Santa Cruz. He then went on to work in software development as a member of the U.S. civil service. His primary focus is health information systems (computers in medicine), a field in which he has now worked for 15 years. His work has ranged from basic networking and database components, to message based interfaces, clinical notifications and financial subsystems. he was a cofounder of Hardhats (http://www.hardhats.org) and a participant in WorldvistA (http://www.worldvista.org), both of which are dedicated to developing and maintaining open source health information systems. He has a strong interest in computer science, mathematics and the physical sciences.

==Areas of Expertise==

*Computer networks and network programming
*Theory of computation and distributed computing
*Database theory
*Mathematical logic, models and languages

==VistA Knowledge==

*VistA infrastructure
**VA Fileman
**Kernel
**Messaging (HL7)

''(to be continued)''

[[Category:HomePage]]

SQL Overview

2007-07-04T14:30:58Z

GregWoodhouse: removed pejorative comment and added a little content

{{stub}}
SQL stands for Structured Query Language. It is an ANSI/ISO standard language for querying and otherwise working with [[relational database]]s. Although there is a standard for SQL, database vendors typically implement slightly different variants of the language (e.g., in terms of the data tpes supported). In addition, vendors often add procedural extensions to the language (e.g., PL/SQL for Oracle or Transact-SQL for SQL server).

Essentially, SQL is a language implementing the [[relational algebra]], adding features such as data types, tranasctions, support for indexes, and other features needed by a concrete database management system

Projects

2007-07-04T14:03:04Z

GregWoodhouse: add new item

Below find the unedited and unprioritized project idea submissions. The project is in process and open for new submissions. This iteration of project submissions will close on 07/06/2006.

== 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 and Greg Woodhouse are 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: Mailman email encryption using a widely accepted standard ===
Purpose: To allow transmission of patient related information securely via
email between VistA and other medical record system and between providers and
patients
Name: Nancy Anthracite

===Project: Enhancing CPRS===
'''Description''': Enhancing CPRS including working with providers and the system
architect to decide what enhancements should be made/incorporated in the WV
EHR gold standard CPRS and which might be optional for local modifications.
This includes developing a method for maintaining and integrating these
enhancements with future versions of CPRS from the VA. We have recently had
an increase in the number of volunteers interested in working on CPRS so that
this project has a much improved chance of success.

'''Name''': 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''': [[User:GregWoodhouse|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''': [[User:GregWoodhouse|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''': [[User:GregWoodhouse|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.

#Diagnose bugs e.g. an undef would be traced back to where the variable was last set or killed.
#Give it integrity constraints e.g. A is a number, and it stops when it is first violated, the source of the problem.
#Test live programs without changing live globals – all global changes are simulated only.
#Make sure all code is tested – tells you what lines were never executed and logical paths to get to them to test them.
#Improve efficiency e.g. variables set to the same value repeatedly in a loop.
#Diagnose infinite loops – tells you the range of code being executed and the FOR or GOTO that repeats.
#Tells you the net result of a subroutine (writes, global sets, local variables passed) to create documentation.
#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

=== Internationalization ===
Brief description: Provide language, date, currency, and support resources for non-English speaking users, both domestic and international. This would include an interface translation process for VistA and WorldVistA EHR systems, client interface translations, documentation translation, and organise a team of foriegn language speakers to communicate with and support non-English speaking users.
 
Benefit: Extend the reach of VistA and WorldVistA user population. Provide an effordable electronic health care to emerging countries.
 
by Peter Bodtke
(support foreign languages, i.e. Spanish)
Kevin Toppenberg (kdtop)
* Multiple language support (I am working on this)

=== Patch stream updating system ===
Brief description: As WorldVistA is now the steward of the WorldVistA EHR code a system needs to be designed to incorporate enhancements from the VA and the VistA community. The process requires an evaluation step, integration and testing. Finally, the system requires stable equipement to host the resources.
by Peter Bodtke (to be detailed)

What does this project need assistance to get started?

=== Marketing and Public Relations ===
by Peter Bodtke (to be detailed)
: WorldVistA organization and WorldVistA EHR VOE V1.0 software package

=== Installers (WorldVistA EHR VOE w/Registration GUI, VistA/G.TM/Linux) ===
Brief description: Develop a suite of installers/set-up files, to assist in copying VistA, WorldVistA EHR files and clients to servers and desktops. This is a multiple stage development effort. First step - define installer types/classes(production, educational, demostration), standardize deployment directories, learning installer tools and records clean-up (VistA). Second step - design and develop basic GUI wizards to localize/customize implimentations, establish large scale resource hosting. Third step - design and develop advance GUI wizards to localize/customize implimentations and provide adminstrative support interfaces for tasks such as journaling management and database back-up.

by Peter Bodtke

=== Achieve United Nations NGO status ===
Brief description: complete any outstanding tasks or application steps to achieve recognized United Nations Non-governmental Organization status. Below are the published requirements:

What are the Criteria for NGOs to become associated with DPI? The NGO must support and respect the principles of the Charter of the UN and have a clear mission statement that is consistent with those principles; • The NGO must be recognized nationally or internationally; • The NGO should operate solely on a non-for-profit basis and have tax-exempt status; • The NGO must have the commitment and the means to conduct effective information programmes, with its constituents and to a broader audience about UN activities; • The NGO should have an established record of continuity of work for a minimum of three years and should show promise of sustained activity in the future; • The NGO should have a satisfactory record of collaboration with UN Information Centres/Services or other parts of the UN System prior to association; • The NGO should provide an audited annual financial statement, conducted by a qualified, independent accountant; • The NGO should have statutes/by-laws providing for a transparent process of making decisions, elections of officers and members of the Board of Directors.

Benefits: Raise the status and credibility of WorldVistA on an international level. NGO status will hopefully open doors to foreign governments and provide opportunities to collaborate with the World Health Organization.
by Peter Bodtke (to be detailed)

=== Standard Development Architect and Tools ===
by Peter Bodtke (to be detailed)

=== VistA Documentation Repository ===
by Peter Bodtke (to be detailed)

=== Educational materials / training materials / book ===
by Peter Bodtke (to be detailed)

=== VistA Demo Appliance V1.2 ===
(next iteration, including "VistA link", Vitals, Patient Registration GUI)
by Peter Bodtke (to be detailed)

=== Community surveys ===
* members skills and needs
* adopters registry
* integrators registry
by Peter Bodtke (to be detailed)

=== OpenForum (not sure what this project team had in mind) ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)

=== Pediatrics Package (will IHS templates suffice?) ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== OB/GYN Package (will IHS templates suffice?) ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== Billing Package ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== Configuration and Installation ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== Ambulatory Care Data Capture ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== WorldVistA EHR / VOE FAQs need to be updated ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== An information / press kit ===
* needed with key articles, links to demos, etc.
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== WorldVistA.org links to software need to be edited ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
=== Combine and edit SourceForge sites ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)
combine (VOE project, WorldVistA EHR, WorldVistA, and VistAOutreach)
=== Add abstract/index and improve naming conventions for software ===
Project topic found on VistApedia (anonymous and other sources) (to be detailed)

Kevin Toppenberg (kdtop)
* Server data "Save As"... i.e. ability to export site-specific data, for import into another installation. This would make VistA analogous to Word, which could open, close, transfer, share etc. data sets.
* Better installation and configuration tools
* Enable CPRS to run on Linux

=== User Directory Registration ===
by Bob Olmedo
- a page where users can document who they are, what they are doing, lessons learned, contact info, etc.
 
(This functionality is supplied by http://members.worldvista.org , take a look at your account features. - PB)

=== Documentation - VistA for Dummies. ===
by Bob Olmedo
I think, we as technical people, assume the abilities of who is doing this.

=== Skype - use this tool as a support line. ===
by Bob Olmedo
For example, we travel all over Palm Beach County. My users have Skype accounts, we all have wireless cards, so when our users need us (wherever we are) they can ask for help. This same setup can be used to support users that can purchase a Platinum, Gold, Silver or Bronze support contract from WV (with volunteers on line).

=== Newsletter ===
by Bob Olmedo
I know that there are several groups, including Ignacio's, but the WV needs a marketing venue.

=== Web-site advertising board ===
by Bob Olmedo
(generates revenue) $100/month (or what you decide) for a consultant to post their availability, this could be part of membership dues to be able to access this site, the person that hires the consultant can fill a "How did he do?" form that can help maintain the quality of service and consultants that are provided.

=== WebEx courses ===
by Bob Olmedo
I bought a 10 user unlimited WebEx account for $39.95/mo. and I'm using it to provide weekly classes that 10 users can register for. You can charge $25 a class - good return on the investment.

=== Corporate support ===
by Bob Olmedo
- leverage the CCHIT to contact different companies (Dell, IBM, etc). I am using Rackspace and trying to get a group discount for using them as a VistA ASP.

=== Grants ===
by Bob Olmedo
there are billions available in grant funding and we can send these out to our registered membership as a service. We can also offer grant writing as a service (there are grant writers out there that charge $5 - $10K).

=== WorldVistA Business Development ===
by Bob Olmedo
- create a business development group. Contact VAR's. (BO)
there is a fab wv biz dev group...of one. expand/grow the biz dev is closer to the need.
wv is in contact with many vendors, many of them are develpoment partners and will become the leading vars for wv ehr. are you thinking of a particular angle? (PB)

=== Develop training CD's ===
by Bob Olmedo
we are using a product called TurboDemo to create training CD's for our members. (DW)
i think he is talking about developing training content, not the need or choice in a tool (PB)

=== Develop a self installing CD for WV EHR for both Cache and GT.M ===
by Bob Olmedo
(it's not clear what Bob means as these exist already)(DW)
(I believe he is interested in production grade installers, WorldVistA EHR has not been released as of this writing...) (PB)

=== Interview groups that are using VistA ===
by Bob Olmedo
Contact groups that are using VistAin their clinics and interview them to gather information on what their experience. Build a reference list from this group and also add them to the User Directory.
=== CPRS - Clinical enhancements ===

A brief description: Extending CPRS to a more useful product, not only to include VA omissions necessary for non-VA use (as I understand WV is already doing, like billing and pediatrics); but to make it more relevant and supportive for clinicians. For example, CPRS has no flow-sheeting capabilities; these would be useful in a variety of settings; but particularly for in-patient care. Also a way to help with major management issues; out-patient anticoagulation for example, or diabetes management, or childhood growth charts, etc. I have made some of these to add onto the Portland VA’s CPRS system, so could provide some screen shots, etc. In this vein, I would like to see a members section for clinicians as WV rolls out, to discuss and prioritize enhancements to the product. The VA is slow to respond to these needs, WV should be more receptive, perhaps developing and testing in cycles to correspond to certification (which if I remember correctly, it was every 3 years), so that the product could grow and remain certified. Also, as you get more experienced with certification, you might get a feel for what minor enhancements can be made between cycles.

I originally thought these changes would (or could) be done by the venders, but both the certification issue, and the ability to make these changes available to the whole subscription base (as well as a source of revenue), it might be better to be part of WV operation.

If WV develops a team of programmers to do this, and to respond quickly to these needs, the product will be untouchable in the marketplace. The VA cannot do this due to their complex bureaucratic structure.
<ul>
<li>Benefit provided
<li>Better product
<li>Source of revenue
<li>Marketing tool; customers (especially the early adopters) will have input into product’s features.
</ul>
Your name: Robert Felder

===Wiki Expansion===
'''Brief description''': Expand scope of Wiki to cover informatics topics that are not (obviously) VistA-specific

'''Benefit provided''': Much of the material on the Wiki today is narrowly focused on VistA applications, APIs and such. It is understandable to want to keep the scope of the Wiki narrowly focused, but there are problems with being too narrowly focused. For example, important topics of general interest to the community (network administration, data modeling and database design, programming topics, ontologies, interfrace design, etc., are either not included at all or (more likely) treated incompletely with information scattered throughout the Wiki where it is difficult to find. Restructuring the Wiki and encouraging a more systematic treatment of informatics topics could enhance it's usefulness.

'''Your name''': [[User:GregWoodhouse|Greg Woodhouse]]

2007-07-03T21:43:57Z

GregWoodhouse: adding bio