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.

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:

Chris Richardson (to be detailed)

• Training Ideas - Tools, Teachers, and Techniques
• I18N (Internationalization) - Issues and Answers
• Transport of Medical and Health Records
• Post-Traumatic Stress Disorder - Developments and Impacts
• New Organizations, MDC (new) and VDC (even newer)
• Ontologies and how VistA fits in with them.

Nancy Anthracite

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



If Fred Trotter does not post these

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: 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: 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

Hopefully, George Welch or someone else will post this.

Project: Scheduling GUI
Description; Completion of the scheduling GUI started by George Welch written
in Delphi.

Greg Woodhouse

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 and expansion of vitals package to include OB and Peds parameters

OB flow sheets (ACOG style)

Reconfigure prescription autofinish to pipe data to windows printer instead of VistA drivers

·         A brief description

Need Head Circ, Fundal height, (See IHS vitals)

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.

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. 

 

·         Benefit provided 

Peds functionality

OB functionality

True Fax functionality

·         Your name (so we know who to ask for clarification -- anonymous posts are accepted.) Matthew King

·         Email address (optional) mking@clinicaadelante.com



Charles Volkstorf

I. Intelligent Database of VISTA Global and Routine Documentation
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. 

II. Program Execution Simulator
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

·         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

Peter Bodtke (to be detailed)

• Internationalization (support foreign languages, i.e. Spanish) 
• Patch stream updating system (does this project need assistance?)
• Marketing and Public Relations: WorldVistA organization and WorldVistA EHR VOE V1.0 software package
• Installers (WorldVistA EHR VOE w/Registration GUI, VistA/G.TM/Linux)
• Integration - localization interface wizards
• Achieve United Nations NGO status
• Standard Development Architect and Tools
• VistA Documentation Repository
• Educational materials / training materials / book
• VistA Demo Appliance V1.2 (next iteration, including "VistA link", Vitals, Patient Registration GUI)
• Community surveys (members skills and needs, adopters registry, integrators registry)

Project topic found on VistApedia (anonymous and other sources) (to be detailed)

• OpenForum (not sure what this project team had in mind)
• Pediatrics Package (will IHS templates suffice?)
• OB/GYN Package (will IHS templates suffice?)
• Billing Package
• Configuration and Installation
• Ambulatory Care Data Capture
• WorldVistA EHR / VOE FAQs need to be updated
• An information / press kit is needed with key articles, links to demos, etc.
• WorldVistA.org links to software need to be edited
• Combine and edit SourceForge sites (VOE project, WorldVistA EHR, WorldVistA, and VistAOutreach) Add abstract/index and improve naming conventions for software

Kevin Toppenberg (kdtop)

• Multiple language support (I am working on this) 
• 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