Tips on Open Source EHR Systems within the Safety Net Community:

A WorldVistA EHR Update

HRSA Health IT and Quality Webinar

February 10, 2011By

Matthew M King, MD

Open Source WorldVistA EHR Implementation

Advantages Challenges Safety Net Update

Edgeware PMS and Billing Chronic Disease Management Meaningful Use in WV EHR UDS reporting from WV EHR CPRS Client Advances

Open Source Implementation: Advantages

Evidenced based, high quality system Flexibility in Scale and Deployment Missions Highly configurable by user Cost Familiar to many new graduates No “Vendor lock”

Challenges of WV Implementation

Available free versions are not configured Billions were spent on functionality; zero was

spent on “eye candy” Not well advertised or packaged Only a few vendors available right now All EHR implementations are difficult, so is WV.

Some of those routine problems may be “blamed” on open source

What's new in WorldVistA for the Safety Net?

Edgeware PMS and Billing is available Registration Appointments Patient in office tracking monitor Sliding fee management, insurance, copays Manual and electronic billing GUI based MySql/Java

TMG-CPRS is available

Powerful Patient SearchCombine multiple search terms– one on each line

Value field will change to match field value: Date picker, record picker, set picker, or free textRange searches are allowed

Web Tabs Allow Integrated Content

{OBJ:... With Math from User Input• User input can be modified by mathematical formulas as part of parameter passing. Example:

Enter value: {FLD:WEIGHT-LB}Here is the Amoxil Dose: {OBJ:TMG DOSE KG{FN:[FLD:1:WEIGHT-LB]/2.2}}

• Let’s say, for example, the user entered 30(lbs)

• [FLD:1:WEIGHT-LB]USER INPUT (“30”)

• {FN:30/2.2} 13.636 (kg)

• {OBJ:TMG DOSE KG {13.636} passed to server• Server code can return dose based on patient’s kg wt, e.g. “545 mg”

Chronic Disease Management in WorldVista

VistA is a particularly good EHR for CDM Chronic Disease Reminders Chronic Disease Templates Chronic Disease Order Sets Chronic Disease Reports

Meaningful Use and WorldVistA

Expect Certification in May or June WV is already certified by CMS for use in the

PQRI data reporting program The tools for CDM are easily adapted for

meaningful use Hypertension Example

WorldVistA and UDS Reporting

Tables Zip through 7 with a single click Export to Excel Requires operational changes to ensure all

information is in the EHR

Thank you.

Questions will be answered after last speaker is finished.