Projects

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: 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

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: Greg Woodhouse

Project title: HL7v3

Brief descriptionDevelop an implementation of HL7 version 3

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

Your name: Greg Woodhouse

Project title : Peds Growth Charts

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

OB flow sheets (ACOG style)

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

Prescription Autofinish

Use Microsoft Windows Printers

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

True Fax functionality

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

Additional Vitals Measurments

Need Head Circumference
Need Fundal height
(See IHS vitals)

by Matthew King

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)

VistA Documentation Repository

Brief Description: Design, develop and moderate a VistA and WorldVistA E.H.R. documentation repository. Such a repository could be a collection of reference materials and practical guides for users and developers. The design and implantation would exceed the value of the Veterans Administration’s “VistA Documentation Library” (VDL) or there would be no need for this repository. The materials ideally would be reviewed for accuracy and quality before publication. An index of URL could be prepared for material is published on the Internet which is not available for inclusion in this proposed repository. Collaboration with the current major repositories (VDL, HUI, etc.) would need to be partnered with to make this a successful project.

Benefits: Provide a single source of accurate and reviewed information. Create a single starting point for all adopter, implementers, students, developers, venders, consultants, evaluators, etc.

by Peter Bodtke

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)