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The VA VistA system is not bad and sure like any software needs constant updates and there are different from ends that can function well with the VA back end, Medsphere is one who created a commercial VistA system, and the VA is working on a web based VistA system. I'll defend the IT folks here a bit as I'm sure they have a burial ground of all kinds of software sandboxes that didn't work, meet specifications and so on or maybe were too just cost prohibitive. Here's another perspective on the VA Scheduler from someone who wrote an EMR years ago and my take on some of this..not making it right but a different angle if you will. With the FBI now it is a who dunnit deal, who spread the bug in the scheduler through out the system and if I were on the IT team with this, I would be mad in the fact that nobody told me, but users will be users.


When you talk about integrating VA with DOD ALTHA medical records system, now you have something very different going on as DOD "likes" their EMR and for good reason as it's been a while since I've seen ALTHA but they have items in there that do not exist in the VA system, i.e. battleground care, etc. It's designed different but the over all meds and general medical data is all there as well.

DOD 4 years ago created an EMR for the White House too. So when you talk integrating the two systems it's a lot of work and time and money. Like I said DOD likes their system as it works. There are also some smaller commercial EMR installations with DOD too that integrate with the ALTHA system. Everyone talks about the VA but never ALTHA DOD EMR.

I'm watching this too as when you buy the Epic system if you want analytics you also have to purchase a Clarity server and that's more money too, aahhh..a few Epic buyers find this out later when they need more analytics than what comes with Epic, Kaiser did and that's what they run and I don't know even if Kaiser has their analytics in real time yet but that's how the reports synch via their facilities.

So Clarity server if you want big time analytics like everyone does today, well there's more cost on top of the Epic System and Kaiser bought and developed their Clarity server apps and functionalities separate from Epic. Middleware is what they need and you can read about this killer product as it also uses a Clarity server in the cloud and sits on top of any EMR and any system can communicate..keep your eyes open as this is the new HIE..programmer is sharp and was product manager fro BEA software years ago and is a full on engineer who's products were sold to Oracle a few years ago and became weblogic server and more. I'll be doing an updated post on them again soon. I only found them as I read about their product and they called me and said I was the only blogger that wrote it up correctly and again that goes back to my hands on days of writing an EMR.


I shared this with an engineer friend at Microsoft and he took big notes as there's nothing out there like this and yes it's in beta at a hospital as well with a couple oncologists and can connect patients as well to let's say a couple doctors looking at the chart at the same time if they want.

I don't always tell the best stories when writing articles or blog posts but I do give you reality I hope in a way you can understand.

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