Warren: VISTA is here to stay

The Pentagon eliminated a bid for an open-source health record solution based on the VISTA software developed by the Department of Veterans Affairs from its $11 billion electronic health record procurement, but that doesn't mean VA is going to shift gears in the future.

"I do not see the VA moving away from VISTA," Steph Warren, acting CIO at the VA, said on a March 19 call with reporters.

Warren said VISTA is inseparable from the VA's workflow. "It's not a tool they have to grasp for. It's how they do their care. It's focused on veterans and patients. It's not about insurance revenue capture, it's not about cost capture, it's not about reimbursement, which in some cases is the core premise for other systems. I'm hard pressed to make the case that we should walk away [from VISTA]," he said.

After shelving plans to develop a single, shared records system, the VA and the DOD have been making strides to get their systems to interoperate, so that data on one system can be read by the other. The Janus Joint Legacy Viewer system, a cloud-based translator that allows data to be accessed by caregivers in DOD and VA health centers. Data can also be viewed by third-party providers.

"There's a lot of data there. It's not necessarily as easily reached as it needs to be. The interface is not as smooth as it needs to be," Warren said.  The question now, Warren said, is "how do we move from a viewer to an interactive [system] where you can fire off orders."

The Janus viewer is an intermediate step along the way to what the VA calls its Enterprise Health Management Platform, which integrates the data from cooperating systems, including DoD and private providers, and "sets up the widgets so the clinician can do the appropriate workflows, and tune it for their particular specialties," Warren said.

The pending move by DoD to a system based on a commercial health record system -- and bids using Epic, Cerner, and Allscripts are still in play -- isn't going to alter the fundamental data sharing relationship between VA and the military, Warren said. "Yes, the DoD is getting a new presentation layer and a new back end, but the connection between us is in place," Warren told reporters. "We're going to make sure the data keeps flowing back and forth between us as we evolve, and they replace."