Project Proposal: An NHS VistA cloud instance use case scenario (disruptive non-coercive parallel implementation of an EMR :-)
Carl Reynolds
The key to health informatics going forward is to be found in re-
engineered (open source) VA VistA HIT based personalization,
commoditization and standardization of nationwide, not-for-profit
medical records and globalized database modeling of health
information, on throw-away mobile hardware and telephony hosted in the
Cloud.
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http://usasinglepayeroption.com/2011/07/occupy-health-care-occupy-healthcare-occupy-wall-street-health-care-health-information-technology/
I've just been having a play with the Open Vista VMware appliance
http://medsphere.org/community/project/openvista-appliance and it got
me thinking.
As I may have mentioned before I think NHS health IT innovation needs
accelerating. It's not good enough at present and this has the
unfortunate consequence of meaning more patient harm, less time with
patients, and less money to spend on patient care, than there needs to
be.
I firmly believe open source solutions are a big part of the answer
(cheaper in the long run, rapid diffusion, rapid development)
I firmly believe in taking action to speed up this needed improvement.
One thing I'd like to see asap is an NHS VistA (www.nhsvista.net)
pilot.
But how to make this happen?
Having a nice NHS Vista Cloud instance to hack on might be a nice
start. One could also imagine a nice pilot on an MAU where patients
were consented by an enthusiastic VistA promoter to let their docs be
in a trial of using Vista.
Business initially continues as usual in that paper notes are
maintained by printing stuff put into the EMR and filing it in the
notes. But docs are given the option of entering (without a pen!!!)
and viewing info using the EMR on their phones and/or tablets and the
hospital computers.
Notice that this implementation would require nothing of the hospital
except computers with a internet connection and printers (to keep the
paper record bit going).
Thoughts?
Best, Carl
v...@doctors.org.uk
Proof of Concepts make for good write ups: user opinion, screenshots etc.
The tricky bit will be Caldicott and the IG. You'll probably need the patients to "sign" up and think through how to provide evidence of destruction of records at the end of the pilot.
If a patient retracts consent, how is data *securely* destroyed?
VJ
v...@doctors.org.uk
Other thoughts, not be mistakened for negativity but a positive proactive attitude:
If it's off N3 then firewalls won't be an issue.
Who admins user names, passwords etc. I.e. who System Manages this?
If I was designing a system, I'd not use passwords at all. Maybe a two token system like VPN, rather than passwords?
VJ
ben bray
Rob Dyke
---Snip
Rob Dyke
Carl Reynolds
get something fit to be deployed though
Ben, agree target important. I know Ireland are v.interested in VistA
at them moment. Foundation trusts are also likely to be a little more
willing to embrace tech/take risk (personally don't think it's a
particularly risky thing to try but it's new and that = risky in many
institutions)
Rob, thank you for your kind offer. Programmer resource will be most
needed in the first instance I think....
Best, Carl
On Dec 14, 5:51 pm, Rob Dyke <robd...@gmail.com> wrote:
> My business has N3 connection, servers, 2FA services, IGSoC policies and
> (nearly) ISO27001. We are already hosting clinical systems for Primary &
> Secondary care settings and are working on software for
> Acutes<http://wardware.info/>too.
>
> We are chockablocka right now.... but in the New Year will be willing and
> able to *give* resources to this endeavour (although money is also helpful!)
>
> BW, Rob
>
> On Wed, Dec 14, 2011 at 3:32 PM, vjjoshi...@gmail.com <v...@doctors.org.uk>wrote:
>
>
>
>
>
>
>
> > I should expand: who will host the cloud and how do you evidence data
> > destruction in such an arrangement?
>
> > Other thoughts, not be mistakened for negativity but a positive proactive
> > attitude:
>
> > If it's off N3 then firewalls won't be an issue.
> > Who admins user names, passwords etc. I.e. who System Manages this?
> > If I was designing a system, I'd not use passwords at all. Maybe a two
> > token system like VPN, rather than passwords?
>
> > VJ
>
> > "vjjoshi...@gmail.com" <v...@doctors.org.uk> wrote:
>
> >> Good idea for a pilot.
>
> >> Proof of Concepts make for good write ups: user opinion, screenshots etc.
>
> >> The tricky bit will be Caldicott and the IG. You'll probably need the
> >> patients to "sign" up and think through how to provide evidence of
> >> destruction of records at the end of the pilot.
>
> >> If a patient retracts consent, how is data *securely* destroyed?
>
> >> VJ
>
> >> Carl Reynolds <drc...@gmail.com> wrote:
>
> >>> ---Snip
> >>> The key to health informatics going forward is to be found in re-
> >>> engineered (open source) VA VistA HIT based personalization,
> >>> commoditization and standardization of nationwide, not-for-profit
> >>> medical records and globalized database modeling of health
> >>> information, on throw-away mobile hardware and telephony hosted in the
> >>> Cloud.
> >>> ------
> >>>http://usasinglepayeroption.com/2011/07/occupy-health-care-occupy-hea...
>
> >>> I've just been having a play with the Open Vista VMware appliance
> >>>http://medsphere.org/community/project/openvista-applianceand it got
Carl Reynolds
Love this idea - have been thinking about how to get a sandbox system
up and running for a while so that it can be used as a demonstrator
and to debunk the myths and concerns that get raised when discussing
this with people.
I recently spoke to the CIO at Imperial Trust where I work about
whether he'd be interested to support such a thing - and he's
definitely interested, subject to a minimal (i.e. zero) cost
implication for the Trust (understandable given the Trust's financial
position). But it occurs to me that the name of a big AHSC behind our
little project could give it even more credibility. We just need to
find a way to finance it...
Open to any and all suggestions...
DTC
Joseph Dal Molin
demonstrator at zero cost depending on how it is hosted. We can help
install a copy of the VA's demo system which is fairly well configured
and has a decent number of patients in it. It is used as the training
system for the VA's VistA University (VEHU) which is run once a year.
The other option is installing a copy of the instance of WorldVistA EHR
server which WorldVistA used to pass the US EHR certification process
for meaningful use, which also has sample patient data in it. If I may
put in a selfish plug, WorldVistA EHR is the most widely implemented
version outside the US: Jordan, Thailand, India and Mexico, and is GPL
and can be supported by anyone who has or develops the capability to do
so like Jordan did.
The devil is in the details and it is important to understand there is a
limit to what you can demonstrate without going deeper into
configuration or actually implementing the system. For example you
cannot demo BCMA (bar code medication administration) nor VistA Imaging
capability.
Cheers,
Joseph
Joseph Dal Molin
President, E-cology Corp.
Chairman, WorldVistA
Tel: +1.416.232.1206
Skype: dalmolin
Carl Reynolds
An interesting article on MUMPS courtesy of Geraint
Best, Carl
On Dec 15 2011, 5:06 pm, Joseph Dal Molin <dalmo...@e-cology.ca>
wrote:
>
> - Show quoted text -
Carl Reynolds
Just got round to watching Joseph's excellent lecture at John Hopkins
on VistA and the Jordan project, recommend it!
Best, Carl
On Feb 3, 8:05 am, Carl Reynolds <drc...@gmail.com> wrote:
> http://opensource.com/health/12/2/join-m-revolution
>
> An interesting article on MUMPS courtesy of Geraint
>
> Best, Carl
>
>
>
>
>
>
>
>
> > There are a couple of options for implementing a decent sandbox
> > demonstrator at zero cost depending on how it is hosted. We can help
> > install a copy of the VA's demo system which is fairly well configured
> > and has a decent number of patients in it. It is used as the training
> > system for the VA's VistA University (VEHU) which is run once a year.
> > The other option is installing a copy of the instance of WorldVistA EHR
> > server which WorldVistA used to pass the US EHR certification process
> > for meaningful use, which also has sample patient data in it. If I may
> > put in a selfish plug, WorldVistA EHR is the most widely implemented
> > version outside the US:Jordan, Thailand, India and Mexico, and is GPL
> > and can be supported by anyone who has or develops the capability to do
> > so likeJordandid.
>
> > The devil is in the details and it is important to understand there is a
> > limit to what you can demonstrate without going deeper into
> > configuration or actually implementing the system. For example you
> > cannot demo BCMA (bar code medication administration) nor VistA Imaging
> > capability.
>
> > Cheers,
>
> >Joseph
>