The Department of Veterans Affairs has launched an initiative to replace the medical-scheduling component of its electronic health record platform and is requesting proposals for how to update and rebuild the application.
The Medical Scheduling Package (MSP) is part of the VA's Veterans Health Information Systems and Technology Architecture (VistA) EHR platform. VistA manages the clinical data for patients throughout the VA health system.
Serving more than 8.3 million veterans per year, the Veterans Health Administration (VHA) is the largest integrated health system in the United States, the VA reports.
More than 25 years old, the current medical-scheduling application is unable to manage the complexities of multiple business processes, according to the VA.
The VA aims to make data from multiple VistA health centers interoperable rather than keep data separate and provide a single view of patient scheduling as well as clinical histories. Multiple locations would be able to schedule patient appointments.
On Dec. 21 at the Federal Business Opportunities site, the VA issued a request for information (RFI) to replace the medical-scheduling package.
Despite the goals of interoperability, "reconciling these separate systems into a single instance will not occur in the near-term future," the RFI states.
The department plans to allow doctors and patients to schedule appointments in the new application on a mobile device or in a Web browser.
"There is significant growth in the younger veteran population that is comfortable using Web-enabled technology and expects to be able to do business online," said the VA. "Other veterans prefer traditional methods of engaging with VA."
A new medical-scheduling system should also be able to handle the secure communications the VA requires. A previous attempt to redesign the MSP cost more than $127 million, according to the VA.
The government uses data in the MSP to measure and manage care access for veterans. The MSP also manages capital resources for VA health care.
A new medical-scheduling application would be able to better link patients, clinicians and supplementary health care services and create new ways to deliver clinical care, the VA reports.
"We envision a scheduling system which is a standards-based, modular, extensible and scalable package, certified as compliant and fully interoperable with the 'golden' version of VistA now held by the Open Source Electronic Health Record Agent (OSEHRA)," said the VA.
The VA launched OSEHRA to increase innovation for its EHR applications using open-source software development as it merges VistA into a joint platform with the Department of Defense.
With its open-source framework, the VistA EHR platform comprises more than 100 applications.
A new MSP would be able to support the virtual telehealth sessions that the VA conducts with patients in remote areas. On Nov. 4, the VA announced an agreement with American Well to provide Web visits through the vendor's Online Care service, which uses two-way video, secure text chat and/or phone.
The VA plans a phased approach to implementing the new medical-scheduling application, with nonscheduling data being the primary data source.
In the first phase, the VA would automate business rules for scheduling and link appointments for in-facility and telehealth visits as well as allow veterans to interact with the database over the Web or on a mobile device.
In the second phase, the VA would remove the current scheduling application and allow for data sources to be VA-wide.
The VA has set a deadline of Jan. 31 for interested vendors to submit proposals for building the new medical-scheduling application for VistA.