VAs EHR System Wins Harvard Award

The Veterans Affairs Department was honored for its extensive electronic medical record system, known as VistA. The system is credited with bringing veterans the "highest quality, lowest cost medical care in the country."

Harvard Universitys Kennedy School of Government singled out an electronic health information system for praise this week.

The Veterans Affairs Department was honored for its extensive electronic medical record system, known as VistA (Veterans Health Information Systems and Technology Architecture). The system is used at 1,400 VA health care facilities nationwide.

The VA was one of seven government initiatives chosen for the annual Innovations in American Government Award.

"This programs decentralized, flexible approach has made our veterans the recipients of the highest quality, lowest cost medical care in the country," said Stephen Goldsmith, director of the Innovations in American Government Award at Harvards Ash Institute.

The software stores veterans health care records electronically and makes them easier to share among clinics.

It also uses a bar-code system to make sure medications are given to the right patient at the right time.

A statement from the Veterans Affairs Department said that the VA is actually reducing costs and errors even as U.S. health care costs outside the system continue to soar.

"The cost of maintaining the system is $80 per patient per year, less than the cost of one unnecessarily repeated lab test.

"The involvement of front-line providers, use of performance measures and universal use of electronic health records have enabled VA to set the national benchmark in quality of care," said Dr. Jonathan Perlin, VA Under Secretary for Health.

Though the VA has made VistA software available to other hospitals and health care facilities at a low cost, most hospitals and doctors offices opt for commercial software when they install electronic medical records.

Many health IT experts say that VistA, designed to handle records of millions of veterans, is not flexible enough to accommodate variation at their hospitals and that commercial vendors provide more support.

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However, other health IT experts say that the open-source software will encourage more physicians to adopt electronic health records, albeit slowly.

In July 2005, the CMS (Centers for Medicare and Medicaid Services) announced that it would supply a stripped-down version of the software, called VistA office, for free to physician offices. However, it did not help with installation or support.

Physicians were slow to take up the offer, and CMS ended up releasing an evaluation version for beta-testing last September. Participating offices pay small fees to obtain copies of the software plus licensing and support fees for the database program and billing codes.

The $100,000 innovation awards are intended to help programs share information with others.

When announcing the award, the VA said it would disseminate information and provide demonstrations of VistA at its medical centers across the country, but did not mention the Medicare program specifically.

The 2006 award winners were selected from an initial pool of 1,000 applicants. They include two federal, two state, one county and two municipal programs. The efforts improve conservation, health care, housing, education, social services and law enforcement.

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