Implementing the Open Source WorldVistA EHR in a Community Health Center Network: One Clinic's Experience

With the corporatization of hospitals across the globe, integrated electronic health systems are becoming the need of the hour. This paper discusses the Veteran Administration's Health Information System and Technical Architecture (VistA), an electronic health system that is being used by more than 1.3 million patients in the VA systems. The system is more prominently being used in Mexico, Sweden, Finland, India and Germany. VistA started to be used in VA medical centers and was obtained from the VA through the Freedom Of Information Act (FOIA). It was then modified by the Pacific Telehealth & Technology Hui Group and was supported by a grant from the Centers for Medicare and Medicaid Services. In 2007, community health center Clinica Adelante Inc (CAI), from Arizona, adapted the WorldVistA through an EHR demonstration project. This paper discusses CAI's implementation of VistA EHR in the context of a community health center. The paper delves on the advantages of using VistA in a community health center and talks about lessons that have been learnt during implementation along with the challenges faced. The paper also discusses the uses of VistA for chronic care and planned care management along with quality improvement, data mining, and quality incentives. The CAI community health center has seven sites and two mobile rural health teams comprising 26 providers. They provide services of family medicine, internal medicine, obstetrics and gynaecology, paediatrics, and dentistry.