VistA and eClinical, Research Paper Example

Introduction

Electronic health records (EHR) system has emerged into an integral aspect of twenty-first century health care delivery process. It is a necessary invention replacing cumbersome paper files, cabinets and eligible doctors’ orders with sophisticated computerized databased collection strategies. This brings the medical profession in alignment with other technological developments occurring in the world of work across the globe. Implementation of electronic medical records databases in doctors’ offices, and other health care institutions has created a systematic information storage mechanism. Essentially, the mechanism facilities sharing of patient information within and beyond institutions to health care providers across a network of services (Traynor, 2008).

Small businesses can access ‘Personally Controlled Electronic Health Record (PCEHR).’ systems. This type of EHR allows storage of admission files/patient information as well as event summaries in specific formats. These features incorporate easy articulation for doctors, GPs, pharmacists , nurses, specialists and other care providers to retrieve pateints’ records without requesting written scripts from these additional patient care providers (Traynor, 2008).

A great advantge to small business is that once the other health care providers agree to t and comply with HIPPA standards and regulations pateints records are easily accessed through the sharing mechanisms implicit in the database designs. The storage and retrieval process ensures a lifetime worth of clinical and demographic patient data, which might have otherwise been lost with the traditional paper and file cabinet storage systems. Hence, EHR is a superb data preservation strategy (Traynor, 2008).

Background

VistA

VistA refers to the Veterans Health Information Systems and Technology Architecture (VistA). This system is described as an enterprise- wide information technology electronic health record system utilized in the United States Department of Veteran Affairs (VA) medical network. It is also called the Veteran health Administration (VHA) consisting of one hundred and 60 software modules integrated to execute clinical care, infrastructural and financial functions. It is one of the largest medical record systems in United States of America (Douglas, 2007).

Importantly, VistA caters for 8 million veterans’ health care. There is a total of 180,000 medical staff functioning within a network of 163 hospitals; an estimated 800 clinics, and 135 nursing homes across continental America, Alaska, and Hawaii. One electronic health record system operates across this network. Interestingly, an approximately 25% of Americans have eligible potential for Veteran health care services being either veterans or family members of veterans (Douglas, 2007).

Physicians who work with VistA are American trained doctors rotating through VHA as clinical electives. As such, currently VistA is now the mostly used electronic health record system in America. Its software is most user friendly above all other electronic health record devices used in American in other health care delivery industries (Douglas, 2007).

eClinical

eClincal Installs is a medical record hardware application aligned to  eClinicalWorks (vendor) since 2004. The vendors offer IT healthcare hardware support; implementation services; deployment for 35 medical practices provider in South Florida, America, for what is considered world class EHR system. eClincal has emerged into the Preferred IT installer for eClinicalWorks ( eClinical, 2014)

Since the vendor is the only one of its kind in South Florida it is committed to engaging patronage of health care providers inclusive of hospitals; nursing homes; assisted living facilities; clinics and related health service participants such as physical therapists and alternative medicine specialist. The vendor installs and supports the HER system. The company boasts of its adequate resources capable of maintaining implementation process making sure that the eClincal system functions effectively (eClinical, 2014).

Comparison

Without getting into the details already it has been established regarding available resources for executing an efficient electronic health record VistA is far ahead in electronic health record dispensation than eClinical, which is a provider only in South Florida. VistA is almost an international electronic record network connecting vetinary health care across America.

Data Housing (Required): VistA maintains a data warehouse described as the decentralized hospital computer program (DHCP). This database stores both ambulatory and inpatient information. The graphical user interface allows providers/clinicians to deposit information through a computerized patient record system (CPRS).eClincal did not offer any specifics regarding this feature in their implementation process and what vendors are capable of offering providers in Florida. The information was geared towards advertising a product.

Remote Hosting: VistA again is way ahead of eClinical in this feature too. Due to the extent of the electronic technology network remote hosting becomes inevitable. A client server interface allows for providers/ clinicians to place orders for medications, X-rays, laboratory tests; nursing interventions, diets, and special procedures.

Local Hosting, etc: eClicnal did not explain a specific loop-back feature in their hardware services. However, VistA local hosting features were not disclosed, but with an extensive electronic network as it is there must be a domain whereby access could be gained to the system through ‘loopback interface bypasses of the local network interface hardware’ (Douglas, 2007, p. 276).

Patient Portal Ability: In the electronic health records science this refers to the ability of a software feature to expose patient information when needed. eClinicalWorks EMR promises on-site as well as patient record remote access. This includes previous visits; medical history, medications, allergies and labs and more. VistA has established strategies that facilitate access to patients’ records in alignment with HIPPA regulation’s according to relevant software applications. For example, MyHealtheVet portal allows veterans to view and update their personal health information; schedule appointments and refill prescriptions. They can also send information outside of the VA health network and keep copies of their health records (Douglas, 2007).

Data Extraction: This refers to retrieving data from poorly constructed or unstructured databases.  However, both VistA and eClincal have well designed electronic record systems. As such, in this case it means providers/clinicians’ ability to retrieve data when needed.  eClincal promises state of the art data extraction features, but have not specified any distinctively. VistA has software responsible for patient data exchange (PDX); remote procedure call (RPC) broker; resource usage monitor and single signon/user context (SSO/UC) (Douglas, 2007).

Training

VistA, certainly is an extensive electronic health record system being the largest in the country and world employees must undergo a period of training during their job orientation. This is onsite where ever the employee is assigned to work. As transfers occur within the tour of duty additional training is continuous. eClinical training is through a small video and support from the vendor.

Conclusion

A major strength in VistA electronic health record system are its district features address some major as well as minute elements in electronic health record delivery. Ownership of the system seems to have an influence into how extensive and effective services are available ton host agencies. eClincal services only one state while VistA is responsible for veterans and their families nationwide. Besides, eClincal has started its operations in 2004 and VistA has been in the electronic record business since in the 1990s.Obviously, my platform choices would be those associated with VistA’s  EHR coverage.

References

eClinical works (2014).Electronic health records. Retrieved on July 25th ,  2014 from http://www.eclinicalinstalls.com/

Douglas, G. (2007). Medical informatics 20/20 (Case Studies of VistA Implementation United States and International) p. 276. Jones & Bartlett Learning

Traynor, K. (2008). National health information network passes live test. American Journal of  Health-System Pharmacy,  65 (22); 2086–2087