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The VA and VistA: A Role Model for Radical Improvement of Health Systems Everywhere

The VA and VistA: A Role Model for Radical Improvement of Health Systems Everywhere. Phillip Longman Senior Research Fellow New America Foundation Senior Fellow Washington Monthly Longman@newamerica.net. Tom Cruise’s depiction of life in a Bronx VA Hospital, 1989

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The VA and VistA: A Role Model for Radical Improvement of Health Systems Everywhere

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  1. The VA and VistA: A Role Model for Radical Improvement of Health Systems Everywhere • Phillip Longman • Senior Research Fellow • New America Foundation • Senior Fellow • Washington Monthly • Longman@newamerica.net

  2. Tom Cruise’s depiction of life in a Bronx VA Hospital, 1989 Sample dialogue: This place is a f***ing slum!

  3. “ . . . Overall, VHA patients receive better care than patients in other settings” Articles About VA’s Quality Revolution

  4. Elements of VA Quality Revolution • Fully integrated, patient-centered, evidence-based care. • Focus on wellness, prevention, and effective disease management. • Low rates of medical error. • Realized economies of scale (drugs, medical supplies and devices) • Low cost per patient. • High rates of patient of satisfaction.

  5. The History of the Hard Hats • Deviant • Secretive • Insubordinate • Persecuted • Persevering • Triumphant • Unsung

  6. “There is no reason for any person to have a computer in their home” ~Ken Olson, President, Digital Equipment Corporation, at the Convention of the World Future Society, 1977.

  7. Wally Fort

  8. George Timson - 1980

  9. Got MUMPS? • MUMPS (Massachusetts General Hospital Utility Multi-Programming System), or alternatively M, is a programming language created in the late 1960s, originally for use in the healthcare industry. • It was designed for the production of multi-user database-driven applications. It predates C and most other popular languages in current usage, and has very different syntax and terminology. • Appeared in 1966 • Designed by Neil Pappalardo

  10. “Hard Hat” Greg Kreis

  11. Open Source before Open Source

  12. VistA today

  13. The Proprietary Threat Code Red: How software companies could screw up Obama’s health care reform. Washington Monthly July/August 2009

  14. VistA 2.0? • “VistA is not a program; it’s a process” • Rick Marshall • Executive Director • VistaExpertise Network

  15. VistA 2.0? • Question: Should VistA be established as a national • standard? What are the implications of this action? • Answer: Given the resources that VA has expended to • date and can bring to bear in the future, VistA 2.0 could • become the international standard for medical center • information systems. This could result in huge financial • savings in the healthcare community, but VistA 2.0 could • result in huge advances in evidence based medicine, • medical research and data standardization and • portability. • American Council on Technology, VistA Modernization, “Legacy to Leadership” Report, May 2010

  16. Phillip Longman Senior Research Fellow New America Foundation Senior Fellow Washington Monthly Longman@newamerica.net

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