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VA Considering Software-as-a-Service Model for VistA EHR System

April 14, 2017
by Heather Landi
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The Department of Veterans Affairs (VA) issued two requests for information (RFI) this week related to potentially replacing or enhancing its aging electronic health record (EHR) system, called the Veterans Information Systems and Technology Architecture (VistA) system.

In one RFI published on, the VA is seeking information about commercial off the shelf replacements for VistA provided in a SaaS model, a Web-based model, as an alternative to VA continuing to operate its VistAs, which are not fully modernized, the department stated in the RFI. The department also is separately exploring commercial off the shelf non-VistA EHR alternatives.

The VA also states in the RFI that although VistA is currently an integrated administrative, financial, business, and clinical system supporting VA's operations, the primary purpose of the RFI is to focus on the clinical component of VistA, which is analogous to its EHR functionality, to include lab and pharmacy.

The department will accept input from interested vendors through April 26.

In another RFI, the department is asking for the industry’s insight to inform its strategy to commercialize or acquire commercial capabilities similar to those developed and planned for VA's health information technology (HIT) platforms such as the Enterprise Health Management Platform (eHMP).

The concept behind VA’s HIT, the department writes in the RFI, is as an intelligence platform and user experience that could potentially "sit on top" of any number of EHR systems and provide clinicians with decision and process support against the longitudinal electronic health record of the patient. It has three main tiers: longitudinal database, service-oriented-architecture-(SOA)-style intelligence applications, and user interface. “VA s newly developed HIT is currently designed to interface with VistA, so responses to this RFI should include how the vendor would interface a commercialized version of eHMP or a commercial alternative with VistA and/or commercial EHRs,” the agency wrote.

The VA will accept input from interested vendors to that RFI through April 25.

In previous RFI, the VA also provides an overview of its current EHR system. “VA currently runs 130 separate VistA Instances. Each one is unique in that there are variations of the routines and data dictionaries for each instance. They are hosted at five data centers across the US and support over 1,200 VHA hospitals and clinics. Each VistA instance is composed of over 2,700 files, 64,000 data fields; 1,300 print templates; 9,100 options structured across 1,700 menus; 3,300 remote procedure calls; 38,000 routines, and 4.7 million lines of code.”

Further, the department states, “Each system has some local variation of all of these artifacts and the current environment is further described at a multi-tier architecture layer level. Additionally, there is a separate DR, Test, and VistA Read Only instance that matches each of the 130 operational VistAs, meaning each VistA instances has four copies currently. “

The department will accept input from interested vendors through April 26.

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