1. VistA on
Doug Martin, MD

2. CareWeb Framework Architecture
Interface
User
Order
Entry
Flowsheet
User Preferences
SMART
Plug-in
Chart
Search
Plug-in
Widgets
Electronic
Signature
Patient
Selection
User
Authentication
SMART
Adaptor
Plug-in
Services
Layout
Manager
Layout
Designer
Framework
Services
Internal
Services
User
Context
Patient
Context
Electronic
Signature
SMART
API Registry
Plug-in
Services
Context
Management
Event
Management
Component
Discovery
Help
Subsystem
Theme
Support
Framework
Services
External
Services
Data
Access
Security
Services
Messaging
Services
Web
Services
Solr Search Engine
Host
Services

3. RMRS OpenMRS VistA/RPMS
The Present
Interface
User
Document
Viewer
Plug-in
Widgets
Patient Selection
Plug-in
Services
Layout
Manager
Layout
Designer
Framework
Services
Internal
Services
Patient
Context
Plug-in
Services
The current state of things.
Context
Management
Event
Management
Component
Discovery
Help
Subsystem
Theme
Support
Framework
Services
External
Services
Data
Access
Host
Services
RMRS OpenMRS VistA/RPMS

4. Introducing Fast Healthcare Interoperability Resources
Defines a common clinical domain model
Resources
Normative attributes by 80% rule
Remaining 20% covered via extensions
Defines standard operations (API)
CRUDS (create, read, update, delete, search)
Resource-specific operations ($expand)
RESTful interface (easy to implement)
Current draft specification DSTU-2

5. RESTful Web Service
Henry"

6. Patient Resource
<Patient xmlns=" <id value=”1234"/> <identifier> <use value="usual"/> <type> <coding> <system value=" <code value="MRN"/> </coding> </type> <system value="urn:oid: "/> <value value="12345"/> </identifier> <name> <family value="Levin"/> <given value="Henry"/> </name> <gender value="male"/> <birthDate value=" "/> <managingOrganization> <reference value="Organization/ "/> <display value="Good Health Clinic"/> </managingOrganization> <active value="true"/> </Patient>

7. RMRS OpenMRS VistA/RPMS
The Present
Interface
User
Document
Viewer
Plug-in
Widgets
Patient Selection
Plug-in
Services
Layout
Manager
Layout
Designer
Framework
Services
Internal
Services
Patient
Context
Plug-in
Services
Again, the current state of things.
Context
Management
Event
Management
Component
Discovery
Help
Subsystem
Theme
Support
Framework
Services
External
Services
Data
Access
Host
Services
RMRS OpenMRS VistA/RPMS

8. RMRS OpenMRS VistA/RPMS
The Future
Interface
User
Document
Viewer
Plug-in
Widgets
Patient Selection
Plug-in
Services
Layout
Manager
Layout
Designer
Framework
Services
Internal
Services
Patient
Context
FHIR
Client
Plug-in
Services
The ideal future state using FHIR.
Context
Management
Event
Management
Component
Discovery
Help
Subsystem
Theme
Support
Framework
Services
External
Services
FHIR
Endpoint
Host
Services
−−−−−−−−−−−−−−−−−−−−−−−−− FHIR −−−−−−−−−−−−−−−−−−−−−−−−−
RMRS OpenMRS VistA/RPMS

9. Clinical Abstraction Layer
HAPI-FHIR client library
FHIR resource model
FHIR-based plugins
EHR platform agnostic
Truly interoperable plugins
Build once, run anywhere
The CAL retooled to use FHIR data model/api

10. VistA Serialization Framework
Originally developed to serialize VistA objects to JSON via RPC broker
Expanded to support multiple formats
XML and JSON
FHIR DSTU1 and DSTU2
Added REST interface via NETSERV
via HTTP
via RPC broker

11. Serialization Control File
(#.01) NAME [F] ^ (#1) CONTENT TYPE [F] ^ (#2) SERIALIZER [F] ^ (#3) VERSION [F] (#10) RESOURCE (#.01) RESOURCE [F] ^ (#1) INTERNAL [YN] ^ (#2) SOURCE [N] (#10) CUSTOM SERIALIZER [M] ^ (#20) PREFETCH LOGIC [M] ^ (#21) POSTFETCH LOGIC [M] (#30) PROPERTY (#.01) PROPERTY [F] ^ (#1) FIELD [F] ^ (#2) TYPE [S] ^ (#3) SEQUENCE [N] (#10) CONTROL [F] (#40) PARAMETER (#.01) PARAMETER [F] ^ (#1) FIELD [F] ^ (#2) TYPE [S] ^ (#3) SEQUENCE [N] (#10) CONTROL [M] (#20) COHORT [M] (#50) TEMPLATE (#.01) TEMPLATE [F] ^ (#1) CONTENT [W] ^ (#99) DESCRIPTION [F] (#20) HEADER FIELDS [1W] (#99) DESCRIPTION [1W]

12. http://acme. org/DSTU2/Patient/1 http://acme. org/DSTU2/Patient
NAME: DSTU2 CONTENT TYPE: application/xml+fhir,application/xml,text/xml,xml SERIALIZER: RGSEFHIX VERSION: RESOURCE: Patient INTERNAL: N SOURCE: 2 (PATIENT) PROPERTY: name FIELD: .01 TYPE: CUSTOM SEQUENCE: 10 CONTROL: D NAME(VL("I")) PROPERTY: birthDate FIELD: .03 TYPE: DATE SEQUENCE: 30 CONTROL: PARAMETER: family TYPE: STRING SEQUENCE: 20 CONTROL: D OPRNAME(VL("E"),1) K PVAL COHORT: S X="$$NAMEITER^RGSERPAT"

13. Supported Formats CWF application/json,text/json
DSTU1 application/xml+fhir,application/xml,text/xml,xml
DSTU1 application/json+fhir,application/json,text/json,json
DSTU2 application/xml+fhir,application/xml,text/xml,xml
DSTU2 application/json+fhir,application/json,text/json,json

14. Questions?