1. Tips on Open Source EHR Systems within the Safety Net Community: A WorldVistA EHR Update HRSA Health IT and Quality Webinar February 10, 2011 By Matthew M King, MD

2. Open Source WorldVistA EHR Implementation Advantages Challenges Safety Net Update  Edgeware PMS and Billing  Chronic Disease Management  Meaningful Use in WV EHR  UDS reporting from WV EHR  CPRS Client Advances

3. Open Source Implementation: Advantages Evidenced based, high quality system Flexibility in Scale and Deployment Missions Highly configurable by user Cost Familiar to many new graduates No “Vendor lock”

4. Challenges of WV Implementation Available free versions are not configured Billions were spent on functionality; zero was spent on “eye candy” Not well advertised or packaged Only a few vendors available right now All EHR implementations are difficult, so is WV. Some of those routine problems may be “blamed” on open source

5. What's new in WorldVistA for the Safety Net? Edgeware PMS and Billing is available  Registration  Appointments  Patient in office tracking monitor  Sliding fee management, insurance, copays  Manual and electronic billing  GUI based MySql/Java TMG-CPRS is available

11. Powerful Patient Search Combine multiple search terms– one on each line Value field will change to match field value: Date picker, record picker, set picker, or free text Range searches are allowed

12. Web Tabs Allow Integrated Content

13. {OBJ:... With Math from User Input User input can be modified by mathematical formulas as part of parameter passing. Example: Enter value: {FLD:WEIGHT-LB} Here is the Amoxil Dose: {OBJ:TMG DOSE KG {FN:[FLD:1:WEIGHT-LB]/2.2}} Let’s say, for example, the user entered 30(lbs) [FLD:1:WEIGHT-LB]  USER INPUT (“30”) {FN:30/2.2}  13.636 (kg) {OBJ:TMG DOSE KG {13.636}  passed to server Server code can return dose based on patient’s kg wt, e.g. “545 mg”

14. Chronic Disease Management in WorldVista VistA is a particularly good EHR for CDM Chronic Disease Reminders Chronic Disease Templates Chronic Disease Order Sets Chronic Disease Reports

23. Meaningful Use and WorldVistA Expect Certification in May or June WV is already certified by CMS for use in the PQRI data reporting program The tools for CDM are easily adapted for meaningful use Hypertension Example

38. WorldVistA and UDS Reporting Tables Zip through 7 with a single click Export to Excel Requires operational changes to ensure all information is in the EHR

43. Thank you. Questions will be answered after last speaker is finished.