1. The WorldVistA EHR Arizona Network By Matthew M. King MD June 17, 2007 Seattle, WA

2. Why VistA? Evidenced-based Link to Quality Open Source Business Model Provider Acceptance Networking Benefits

3. Evidenced-based Link to Quality EHR Deployment Does Not Guarantee Improved Quality VistA has the Tightest Link to Quality, Compared to any other EHR The Uniqueness of VistA May be Responsible for This Linkage

4. Unique Features of VistA Highly Customizable, While Maintaining Core Compatibility A Mature and Successful Inter-site Data Sharing Protocol Sophisticated, Research-friendly Data Mining Advanced Point of Care CCM Tools Rapid Software Cycle The VistA Community

5. The Open Source Business Model Less Costly (30-50%)‏ Promotes Networking if Done Thoughtfully Promotes Collaboration Across Networks by Sharing Interfaces, Clinical and Quality Management Tools

6. The Hallmarks of the Open Source Business Model for CHC Networks No Licensing Fees When Using the Linux, GT.M, VistA (LGV) Stack Support Fees are not Based per User Core Product is Only EHR, Lowering Costs of Networking Resources are Shared: Staff and Technology Vendor Competition

7. Arizona Project Basics Started with Clinica Adelante Inc, a CHC Collaborated with WorldVistA Plan First Site “Go Live” for August 10 th Started a EHR Network with 4 Other Centers Using Centricity PMS 116,000 Patients

8. Clinica Adelante, Inc- Who Are We? CHC founded in 1979 32,000 patients and growing 90,000+ Encounters Six Sites and growing in the Phoenix and surrounding area 2 Rural Health Teams with mobile clinic 26 Providers, 12 WIC sites, Patients: >50% uninsured and 50% Spanish speaking only

9. Network Essentials Phase One Involves Marana, Mountain Park, United Community Health Center and Clinica Salud, all in Arizona Partnerships with Quest Labs, Banner Health and AHCCCS (Medicaid) for Interface Development Phase One Implementation Over a Three Year Period.

10. Network Essentials: Phase Two ASP Model Developed for Smaller Clinics Heterogeneous PMS Allowed Network Data Exchange Extended Late Comer Incentives Explored

11. EHR Deployment is a Large Project Four Teams –Implementation Team –IT Team –Clinical Team –Research/Oversight Team Hired CAC Full Time Followed VA Protocols Found in Web Documentation

12. Extensive VistA Documentation Exists

13. Last Slide VistA Implementation is not Easy, But it May Well be the “Disruptive Technology” in Health Care. The VistA Community is Passionate, Competent and Inclusive. Questions?