Blue Cliff Experience

The core members of the company have been intimately involved with a number of VistA and open source VistA development and implementation activities.

Modifying the VA’s FOIA version of VistA for use in Lyndon Baines Johnson Tropical Medical Center (LBJ TMC), a 200-bed hospital and outpatient clinic that provides healthcare services for American Samoa residents and approximately 3,000 federal beneficiaries. This marked the first implementation of VistA in the Pacific Region in a non-VA facility using the public domain software released by the VA under the Freedom of Information Act (FOIA).

Porting VistA to operate under GT.M on Linux to permit VistA to operate on a completely open source stack. This project required 3-man years of development within one calendar year. The project required the core VistA application to run on Linux, an open source operating system, and GT.M, an open source database management system based on the MUMPS programming language. 

Field testing of an Application Service Provider (ASP) pilot of VistA that provided concurrent access from an HIV medical/research clinic and a geriatric medicine service. Open Source Vista is maintained on servers at a central location from which healthcare sites can access the system via workstations either at their local facility or anywhere internet access is available.

Providing operation and maintenance support for the Hui Open Vista ASP
Developing client specific templates, menus, reports, lists, etc. for use by end-user. Providing on-call help desk, troubleshooting and problem resolution for clients. Educating and training of end-users and Clinical Application Coordinators in the use of the application. Documenting the process for operating and maintaining the Hui Open Vista ASP.

Designing middleware to allow functions such as pharmacy drug orders and provider and patient identifiers to be electronically shared between the DoD and VA.
Laboratory Data Exchange
Development of a Laboratory Data Interchange that allows seamless data sharing of laboratory orders and results between Tripler Army Medical Center (TAMC) and the VA Pacific Islands Health Care System (VAPIHCS.)
Pharmacy bi-directional interface that enables dual-beneficiary veterans to receive care in both Dept. of Veteran’s Affairs (VA) and Dept. of Defense (DoD) healthcare systems. The interface allows providers to enter medication orders that are posted in the VA’s VistA system.

Developing Obstetrics Guidelines for Open Vista by utilizing the basic design and functional features of a Clinical Practice Guideline application within the constraints of VistA without drastically changing VistA or the client application called CPRS. This was the challenge to take an existing application based on different system capabilities and conform it to the VistA architecture providing as much functionality as possible.

Designing, building, and implementing a data warehouse to facilitate the manipulation of patient and provider data contained in clinical informatics systems such as VA’s VistA. In Phase 1, the goal was to build an Open Architecture database management system that allows compatible systems direct access using Structured Query Language (SQL) and Open Database Connectivity (ODBC). Phase 2 consisted of building the framework and Data Marts (from the data of the existing Data warehouse).

Development of a Graphical User Interface named Janus that links the DoD automated medical information system Composite Health Care System and VistA patient data. Janus allows access to data through a web browser and has the “look and feel” of the Clinical Health Portal, a product developed by CITPO to support a GUI interface to a different platform. All clinically relevant information including data on clinical practice guidelines is available in near real-time from a VistA “shadow server.”

Designing and upgrading the VA’s intranet to allow for telehealth projects in remote areas to communicate with Honolulu. Completed in 2000, the upgraded network supports multiple protocols for a full range of telehealth applications. Veteran Affairs Pacific Island Health Care System (VAPIHCS) connects 22 Pacific Island jurisdictions, a geographic area of 4.8 million square miles. It connects to the State of Hawaii Telehealth Access Network (STAN), an ATM network interconnecting 18 private hospitals, the University of Hawaii’s John A. Burns School of Medicine, Department of Public Health, and the University of Hawaii School of Nursing. 

Designing and developing a search engine to VistA CPRS that provides Boolean search capability to any selected CPRS report.

Designing and developing a note-generating tool for VistA CPRS that utilizes a tablet PC and enables physicians to write and select text directly to the screen using preset macros from a pop-up list.