User:JsandHIM

WorldVista: I've been working in the Maryland Veterans' Health Care Administration for about 10 years in mental health doing both clinical and administrative work. I have a Bachelor of Science in Psychology and a Master of Science in General and Organizational Psychology. I also maintain certification through the American Health Information Management Association (AHIMA) as a Registered Health Information Technician (RHIT). Although an odd combination, I suppose, these academic degrees and professional certification do provide good foundations for both the patient care (including use of the electronic medical record (EMR-CPRS) and VistA provider schedule set-up and maintenance tasks that comprise my work days.

I am interested in two specific areas of VistA and CPRS. A new facade-of-VistA scheduling program (VSE GUI) is being used by schedulers who only do scheduling. Only scheduling can be done using this program; all VistA clinic schedule builds are still done in the "ultimate authority" program - VistA. New users therefore are blind to the hows and whys of their tasks. I don't know if VSE GUI will interface better with Cerner in 10 years, which apparently is the plan with the VA/DOD EMR merger, however, these scheduler knowledge gaps result in many questions that interrupt work flows. Answers are not absorbed by the inquirer because they have no frame of reference, and the questions are repeated.

The other area I am most interested in is the continuing influx of additional steps in the EMR for clinicians. The placement of a return-to-clinic order was required last year, in addition to the use of the Consult Toolbox, and now the addition of the Community Care Decision Support Tool (DST), which takes the user through many steps to get back to the original consult attempting to be placed. Because the user begins a consult, that user has already made the decision the DST is supporting. These are examples of more administrative demands being placed on clinical specialists who should be focusing on training for their specialty. I would much rather my physician receive more training in diagnosing and treating illnesses than in computer applications.

In summary, VistA, although viewed by many as outdated, won awards in 2006 and 2007 I believe, and was later scapegoated; the answer was the VSE GUI program, which has required an isolated group of users who are blind. And perhaps it is the data analysts who are also blind to clinical realities who are creating more steps for clinical users that may provide data but with a cost - less time, less quality for patient-provider interaction.