Transcript Document

VA Design Patterns Briefing
and VistA Evolution Update:
Questions and Answers
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: Would like to get more information on HSPC and the specs
that they have discussed.
Answer: For more information on HSPC, please contact Reggie
Humphries ([email protected]), 540-969-9410.
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: What does “Enterprise-wide secure FileMan access expand/enhance single character use,” mean?
Answer: FileMan security would be enhanced in such a manner as to provide tiered capabilities / access or
introduce additional limitations beyond the single key currently used.
Question: In Enterprise Fileman, when you do updates to a database, how do you detect and mitigate
deadlock in the distributed database? Because Database 101 says it will be there.
Answer: There are several options being discussed at this time. Additionally VA will plan to solicit feedback
regarding the best way to do this.
Question: Is there a possibility that UNICODE will be used in the future FILEMAN database?? Today only
ASCII is used.
Answer: At the time of this writing, UNICODE utilization has not been discussed; that is not to say that it may
not come up in the future. This work is still fairly early in the design and requirements phases.
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: Has anyone talked with IBM about the similarities between the underlying Vista database
structure and IBM’s flagship database VSAM? From my experience with both, they look very similar. If an
architecture could be devised that made them work together, a world of software, security, hardware,
flexibility and programmers would become available to the VA using the existing underlying data and
software.
Answer: At the time of this writing a request for information is being developed and will be released to
anyone interested for review and comment. All perspective vendors may reply with their suggestions. An
extensive analysis comparing VistA's database structures to any proprietary database structures has not yet
been conducted. VA favors vendor neutral solutions although VA remains open to proprietary options if they
are advantageous and cost-effective. The acquisition process is just starting; VA acknowledges your
suggestion, indicating that you feel this option should be considered as part of the acquisition phase,
determining the appropriateness of a purchase versus build discussion.
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: What effect will the VistA Evolution work have on the future Innovation projects from VHA?
Answer: The VistA Evolution Program will oversee the transformation of VistA so that it adheres to a ServiceOriented Architecture design pattern. This result in a vendor-agnostic technology platform that is highly
responsive to changing clinical needs: new functionality can be added as new services, old functionality can
be changed by modifying or replacing existing services. Other applications will connect through middle-tier
components, such as VistA Exchange, which will themselves appear as services. They, in turn, will reach
down to patient-related information, such as that accessible through Enterprise FileMan, VA eHealth
Exchange, the outpatient-appointment scheduling system, and DoD. These enhancements will allow
Veterans to access their health data quickly and easily from a wide variety of devices.
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: Is it the VA’s intent to adopt or support a common, open standard such as FHIR (Fast Healthcare
Interoperability Resources) to interoperate with external partners via web services?
Answer: FHIR is not yet part of the DoD/VA Target HSP, nor a Nationally-approved standard. However, the
DoD/VA interoperability approach has proactively adopted Consolidated Clinical Document Architecture
(CCDA) for external exchanges and HL7’s Fast Healthcare Interoperability Resources (FHIR) standard for realtime, dynamic DoD/VA exchanges. These information model standards will define specific XML and JSON
formats for health data. This will allow both parties to bi-directionally translate their local representations to
the common format. VA will continue to work with DoD, as well as outside Standards Development
Organizations, to incorporate emerging standards within OneVA enterprise architecture, as well as drive the
their adoption as nationally recognized health data standards. Please note that eHMP has FHIR APIs that can
be used to pull data out of VistA Exchange for interoperability.
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: Who is the Point-of-Contact with work with the eMI Sandbox to test/prototype new applications?
Answer: Sandbox development work is being handled through HSPC. For more information on HSPC, please
contact Reggie Humphries ([email protected]), 540-969-9410.
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: How do you plan on building security within Open Source VistA?
Answer: Legacy VistA is reliant upon VistA logon capabilities to maintain system security. As VistA migrates
to a Service Oriented Architecture, responsibility for Authentication and Authorization will migrate to the
eMI. In the case of VA, Single Sign On capability will be provided by VA’s Identity and Access Management
(IAM) service, while authorizations will be maintained within the eMI itself. In the case of Open Source VistA,
this same architecture will be implemented. While VA is using a proprietary product as its eMI, Open
Source VistA will have the capability of using proprietary, or open source, messaging infrastructures to
provide the same capability. Note that this refers to a desired end-state; the business rules for eMI to
enforce authorization on requests have yet to be developed. Until these rules are developed, authorization,
enforced by existing access logic, will reside within VistA.
VA Design Patterns Briefing and VistA Evolution Update: Questions and
Answers
Question: How do you see VistA Open Source integration with the new DoD System? No drop-in service?
eHMP?
Answer: Vista 4 will rely on its open source code base, open architecture, and adherence to open standards
(as contained in the DoD/VA Health Standards Profile), when possible, to interface with DoD, as well as other
industry partners. eHMP will eventually replace the Computerized Patient Record System (CPRS) as VA’s
primary point of care application to show information in a single view, which will allow clinicians to use
comprehensive patient data and images more easily. The middle tier components of eHMP will allow for
federation of a complete enterprise Virtual Patient Record (eVPR), which contains all available patient data
from exchange partners, such as DoD.