The Veterans Health Information Systems and Technology Architecture (VistA) supports both ambulatory and inpatient care through its EHR known as Computerized Patient Record System (CPRS), which was released in 1997. The VA’s CPRS was developed by utilizing Medscape’s open source, license free code. VistA is an enterprise-wide information system used throughout the United States Department of Veterans Affairs (VA) medical system. It’s the only EHR installation in the U.S. with a truly national footprint. As a single software solution, VistA is designed to support almost 9 million vets through about 1,700 different care sites around the country.
In their 2014 EHR Report—a survey of 18,575 physicians on their EHR preferences—Medscape concludes that doctors like using the VA’s Computerized Patient Record System (CPRS), the core electronic record in the broader VistA platform, more than any other solution. The highest-rated EHR, with a score of 3.9, is the Veterans Administration EHR: VA-CPRS. It’s regarded as one of the best overall by our physician respondents. (With regard to physician satisfaction, Epic finished in 8th place, Cerner was rated 15th best and Meditech 18th. Scattered among these enterprise solution providers are practice-based EHR vendors like Practice Fusion, Amazing Charts, Medent and eMD’s.
WHO KNEW? I say this because, when I first began utilizing the VA-CPRS as the “hands-on” EHR system for my students, in my online Health IT Jobs Training Curriculum, my very first impressions were – “this is so 1990” and it looks like Epic’s EMR from many, many versions past! But as I became more familiar with its core functionality (and my enrolled student’s ability to pick up the basic concepts of an EHR system (i.e. patients list, placing orders (CPOE), clinical documentation, best practice alerts, reporting, etc.)…and so when this report came out earlier this year – I was pleasantly surprised (you can’t judge a book by its cover, I guess). I now realize why VA-CPRS is so well liked by physicians who use it.
Other studies confirm that physicians find VistA CPRS “straightforward” to use. It was reported, it was designed to take better care of patients, and doctors can see how the system directly and positively impacts clinical care.
Edmund Billings MD, full article – If Physicians Prefer the VA’s EHR, Why Is Adoption Outside the VA So Low? – details a summary of categories in which VA-CPRS was rated #1 among enterprise solutions illustrates how well the VA did in meeting physician needs.
- #1 – Ease of data entry
- #1 – Physician satisfaction
- #1 – Staff satisfaction
- #1 – Overall usefulness
- #1 – Usefulness as a clinical tool
- #1 – Connectivity
- #1 – Reliability
- #1 – Practice Situation: Hospital Network
- #1 – Practice Situation: Independent
Dr. Billings’s article also ponders how a government-derived software system could be more highly rated than private sector alternatives. As mentioned above, the VA’s goals are to develop a system that improves care for veterans and is easy to learn.