1. technology and computing
2. software

www.vxvista.org
vxJourney – vxVistA Webinars – Sponsored by DSS, Inc.
vxVistA.org Community Collaboration Web
Portal Uses Atlassian Open Source Web Tools
to Deploy vxVistA-OS EHR
Hugh P. Creedon, PhD.
Deanne J. Clark
J.D. Keith
www.vxvista.org
www.vxvista.org
Sponsors:
• About DSS, Inc.
– DSS, Inc., is a privately held company founded in 1990, that
specializes in healthcare IT solutions that enhance the VistA EHR.
With over 1200 installations of software in the VA and six VA
National Contracts, DSS is the premier integration and development
company for VistA. DSS develops and supplies integrated
enhancements to the VistA system in the Department of Veterans
Affairs, Indian Health Services, and the Private Sector. DSS
released vxVistA-OS in January 2010.
• About Open Health Tools
– Open Health Tools is a community of open source developers,
health professionals, and an ecosystem that brings together
members from the health and IT professions to create a common
health interoperability framework, exemplary tools and reference
applications to support health information interoperability. vxVistAOS is a conditional project with OHT.
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
What is the difference between FOIA VistA & vxVistA-OS?
VistA is an acronym for Veterans Information
System Technology Architecture. Is a
comprehensive system developed by the
Department of Veterans Affairs.
vxVistA-OS is FOIA VistA that has been modified and
enhanced by DSS, Inc. for over 4 years to work in
non-VA healthcare delivery settings. It was released to
the world as an Open Source Project in January 2010.
VistA is a patient centric, longitudinal health
record system used by 163 hospitals, 135
nursing homes, 850 community outpatient
clinics, and 180,000+ health care professionals
Key Components of DSS vxVistA-OS
• vxVistA-OS(M)
• vxCPRS (Computerized Patient Records System)
• vxBCMA (Bar Code Medication Administration)
• vxVitals Lite (Vitals Management)
• vxGroupNotes (Group Visit Documentation Tool)
VistA was built on a model of outcomes
tracking, continuity of care, reporting, and
research. Funded by tax payers and designed
from clinician requirements it is the most used
EHR in the world today.
VistA by the Numbers…
• More than 1,000,000 lines of code
• ~ 24,000 routines
• 2,000 files
• 20,000+ pages of Documentation
vxVistA.org—O’Reilly OSCON 7-22-2010
Key Enhancements
• Prescription writing and printing
• Laboratory Interfaces and Order Sheet printing
• Pediatrics
• Enhanced Women’s Health (OB/GYN)
•Patient Medical Record Numbers
•Provider Alternate ID Numbers
•Redaction of many VA-isms in GUIs and
www.vxvista.org
commonly used options
vxVistA –OS Team Challenge
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Build the Open Source version of vxVistA
--Implement, support, and maintain VistA worldwide as public domain software under
the Eclipse Public License (EPL)
--Maintain the integrity of FOIA Enhancement and Patch Process
--Develop enhancement products to promote best practices, performance measures,
and workflow efficiencies providing a great return on investment
--Work with partners in Open Source and Commercial community to interface/integrate
best of breed systems and offer new modules
•
Distribute vxVistA-OS
--Free Open Source (FOSS) and Commercial Open Source (COSS) models for
complete DIY or robust support and customization services including hosted options
•
Deliver a Collaboration environment
-- A place where a community will find the information needed for Installation, Use of the
system, Training and Support of the vxVistA-OS Enhancement Process.
•
Build a web-framework that inspires a Community-driven, Collaboration
Environment to Promote Use and Knowledge of the vxVistA-OS EHR
--Hospitals, community health organizations, practices and other healthcare entities to
benefit from VistA forums featuring best practice discussions and posts by thought
leaders.
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Atlassian Suite – The Solution
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We analyzed more than 8 collaborative solutions
Atlassian suite of products was selected because:
– Proven power of their components (Confluence, Crowd, JIRA)
– Readily available Support
– Extensive Plug-ins repository (Balsamiq, Gliffy, Community Bubble, etc)
– Seamless integration with OS Plug-Ins, COTS Plug-Ins, & COTS Business Apps
– Friendly user interface
– Flexibility for change over time as the project evolves
– Willingness to support our Open Source Community
Our goals were:
– To leverage Open Source tools & Plug-Ins while retaining integration with proven
commercial technologies—hybrid blend of COSS, FOSS and COTs
– To provide the right tools to nurture the vxVistA-OS evolution from its birth as a COTs
system to its second life as an Open Source EHR through adoption, education, and
beyond as the project matures and grows—a Sandbox for Innovation
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Atlassian Suite – The Solution
•
Atlassian Understood and Supported the effort to release the vxVistA-OS EHR and
its potential benefit as a Global Healthcare model with the potential to impact
Individuals and Nations around the World
•
Atlassian donated its non-Open Source components under a special license to
support this Open Source project
•
Collaboration between Public, Private, Proprietary and Open Source models is key
to the success of any fledgling OS project, and the vxVistA team greatly
appreciates that Atlassian recognized the value of the vxVistA-OS EHR and made
the vxVistA.org site possible with their generosity
•
During the design and development phase of this project, experts in collaboration
from all around the world including USA, Argentina, Italy, Australia, Canada,
Germany, England and Netherlands, joined forces to support this Endeavor.
Companies and Individuals donated their time and software licenses to make this
happen. Thanks to all of them!
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Open Source Plug-ins
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Analytics Plugin for Confluence — David Simpson
Atlassian Universal Plugin Manager — Atlassian
Table Plugin — Bob Swift
Autowatch Plugin — CustomWare
Community Bubbles — Adaptavist
Chart Plugin — Atlassian
Checklists Macros — Comalatech
Composition Plugin — CustomWare
Confluence JIRA Macros — Atlassian
Confluence Page History Slider — CustomWare
Confluence Smilies — Andy Brook
Confluence Tabular Metadata Plugin — Atlassian
Confluence Usage Tracking Plugin — Atlassian
Contributors Plugin — Atlassian
CustomWare Page Templates — CustomWare
Flexi Blog Posts Plugin — CustomWare
Footnotes — Adaptavist
Office Connector — Atlassian
Reporting Plugin — CustomWare
Table Plugin — Bob Swift
Tagcumulus plugin — Herman de Boer
Widget Connector — Atlassian
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Open Source Plug-Ins
www.vxvista.org
Target Audience – A new challenge
Interaction diversity – (low and high technical interaction in the same environment)
vxVistA.org Users
Activity
Tool
Individuals/Researchers
Looking for improvements on
healthcare services, best
practices, information about
EHRs/Jobs/Data sharing
Confluence Wiki
Adaptavist Community Bubbles
Healthcare professionals
Evaluating EHRs or who use
vxVistA-OS
Recommending new modules,
workflows or GUI Mockups
Confluence
Gliffy Diagrams
Balsamiq Mockup
JIRA
Software Developers
Tracking bugs and implementing
Agile Project Management
JIRA + GreenHopper
Crucible - FishEye
Product Managers
QA Specialists
Requirements and Quality
Assurance Scripts
Confluence
JIRA
Project Managers
Task Assignments, Workflow
development, Issue tracking
TaskDocs, ad hoc Workflows
JIRA+ GreenHopper
Implementation Specialists
Implementation Strategies,
Issues tracking, Documentation
Library, Add-ons
JIRA – TaskDock
adhocWorkflows
Confluence
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Our building process - Structure
Initial Structure -> FreeMind
Mockups -> Balsamiq
Staging Site -> Contegix
Initial Theme Development -> CustomWare
Graphic Design & Animations -> Kainoway - Argentina
Continuous development -> DSS vxVistA Team & OS Community
Banner
vxVistA
People
Developers
Navigation menu
Ads
Spotlight Section
Ads
Area of
Interest
News
Recently Updated
vxVistA.org
News
Learning
Campus
Press
Room
Site Navigation – Categories and Sections
Phase I
• Collaboration Environment
• Resource Pool
• GUI Mockups examples
• Workflow Diagrams examples
• Issues and Bug Tracking
• Agile Project Management
• vxVistA You Tube Channel
vxVistA.org—O’Reilly OSCON 7-22-2010
Community
Media
Library
During the construction of the site, we received collaboration from experts residing in
USA, Australia, Canada, Argentina, Italy and Netherlands
www.vxvista.org
Home Page Mockup (Collaborating using Balsamiq)
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
vxVistA-OS Module Page Mock-up
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Workflow Diagram drawing tool (Gliffy)
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
vxVistA and vxVistA.org released on January 2010
Visits came from 84 countries/territories
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Current Confluence content
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
The first two quarters (Q1 & Q2 2010)
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Community Projects…
•Collaborate
•Innovate
•Share with other Projects/Community
•“Intranet” for Project Specific Work that is not “Public”
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
The vxVistA Enhancement Process
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Brief Demonstration of vxVisA.org…
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Looking Ahead…
The introduction of open source development in the EHR arena
will change the way healthcare is delivered in the U.S.
The vxVistA-OS EHR will improve the quality of care by eliminating
the need for providers to spend exorbitant amounts of money on
software licenses.
Instead, the money can be invested funds in skilled personnel for a
safe and successful implementation, used to fund needed work to
make data exchange better and easier, used to develop better
treatments with real research behind the science across large pools
of patients that will directly result in better patient care and
enable sites to manage their records and their facility with one of
the most robust and reliable systems on the market.
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
Collaboration Environment Roadmap
Technical
Interaction
Atlassian
Collaboration
Tools
Low
Jan 10
Phase 1 A
Social (non technical) Collaboration
Phase 1 B
Users / Developers Collaboration
Q3 2010
Issues/Bug Tracking / Agile Project Management
Phase 1 C
Q4+ 2010
Phase 2
Source Code tracking
Q4+ 2010
Peer Code Review
Phase 3
Q1+ 2011
Continuous Integration / Software Version Control
Phase 4+
High
2010
2011+
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
2G – JIRA, GreenHopper and Tempo
Issues Management
JIRA provides issue tracking and
project tracking for software
development teams to improve code
quality and the speed of development.
Time Tracking
Tempo updates Atlassian's popular
JIRA platform with support for
billing and salary administration
with sophisticated time-tracking
and cost reporting capabilities.
vxVistA.org—O’Reilly OSCON 7-22-2010
Agile Project
Management
GreenHopper adds agile project
management to any JIRA project.
Whether you are a certified Scrum Master
or just getting started with agile concepts,
GreenHopper is the perfect tool for
managing your backlog, planning sprints
and tracking your team through the entire
release process
www.vxvista.org
2G – Balsamiq, Gliffy and TaskDock
GUI Mockups
Task Management
Graphic Diagrams
Elegantly extend JIRA into Confluence
with the TaskDock JIRA integration.
When creating a TaskDock task in
Confluence easily add it to a specific
JIRA project and fix version. JIRA users
now have one queue for tasks across
both systems. Both tasks are synced so
when it is completed or re-opened in one
system it updates in both.
Using Balsamiq Mockups feels
like you are drawing, but it's
digital, so you can tweak and
rearrange controls easily, and
the end result is much cleaner.
Teams can come up with a
design and iterate over it in realtime in the course of a meeting.
With Gliffy online diagram software,
you can easily create professionalquality flowcharts, diagrams, floor
plans, technical drawings, and more.
Our online diagram editor makes it
easier than ever to create great looking
drawings.
vxVistA.org—O’Reilly OSCON 7-22-2010
www.vxvista.org
vxVistA.org – Second Generation
Launch Week – August 2 – 6, 2010
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010
DSS, Inc. and Open Health Tools are sponsoring this website because we strongly
believe that it takes a committed and involved community for open source
software to be a success. We hope that you will take us up on our invitation, visit
the website, provide feedback on what you like and don’t like and ultimately
become part of the vxVistA.org community…
Links to Learn More…
vxVistA-OS web link: www.vxVistA.org
DSS web link: www.dssinc.com
OHT web link: www.openhealthtools.org
Eclipse web link: www.eclipse.org
www.vxvista.org
vxVistA.org—O’Reilly OSCON 7-22-2010