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Welcome to the Phoenix Area Interactive Learning Session

Welcome to the Phoenix Area Interactive Learning Session. Making Timely and Accurate Patient Care Decisions through Vista Imaging. Presenter : Michael Fairbanks, Phoenix Area Vista Imaging Coordinator. VistA is a multimedia extension of RPMS.

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Welcome to the Phoenix Area Interactive Learning Session

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  1. Welcome to the Phoenix Area Interactive Learning Session

  2. Making Timely and Accurate Patient Care Decisions through Vista Imaging Presenter: Michael Fairbanks, Phoenix Area Vista Imaging Coordinator

  3. VistA is a multimedia extension of RPMS. • It is used to capture scanned documents, clinical images, DICOM images, and other non-textual data files. • VistA Imaging and its accompanying client software is an FDA approved medical device. What is Vista Imaging?

  4. Originally conceived in 1987 by the Veterans Health Administration (VHA). It was first designed to capture and view video frames of pathology specimens. • It quickly developed into a Picture Archiving and communication system (PACS). Used to incorporate radiology imagery. And this was when Vista Imaging was born. History of Vista Imaging1 of 3

  5. VistA Imaging is unique in its tight integration with VHA VistA HIS system. Which is the equivalent of IHS’s RPMS system. • The VHA rollout started in 1998. • August 2001 a VHA mandated the installation of all core VistA imagining components for all VHA medical centers. History of Vista Imaging2 of 3

  6. Why Vista Imaging for IHS? • EHR/RPMS has no image storage capabilities. • Needs: Reports, Advanced Directives, Patient Photos, DICOM images. • Portland Area the first site to go live with Vista Imaging. • National rollout began in 2007-2009 History of Vista Imaging3 of 3

  7. Clinical • Patient • Cost Savings of VistA Benefits of VistA

  8. Immediate availability of patient images and data. • Less time spent locating images. • Increased communication among clinicians. • Enables remote consultation with specialists. Clinical Benefits of VistA1 of 2

  9. The VA is one of the largest healthcare providers in the US. • VistA Imaging features remote viewing technology. • Any facility within IHS running VistA imaging can easily consult with other facilities. Clinical Benefits of VistA2 of 2

  10. Better care because all patient data is readily available. • Improved continuity of care • Decreased waiting times for patients. • Patients can see their condition and participate in treatment decisions. Patient Benefits of VistA

  11. Curtails the cost expansion of medical record storage. • Can store Radiology (DICOM) imagery as well. • Cost of duplication of electronics records is almost non existent compared to paper. Cost Savings of VistA

  12. Digital Storage is cheap. And gets progressively cheaper. • Average cost per Gigabyte today: $0.03 • The entire print collections of the Library of Congress roughly equals to 10 Terabytes of digital storage. • This would cost $300. • Kilobyte = 1 Thousand bytes • Megabyte = 1 Million bytes • Gigabyte = 1 Billion bytes • Terabyte = 1 Trillion bytes Digital Storage (1 of 2)

  13. Median image size: 150 kilobytes. (Non Radiology) • Three federal service units started scanning in Jan 2012 accumulated 10,000 images in 4 months. • At that rate they’ll reach 1 Terabyte in 240 years. • Phoenix Area’s Vista Imaging unit can store. • Kilobyte = 1 Thousand bytes • Megabyte = 1 Million bytes • Gigabyte = 1 Billion bytes • Terabyte = 1 Trillion bytes Digital Storage (2 of 2)

  14. Physical Storage Digital Storage Disk storage has increased in capacity exponentially over the past 30 years. And will continue to do so. Physical housing for digital storage as also become increasingly dense, smaller in physical size and consume much less power. Digital data will maintain its quality forever. Digital data can be duplicated within minutes or hours. • Paper records require a fixed amount of space. • Space saving technologies exist but can only reduce paper’s finger print by so much. • These records will be required to be held for a good number of years. • Paper is susceptible to the elements and will degrade overtime. • Duplication of records may take months or even years Physical versus Digital Storage of records

  15. How Vista works (short version) Image Capture

  16. How Vista works (short version) Image Display

  17. How Vista works (short version)The Display Client

  18. How Vista works (Full version)

  19. VistA utilizes Windows Server 2008 high availability clustering for primary storage. • LTO-4 backup media is used for the 1st level backup. • The Plasmon (Jukebox) is utilized for long-term archival and a 2nd level backup. • The Jukebox creates two backup cartridges of each set of data. When both are full the second is removed and transported to a secure storage location. Vista Imaging Redundancy

  20. Tier 1 – Local Site • Tier 2 – Area Level • Tier 3 – VHA Enterprise Solution help desk Vista Imaging Support

  21. A majority of full scale deployments of VistA Imaging have a high level of redundancy built in. • Downtime has been non-existent to very minimal. • Majority of downtime if any will come from network outages that affect more systems then just VistA Imaging. Vista Imaging Reliability

  22. Vista Imaging Reliability

  23. Questions? Michael R. FairbanksPhoenix Area Vista Imaging CoordinatorPhone: 602-364-5283Email: Michael.Fairbanks@ihs.gov

  24. Phoenix Area Webinar Schedule 2013

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