7, 1963, the Western Baptist Osteopathic Hospital opened with 35 beds in 1,300 square feet and with three physicians and a staff of 36 employees.
• The first baby born in this location arrived at 1:15 a.m. on Oct 15, 1963.
• In 1966 the name was once again changed to Sierra Vista Community Hospital.
• In 1972 the Solarium was converted to an eight-bed wing.
Four decades ago, in 1977, a conspiracy began bubbling up from the basements of the vast network of hospitals belonging to the Veterans Administration.
In 1978, with personal computers just starting to appear in the homes of nerdy hobbyists, the Hardhats bought thousands of personal data processors and distributed them throughout the VA. Software geeks and physicians were soon exploring how patient care could be improved with these new devices.
You needed a “co-evolutionary loop between those using the system and the system you provide them,” says one of the early converts, mathematician Tom Munnecke, a polymathic entrepreneur and philanthropist who joined the VA hospital in Loma Linda, California, in 1978.
In 1979, Ted O’Neill was fired (he drove a cab for a while, and later became a real estate agent). The main Hardhats office was shut down, and “pretty much everybody in the Washington part of the organization headed for the hills,” says Munnecke.
• In 1980 construction began on a 1,200 square foot storage facility and an addition of 4,000 square feet to house administration and the main part of the building underwent extensive remodeling.
In June 1981, VA MUMPS was renamed the Decentralized Hospital Computer Program (DHCP), and VA Administrator Robert Nimmo joined Rep.
Then one day in 1981, VA Chief Medical Director Donald Custis visited the Washington VA medical center and found administrators and practitioners using the unauthorized software.
VA Administrator Robert P. Nimmo followed up on February 18, 1982 with an Executive Order describing how the DHCP was to be organized and managed within VA's Department of Medicine and Surgery.
By 1985, most hospitals were being updated regularly through a database management system Timson developed called FileMan.
• In 1994 the new Emergency Department and new building entrance were officially opened.
WHEN KEN KIZER, who had run California’s Medicaid program, took over the VA health care system in 1994, it was under widespread attack for poor access and quality of care, to the extent that some GOP leaders were calling for its privatization.
In 1995, patient charts were available only 60 percent of the time at VA facility patient encounters.
Due to a number of shortcomings, including lack of enforcement mechanisms, the section was updated in 1998 as part of the Federal Electronic and Information Technology Accessibility and Compliance Act.
• In 1999 the name was changed to Sierra Vista Regional Health Center.
By 1999, Kizer testified in Congress that the new system he’d built—it was rechristened VistA from Decentralized Hospital Computer Program—wasn't just working out for the VA, it could be the basis of a national commercial health IT system.
The main phone number for the Canyon Vista Medical Center is (520) 263-2000.
The Hardhats have worked to help make the FOIA release of VA VistA more useful to the world outside the borders of the big four adopters, and to encourage cooperation among them. Therefore, the original WorldVistA board of directors, in order better to pursue the OpenVistA project, incorporated WorldVistA March 1, 2003 as a non-profit corporation, to extend the Hardhats' reach into more formal arenas.
VA launches My HealtheVet nationwide on Veterans Day 2003.
• In 2004 an expansion in the Maternal Child Department was completed and expansion of the Emergency Department was started.
In 2004, the Pentagon hired outside contractors to revise its medical-records system, implementing a clunky version of VistA known as AHLTA. The Pentagon’s approach was strictly a top-down IT job, unlike the collaborative approach used with such success in building VistA, and it lacked finesse.
VA patients in New Orleans were the only ones in the city who emerged from Hurricane Katrina in 2005 with their records—including medication lists—intact.
A 2005 Gartner study said the agency could save $345 million a year by consolidating the agency’s health IT efforts within the central office.
In 2006, two important things happened to VistA: It won the Harvard Business School’s coveted Innovations in American Government Award—given each year to promote creativity in the public sector—and its budget disappeared.
Top VA officials attend a House Committee hearing in 2006 on the breach of data security at the department. | Getty Images
By 2007, VA and DoD expanded the capabilities for prescription and drug allergy data to include semantic interoperability, allowing for a more complete clinical understanding of data across both systems.
Back in 2009, some of the architects of the Affordable Care Act saw VistA as a model for the transformation of American medical records and even floated giving it away to every doctor in America.
As part of the American Recovery and Reinvestment Act of 2009, the United States Congress appropriated $19.2 billion to increase the use of EHRs by physicians and hospitals.
Prior to 2009, VA only delivered about one-third of its projects on time and new functionality every three to seven years.
When Buyer left Congress in 2011, he took an assignment for the giant contractor McKesson—lobbying Congress for the company, a major producer of commercial EHR systems—on health IT and Veterans Affairs issues.
According to VA figures dated April 20, 2013, the number of claims pending for more than 125 days was 613,469, while the total number of pension and entitlement claims was 886,345.
Since the failure of the integration effort, and the subsequent 2014 scheduling fiasco, in which VA officials in Phoenix falsified records to make the agency look better at timely treatment of veterans, congressional committees have repeatedly called VA and Defense officials to testify.
The VA Point of Service (VPS, aka Kiosks) Project which was completed in 2014, resulting in approximately 5,500 total VPS kiosks deployed to 146 VAMCs nationwide.
President Obama signed into law the Veterans Access, Choice, and Accountability Act of 2014 (VACAA).
An updated user interface for VistA, called the Enterprise Health Management Program, seems to be progressing, although when it was implemented at the VA in Hampton Roads, Virginia, in a March 2015 pilot, it caused a system crash that affected clinical services at the hospital for a month.
VA OIT Product Development is developing the Airborne Hazards and Open Burn Pit Registry (AHOBPR), targeted to deploy at the end of Q3 2015.
You’d have to be a very brave VA administrator, and perhaps a foolhardy one, to keep VistA in 2017: The system’s homegrown structure creates security and maintenance challenges; a huge amount of talent has fled the agency, and many Congress members are leery of it.
Under its current tentative plans, the VA will continue to update VistA’s interface through 2018.
|Company Name||Founded Date||Revenue||Employee Size||Job Openings|
|CommuniCare Health Services||1984||$125.8M||200||107|
|Village Care of New York||-||-||1,193||39|
|Integrated Care Management||-||$2.5M||66||20|
|Mid -South Health Systems||1968||$530,000||7||1|
|Pine Grove Behavioral Health & Addiction Services||1984||$4.8M||67||-|
|Haven Behavioral Healthcare||2006||$77.8M||1,000||168|
|Meridian Health Services||2014||$31.7M||350||1,721|
|Lindner Center of HOPE||2008||$50.0M||200||-|
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