Features
VISTA includes computerized order entering, barcode administration, electronic prescribing and clinical guidelines. UPTODATE can be accessed from within the system. It also allows (at least for the Veteran population) patients to access their own medical records, similar to the KP system. Vista Imaging allows integration of PACS, pathology, EKG etc. the VISTA system has been used in conjunction with telemedicine to provide surgical care to rural Western States.
Achievements
VA claims a pharmacy prescription accuracy rate of 99.997%, and the VA outperforms the vast majority of public hospitals, supposedly based on its EMR implementation. There are only three hospital systems in the US, which have achieved HIMSS stage 7, (the highest level of IT implementation), one of which is the VA. A non-VA hospital using VISTA is one of only 42 US hospitals to achieve HIMS level 6.
Implementation
Approximately 50% of US hospitals with a full EMR implementation are VA hospitals using Vista. It has also been implemented worldwide, including Finland, Germany, and Denmark as well as developing nations.
Cost
As it is open source, the license is free. Obviously there are large costs relating to localization, hardware, training, and implementation. I have found one reference to implementation of VISTA over 8 hospitals in one state costing $9 million, as compared to a commercial installation over the same number of hospitals costing $90 million.
