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Physicians sought to test electronic health record software.

Officials at the Centers for Medicare and Medicaid Services are seeking physicians to test electronic health record software originally developed by the Department of Veterans Affairs and adapted for use in physicians' offices.

CMS is releasing a test version of the software--called VistA-Office--in an effort to assess its effectiveness, usability, and potential for interoperability in small physician practices, the agency announced late last month.

"The release of an evaluation version of VistA-Office will provide a testing laboratory for interoperability and will supplement efforts by the American Health Information Community to establish a certification criteria and process," CMS Administrator Mark B. McClellan, M.D., Ph.D., said in a statement.

The goal is to refine the software based on the results of the test period and develop a version of the VistA-Office electronic health record (EHR) that could be certified under a process recognized by the Department of Health and Human Services.

The VistA-Office EHR was adapted from the hospital information system that is used by the Department of Veterans Affairs (VA). The VA information system is used at 1,300 sites nationwide and has been in use for more than 20 years.

The test version of the software includes core functions such as clinical order entry, standard progress note templates, and results reporting. It also includes features designed specifically for physician offices including interfaces to existing practice management and billing systems, quality measure reporting capabilities, clinical reminders for disease management, and templates for ob.gyn. and pediatric care.

The VistA-Office test software will not be free. The first-year costs (cost of software, licensing fees, and support) are estimated to be about $2,740 for a group of 1-7 users, according to a CMS spokesman, who added that practices are likely to incur added office staff costs associated with implementing the EHR.

Health information technology experts welcomed the testing of a new office-based EHR product, but cautioned that not all physician practices are suited to becoming a beta-test site.

"It's good for physicians to have more choices," said Mark Leavitt, M.D., Ph.D., chair of the Certification Commission for Healthcare Information Technology, a voluntary, private-sector initiative to certify health information technology products.

But Dr. Leavitt warned that participating in a beta test isn't for everyone. Generally in such a test, practices are not supposed to rely on the new software, so physicians would have to run the test software parallel with their paper systems. That extra step can cost the practice in terms of time and money, he said.

"A beta test definitely stresses the office," he said.

The best candidates for a beta test are physicians who are technically savvy and who have the extra time and interest to devote to the project, Dr. Leavitt said.

Physicians should carefully review the VistA-Office product before volunteering to test it and not just choose it because it is less expensive than some other options on the market, said Joe Heyman, M.D., secretary of the board of trustees of the American Medical Association and a gynecologist in solo practice in Amesbury, Mass.

As with any other EHR, it's important for physicians to survey their own office and work flow, he said.

More Than Half of Patients Discussed Health Information Found Online
With Their Physician in the Past Year

Never 43%
Sometimes 25%
Once or twice 18%
Always 15%

Notes: Based on a nationwide survey of 1,015 adults conducted June 7-12,
Percentages do not add up to 100% because of rounding.

Source: Harris Interactive

Note: Table made from pie chart.

Physicians who are interested in being part of a beta test should contact an approved vendor who will actually run the test of the software. Vendors will select a small number of physician practices to participate. A list of approved vendors is available online at A video demonstration of the VistA-Office software is available at


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Title Annotation:Practice Trends
Author:Schneider, Mary Ellen
Publication:OB GYN News
Date:Nov 1, 2005
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