After nearly two months of delay, the Centers for Medicare and Medicaid Services (CMS) on Monday released the much-anticipated VistA-Office EHR, electronic health records software for physician offices based on an enterprise system developed by the Department of Veterans Affairs. But there is a catch.
The software made available this week is considered beta version 1.0. CMS will select a small number of physician practices -- likely between 10 and 20 -- to work with vendors to evaluate the system and develop a version that is compatible with future certification standards.
Establishing standards for EHR certification is among the first responsibilities of the American Health Information Community, recently chartered by the Department of Health and Human Services. (See http://www.bio-itworld.com/hitw/enews/new/06-14-2005_607.html.)
The Windows-based program is a scaled-back version of the Veterans Health Information Systems and Technology Architecture (VistA) EHR system long used in VA hospitals and clinics. In addition to EHR capability, the beta release contains some e-prescribing functions, but CMS says that additional vendor work is necessary before a physician can bypass a fax or printer and send signed electronic scripts directly to pharmacy systems.
VistA-Office does not contain payer formularies, though it does include medications tracked by the Doctor's Office Quality-Information Technology (DOQ-IT) program, plus about 100 other popular drugs. It does check for drug-drug interactions.
CMS is compiling a list of vendors that have met criteria to provide VistA-Office EHR installation and support. To date, only four vendors are on the qualified list -- Document Storage System, Executive Software Systems, Medsphere Systems, and VOE Solutions -- but CMS says that a fifth will be added soon at http://www.worldvista.org/vvso/qlist. Other details are contained in a 10-page, question-and-answer document posted at http://www.cms.hhs.gov/quality/VistAQsAs2.pdf. Interested practices should contact any of the vendors or visit http://www.vista-office.org/. The vendors will propose to CMS which sites should be chosen for the test.
Contrary to some published reports, the software is not free. CMS will charge about $36 to prepare and ship a copy of VistA-Office on CD. Users also will have to license the Caché database program from software developer InterSystems.
For an office with seven users, Caché costs about $1,600 in one-time licensing fees, as well as an estimated $900 per year for support services and $240 annually for software updates, according to CMS.Users also must license Current Procedural Terminology (CPT) code sets from the American Medical Association.