Tennessee Medicaid looks to VistA
November 27, 2012 in Medical Technology
With its DOS-era IT system approaching obsolescence, the Tennessee Department of Health is looking to build a new Medicaid IT system with the Veterans Health Information Systems and Technology Architecture, the VistA open source platform.
“Though innovative when it was first implemented more than 20 years ago,” the Tennessee Department of Health’s Patient Tracking Billing Management System “is incredibly inefficient today,” said commissioner John Dreyzehner, MD. “The current system, centered on paper documents, is cumbersome and does not allow information to be shared efficiently.”
In its $577 million budget request for the 2013-2014 fiscal year, the agency is asking the Tennessee General Assembly for $9 million to build a new Medicaid system using VistA.
While it’s not clear if other states have used VistA interfaces for their Medicaid information systems, Dreyzehner says the agency has been mulling the switch to the VA’s open source platform for several years, after a third party study on the agency’s IT options recommended VistA in 2007.
In the agency’s quest to increase health information sharing and streamline Medicaid administration, Dreyzehner said in an email that “a key goal is uniform submission processes by regional staff that will eliminate inconsistencies in records and increase efficiency in reviewing and managing case files.”
And as more providers throughout Tennessee adopt EHR systems and join health information exchanges, particularly the wired urban health networks, the agency wants to keep up.
VistA is appealing, Dreyzehner said, partly because of its open source license. “Its regular updating of features is also a plus as patient tracking needs and system requirements evolve,” he added.
A federal technology project with roots in the 1960s, VistA is integrated with the Veterans Administration’s EHR system, which serves some eight million patients in 163 hospitals and 3,000 clinics nationwide. Like other open source health IT platforms, VistA offers DIY-minded organizations some potential for affordability, with close to 200 clinical, financial and data management interfaces, including a Master Patient Index.
The Tennessee Department of Health wants to devote several years to implementing a new Medicaid system, with about 25 staff members working on the project. Dreyzehner, a one-time Air Force flight surgeon who has a background in occupational medicine, said the variety of interfaces available for VistA offered a good potential for customization.
Now governed by the Open Source Electronic Health Record Agent, VistA is being tweaked for meaningful use certification and is also a host for plug-ins or apps that software developers are creating.