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VA Code in Flight Submission - VistA Evolution Radiology Package GUI BRD (BRD Document)
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Submitted by OIT EPMO EPMD ACOE Tools Operations Open Source Service on 09-17-2015.
Veterans Health Administration’s (VHA) Office of Patient Care Services (PCS), Diagnostic Services requests the development of a Veterans Health Information Systems and Technology Architecture (VistA) Evolution Radiology Package Graphical User Interface (GUI).

The VistA Evolution Radiology Package GUI will provide an enhanced presentation layer for the VistA Radiology Package. The system’s current user interface (UI) consists of an outdated “roll and scroll” text-based environment which requires users to memorize keyboard-entered commands and provides few visual cues to users about available functionality and features. The VistA Radiology package is the primary Information Technology (IT) tool for the entirety of the radiology workflow, beginning with receiving a radiology order to performing the required study and delivering the resulting images into the patient’s electronic health record (EHR). The inspiration for this request is VA’s Computerized Patient Record System (CPRS), the application GUI that allows users to interact with a patient’s EHR through direct manipulation of its graphical elements while maintaining context with the functionality of the underlying system.

A robust, user-centric Radiology Package GUI will not only improve the usability of the software, but will also help improve the radiology business process itself in a number of ways. First, the GUI will greatly reduce users’ reliance on printed hard copies of orders and related documents. Heavy use of paper documents is the source of many risks and issues in VHA radiology labs. Documents can easily be lost, misplaced, or damaged. Handwritten notes can be illegible or difficult to interpret. Paper copies of orders are only readable to those staff in possession of the copy; nobody else in a radiology lab can view paper documents and notes without knowing where the printed copy is and walking to wherever it is stored. In addition, constant printing of orders is expensive due to the cost of paper, ink, and printer maintenance. Adoption of a fully electronic system with a user-friendly GUI for processing radiology orders will help reduce or eliminate these issues.

Second, the GUI’s features will enable more robust communication and collaboration among staff. Radiology staff frequently has to “chase down” hospital staff in order to communicate vital information related to patient care. For instance, administrative staff such as schedulers and other clerical positions often have information related to appointments that would be useful to radiologists and technologists, but they do not have an IT solution that allows them to associate an electronic note with a patient or procedure. A GUI that provides the ability for users to enter notes that are viewable across the team will greatly enhance the ability to efficiently and effectively perform radiology studies.

Third, the GUI will enable more efficient scheduling. The current process for scheduling a patient procedure in the VistA “roll and scroll” environment can be both confusing and time consuming. For example, schedulers must use keyboard commands to enter date ranges and identify open times for studies as the current package does not offer calendar views for scheduling patient procedures and/or specific pieces of radiology equipment. Developing a GUI that provides a logical workflow for identifying studies to be scheduled, viewing available times, and scheduling studies will have several positive outcomes for staff and patients. Schedulers will perform their jobs more efficiently as they will be able to view calendars showing available time slots at a glance. This will allow schedulers to view all of a patient’s pending and scheduled studies so they can easily select times based on patient preference resulting in improved patient satisfaction. Inpatient procedures have the potential to be scheduled back-to-back when possible so patients are transported within the hospital less frequently. Finally, equipment will be more efficiently utilized, as schedulers will be able to view a calendar for a single piece of equipment, such as a Magnetic Resonance Imaging (MRI) machine, and schedule studies strategically to avoid gaps in utilization.

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