VA initiates big expansion of its EMR

An integrated electronic medical record that one of its developers calls the largest in the solar system just got a little bigger. The adoption of a new feature will draw in images from five additional specialties.

DICOM-linked images from ophthalmology, dentistry, cardiology, endoscopy, and pathology will join radiologic images in an EMR that serves the 24-million-patient VA medical system, said Peter M. Kuzmak of the VA's Vista Imaging Project. Information about the project was presented at an infoRAD exhibit at RSNA.

The VA's Vista EMR has been evolving since the 1980s and has featured multimedia capabilities since 1990, Kuzmak said. The latest advancement is the ability to incorporate images from other specialties into the system for ready access by VA physicians.

Software updates have been released to all 120 VA sites and implementation is under way. The system now has 120 million DICOM images, an average of five per patient.

The first big project will be to provide annual diabetic retinopathy screening exams to the VA's seven million patients with diabetes. New fundus cameras that can take photos of the retina without dilating the patient's eyes will collect images that can be electronically routed to ophthalmologists, who will check for diabetic retinopathy.

The cameras, which cost about $20,000 each, can be widely distributed to facilitate the screening exams. Ophthalmologists can interpret about 20 of the studies per hour, Kuzmak said.