Vista Imaging Expertise Center

Under the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA), the Indian Health Service has received special funding for Health Information Technology (HIT) projects. The Indian Health Service (IHS) is the principal federal health care provider and health advocate for Indian people and provides a comprehensive health services delivery system for American Indians and Alaska Natives (AI/AN). IHS provides comprehensive health services through a system of Federal (direct) Indian Health Service, Tribal, and Urban (I/T/U) operated facilities and programs. These I/T/Us provide health services to 1.7 million American Indians and Alaska Natives through 144 Service Units composed of more than 500 direct healthcare delivery facilities. The range of services includes traditional inpatient and ambulatory care and extensive preventive care. Facilities are in both urban and rural areas. Efforts focus toward health promotion and disease prevention activities, as well as the delivery of appropriate clinical care.



IHS recognizes that health information technology is intrinsic to the success of its ability to serve the American Indian/Alaska Native (AI/AN) populations for whom it was created. The role of the Office of Information Technology (OIT) is to manage all technology elements for the IHS, including telecommunications, network (LAN/WAN), security, data warehouse (NPIRS), and Resource and Patient Management System (RPMS) development, deployment, and support.



VistA Imaging (VI) supplies the multimedia component that completes the functionality of the RPMS Electronic Health Record. VI enables EHR users to view scanned documents and clinical images (photos, radiographs, etc.) that are linked to a patient's electronic record. It also provides Picture Archiving and Communication System (PACS) capabilities for the long-term storage of images.



The VistA Imaging application was written by VA and has been certified by the Federal Drug Administration (FDA) as a medical device. This FDA certification encompasses both the VistA Imaging application and the hardware/software configurations that make up the VistA Imaging operating environment



Indian Health Service (IHS) and the Department of Veterans Affairs (VA) are in collaborative agreement for the use and implementation of VistA Imaging for electronic image capture, storage, and retrieval. IHS implemented their first VistA Imaging system at the Portland Area Office in 2006, followed by the Nashville Area Office, Billings Area Office, Phoenix Area Office, and several tribal sites in Oklahoma and Alaska. The IHS has purchased its VistA Imaging equipment from Hewlett-Packard (HP) which is approved to sell the FDA approved hardware configuration. IHS currently has break/fix maintenance service through the HP Customer Support Center (CSC). The CSC can perform hardware diagnosis and dispatch local HP engineers with parts, but does not have knowledge of the VistA Imaging infrastructure.



The primary objective of this fixed price order is to obtain VistA Imaging infrastructure support services to augment the hardware maintenance of IHS VistA Imaging systems.



This order was awarded using a limited sources justification. The rationale for the limitation on competition is the VistA Imaging hardware and software platforms have been certified as a medical device by the FDA. Therefore, there are very specific requirements concerning the types of equipement and configurations that must be used for scanning, storing, and archiving images. The FDA requires that vendors pursuing certification go through the Veteran Administrations' validation process. Currently, Hewlett Packard is the only vendor that has completed the validation processa nd is certified to provide hardware, installation, and maintenance services for VistA Imaging.