The Simple Answer:WebVista is a completely web-based system created by ClearHealth providing comprehensive practice management and electronic medical records for in-patient facilities. It is based on the Veteran's Administration VistA system but modernized to including comprehensive scheduling, billing and to eliminate many of the common complaints and added costs with VistA relating to MUMPS, CACHE or GT.m and non-compliance with current standards regarding HL7, XML, clinical data sets (such as ICD-10, SNOMED, LOINC, RXNORM, etc), ePrescribing and full electronic billing.

The Technical Stuff: WebVista is a system created by ClearHealth which is a complete modernization of the Veteran's Administration VistA system. Key goals of the project were to offer a completely web-based system, comply with modern standards and commodity technology in deployment and operation, unlimited horizontal scalability and the ability to add and integrate functionality without esoteric conversion of the VistA runtime and MUMPS source was made that flattens that entire architecture to a C & C++ based shared object library which can be accessed through a customized extension to the PHP programming language. WebVista is NOT simply a web-based front-end to a traditionally powered VistA system. WebVista is also NOT a customized version of the base VistA source code similar to the WorldVista and OpenVista projects.

Yes! There are several open source components to WebVista including the shared object library (libwebvista), which is under the LGPL v2, the PHP extension (php-webvista), which is under the PHP license and the WebVista PHP UI, which is under the GPL v2. Additional some add-on data sets and RPC style modules are under the LGPL and AGPL v3.

Private Beta: WebVista has not yet had a public and complete source code release. There are several reasons for this including the limited amount of resources we currently have to provide documentation and guidance on getting the system installed and running to the community at large. Furthermore the size of the project is an issue: libwebvista for example is 5.5GB of source code which produce somewhere between a 500MB and 800MB binary.

Our first private beta site belongs to a large hospital organization with more than 70 sites overall. It is a 30-bed hospital including an ICU, 3 general surgical theatres, an ER and internist consultation suites that went live in December of 2008 with a phase one implementation. We expect them to provide public information about their installation and usage after their phase 2 implementation is completed in the June-Aug timeframe of 2009. They have already received the system under the licenses mentioned above.

Absolutely Not! Don't just take our word for it, several notable people in the Open Source HIT field including Fred Trotter, Roger Maduro and others have been provided tangible demonstrations of the system and access to the source code. If you are one of these notable people or a member of the press and are interested in seeing the system, please contact us at: This email address is being protected from spam bots, you need Javascript enabled to view it

Prevalent Web Cluster Commodity Architecture WebVista runs on a web cluster very similar to that employed on a massive scale by sites like Google, Facebook and Yahoo. A cluster is a minimum of six commodity systems running linux (preferably RedHat Enterprise 5+ AP) and an optional SAN (Dell MD3000I or EMC both via ipscsi). The system includes 2 load balancers in fail-over mode utilizing the Open Source Pound or NGINX systems, 2 web servers utilizing GFS running apache, PHP and Memcached (for sessions and some other cached data) and 2 databases running MySQL in master/slave with MySQL-Proxy setup to redirect reads to the slave and also pull data from the Memcached clinical data store persistent cache (which assumes some of the role of EAV operations in traditional VistA). The web servers can be scaled out to approximately 30 systems for additional redundancy and load distribution without special engineering. The databases can be scaled out to 6 systems but are limited by a single masters write speed without special engineering. The load balancers can handle traffic up to wire volume of around 10mbps, special tcp/ip offload hardware is used to handle wire volume over 10mbps.

A typical 6 system cluster offering total 24/7 availability, and single failure redundancy can handle approximately 200-1,000 users (depending on modules and number of encounters) on up to 12GB of live data operating on 4.5TB of total data. A certified configuration from Dell is approximately $30,000-$45,000.

Software Architecture: WebVista includes the libwebvista shared object library to perform native VistA operations. These are accessed through the php-webvista wrapper extension. EAV operations that traditionally occur in VistA fileman are completed through a non-persistent shared memory block or as callbacks to the php-webvista extension which handles the persistence of data in the clinical data store (which is based on Memcached, lazy persistence to MySQL) or to MySQL directly. No command line/terminal style operations are provided, all operations occur through the PHP WebVista UI including PBM, patient add and management/administration tools. New features such as scheduling, billing and XML templates are implemented in the PHP code but are functionally seamless with all VistA based operations. CACHE/GT.m is not used. Very little MUMPS script is used but certain select MUMPS code can be evaluated through the libwebvista library. To develop on the system C/C++/PHP skills are needed, traditional VistA experience is helpful but not required. An understanding of modern web cluster systems employing memcached is extremely helpful.

Yes, It Was! We have been working on WebVista for more than 2 years now from initial conception. VistA overall has approximately 29,000 functions across several hundred modules. Fortunately, a good deal of that is not used or needed by common operations at non-VA facilities. Currently around 60 modules are in a beta state with another 100 in an alpha state. The core 60 modules include virtually all of the common operations for most in-patient facilities.

Our approach to modernizing VistA was intended to meet the needs of our customer base and offer the TCO, flexibility, and inexpensive horizontal scaling our company is known for. Our approach isn't a comment on anything to do with the traditional VistA systems or the MUMPS language. For many organizations, the prohibitive expense of working in MUMPS and finding qualified personnel is insurmountable, given the very limited number of potential staff versus the available staff with experience in web based system using PHP/C/C++. Additionally, turn around times and flexibility can be very fast; our first 30-bed facility implemented their phase 1 in just 60 days from inception. That is not a reasonable time-line for most facilities and situations but is possible given the technology.