Posted by: Tony Shannon | December 30, 2013

2 Clinicians: 2 Developers: 20 Days: Agile Development towards NHS VistA

A few posts back in my earlier article on “Transatlantic Thoughts.. on VistA .. in the NHS“,  I was commending some joint working between OS pioneers in both the UK and the US to move our learning forward on both sides of the Atlantic.

One of the recommendations in my presentation to the recent 2nd OSEHRA conference, in the Transatlantic blog article and at a recent related EHI presentation was to pursue an agile demonstrator of some key NHS standards (i.e. the NHS Common User Interface , Royal College of Physicians HIU Record Heading Standards) in the VistA stack.

Building on an earlier, though related “1 Clinician: 1 Developer: 10 Days Agile Development” project I had done with the UK based Rob Tweed and Chris Casey, they were keen to help..

On the “US side” and to their credit Medsphere and GDIT also picked up this recommendation.. so this has formed the basis of the first cut NHS VistA collaborative work described in this “First cut of VistA for NHS developed” article by Rebecca Todd from eHealth Insider.

The NHS VistA “first cut” work involved a week of my (Frectal Ltd) time, plus 3 weeks of Chris Caseys time, plus some of Dr. Edmund Billings (Medsphere) time, plus approx 1 other developer in the US.
(I should clarify that my input into this team effort was on my own behalf, i.e. not on behalf of either LeedsTH/LeedsNHS or the wider NHS..).
So a team of between 2-4 people working over a 3 week period… i.e. user-centred, agile and focussed.

The results were very interesting.. an open source, web-based, demonstrator of NHS VistA,
-inc basic NHS Common User Interface Patient Banner,
core Royal College of Physicians Headings etc
… which can be used on a PC, tablet (eg iPad) or smartphone.

See screenshots below to give a taste and the related OS code here.






Thanks to Chris Casey for his very helpful video on this demonstrator.



Where this small first step goes from here is now to be considered….(e.g  we are planning to meet with the Royal College of Physicians to offer this as an open source showcase of their important standards).
I hope its been a helpful exercise and another demonstration of the art of the possible, with clinically led, agile, collaborative development using open source.

If folk do want to know more/see more of the work done, please do feel free to get in touch.



  1. […] secure, federated integration with real, working VistA systems (instead of mocked up EHRs).  Rather than using the VistA-derived CCDAs, I could just as easily have used a JSON-based getVitals() API such as the one developed at Oroville Hospital, or the equivalent used for Tony Shannon’s NHS VistA demonstrator. […]

  2. […] Dr Tony Shannon, in his presentations on NHS VistA, has often remarked that what is needed is an Open Source, hackable EHR platform.  If such a platform became available, packaged in a such way that any interested Open Source developer (or, dare I say, hacker) could fire it up, dig into it and start developing new stuff on top of it, we’d have the basis of a really powerful Open Source EHR and a proper means of developing a vibrant and active development community. […]

  3. Reblogged this on Clinical UI Patterns and commented:

    Updating Clin UI P to show how our work progressed. This was the next phase of the work , done in collaboration with those interested in NHS VistA

  4. […] on learning from several phases of earlier work (including PPM+, Leeds Care Record, ClinUiP, and NHS VistA), we have quickly developed and deployed our Ripple UI framework as part of our Integrated Digital […]

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