VistA Imaging

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VistA Imaging is an FDA-listed image management system used in VA hospitals across the United States. It stores and organizes many kinds of medical images tied to a patient’s record, from X-rays and CT/MRI scans to EKGs, pathology slides, endoscopy pictures, surgical images, and scanned documents. It started as a research project by Ruth Dayhoff in 1986 and was launched in 1991.

The system uses hardware storage, network servers, and a DICOM gateway to communicate with PACS and imaging devices. A background processor moves images to the right storage and helps manage storage space. It is integrated with the VistA electronic medical record but can also work with other EHRs. A nationwide backbone lets clinicians access about 350 million VA images via Remote Image View, with interfaces to more than 250 medical devices through the VistA Imaging Viewer.

The Department of Defense plans to use the VistA Imaging Viewer to improve sharing of images with the VA as part of a DoD-VA effort to coordinate care, aiming to exchange all image types across sites.

Future enhancements include a central VA image archive and improved indexing and search capabilities.

Licensing and access: the software is available through FOIA as public-domain material, but because it is a medical device, it cannot be freely modified or implemented without FDA approval. Outside VA, use requires licensed proprietary modules and FDA registration. The source code is available in the OSEHRA VistA-M.git repository.

VistA Imaging uses proprietary modules, so public-domain use is limited. It proved robust when the New Orleans VA data facility lost power during Hurricane Katrina, offering better backup than paper records.