The Tennessee Department of Health (TDH) provides healthcare services to citizens who are underinsured or non-insured. TDH receives funding from both state and federal grants based upon reports derived from an older AS400 solution called Patient Transcription Billing Management Information System (PTBMIS).

TDH was looking to revamp their current record system by implementing an Electronic Healthcare Record System that would allow for highly customized workflows that are not seen throughout hospital systems when it came to nursing and patient drugs.


TDH sought out an open source solution to move from paper medical records to an electronic medical records during phase I of implementing an Electronic Healthcare Record (EHR) system.

Additionally, the goal of TDH is to seek out Meaningful Use funding during the Phase I roll out to help offset the cost of the roll out in all 126 sites.

DSS Inc. was awarded a contract to implement vxVistA and vxCPRS for the State of Tennessee Department of Health. TDH was in need of project managers to lead the implementation of the project. Due to the overall cost and size of the project Business Solutions Delivery, a state organization, was brought in to oversee the project.


During this phase PTBMIS will continue to be in place for clinical areas not moved to the EHR as well as for the patient registration. Once the patient is registered and checked in at the clinic an HL7 message sends the information to both the Master Patient Index (MPI) and vxVistA. Additionally vxVistA communicated to the MPI and PTBMIS.

Healthcare providers use both vxVistA to document services rendered such as Clinical Notes, Labs, Vitals, WIC measurements and more.

Derek K. Douglas, one of the principal founders of DKDouglas Consulting, LLC, was hired to lead project teams on both the clinical and business side. Additionally Derek:

  • Developed the project schedule from one delivered by DSS Inc.
  • Managed the project schedule.
  • Developed executive level reports

Derek’s background in Information Technology and Clinical Applications allowed him to bridge the gap between all groups involved in the project.

Lester Skinner ( led the project on the Information Technology side. Lester works closely with OIR, a state organization in charge of the state IT infrastructure, to create a hardware and software platform that allowed for Business Continuity and Disaster Recovery. Additionally he worked to encrypt all possible endpoints.

Both Lester and Derek worked to develop a project site hosted on Tennessee’s Office365 SharePoint site. The site allows the TDH Project Management Team to have real time reports to Development tasks, Risks, Issues, Action Items and more. Additionally workgroup information such as documents and notes were setup to sync to individual workspaces.