Healthcare Information Systems (HIS) are essential to the record-keeping functions and clinical care management of a medical center or outpatient clinic. The U.S. Department of Veterans Affairs (VA) has developed and continues to maintain a robust HIS known as VistA - the Veterans Health Information Systems and Technology Architecture. This system was designed and developed to support a high-quality medical care environment for the military veterans in the United States. The VistA system is in production today at hundreds of VA medical centers and outpatient clinics across the country.

VistA has a proven track record of supporting a large variety of clinical settings and medical care delivery systems. Facilities range from small clinics that provide solely outpatient care to large medical centers with significant inpatient populations and their associated specialties, such as surgical care or dermatology. These systems focus on clinically relevant record keeping that improves patient care by improving clinical and administrative decision-making. Versions of this system are in active use in the U.S. Department of Defense Military Health System, the U.S. Department of Interior's Indian Health Service, and internationally as well, e.g., Berlin Heart Institute of Germany (Deutsches Herzzentrum Berlin, Deutschland), and National Cancer Institute of Cairo University in Egypt.

The costs associated with the acquisition and support of an HIS can indirectly affect the quality of health care provided by limiting the availability of timely and accurate access to electronic patient records. One solution is to lower the cost of acquiring an HIS by using a software stack consisting of open-source, free software (OSFS). Since VistA is in the public domain and available through the US Freedom of Information Act (FOIA), software license fees are not an issue with regard to its deployment.