Veterans Health Information Systems

To enhance its hospital information system and provide quality healthcare services to some 25 million veterans across the United States, the Department of Veterans Affairs instituted the Decentralized Hospital Computer Program (DHCP) in 1982. Information system at this time was in its infancy and mostly focused on hospital-based activities. The Department operates the largest direct health care delivery system in the country and conducts supporting medical research.

VA also administers veterans’ benefits including monthly disability payments, education assistance, life insurance, home loans, and vocational rehabilitation and employment services. (The White House, 2006, Overview, ¶2). It manages 158 hospitals, 840 ambulatory care and community-based outpatient clinics, 133 nursing homes, and 206 community-based outpatient psychiatric clinics. Due to the growing demand for more efficient and faster access to medical services as well as meet its unique needs, the department upgraded its system in 1996 with the Veterans Health Information Systems and Technology Architecture (VistA).

It has incorporated the capabilities of the original system. VistA is an automated setting supporting various operations of the department’s medical facilities. The system, which maintains ambulatory and inpatient care, comprises over a hundred applications that cater to pharmacy, radiology, nursing, and laboratory among others. VistA aims to guarantee timely and quality medical care to veterans, to lessen the processing time in claiming disability benefits, and to effectively coordinate medical care and patient information between the Veterans Affairs and other healthcare providers.

VISTA is built on a client-server architecture, which ties together workstations and personal computers with graphical user interfaces at Veterans Health Administration (VHA) facilities, as well as software developed by local medical facility staff. (DVA, 2006, ¶2). It is composed of several software packages that increase the sharing of essential information about the patient’s health conditions to the physicians for better monitoring throughout the process of treatment and recovery.

This health informatics consists of a Health Data Repository, a collection of clinical information from the department and other health organizations for use by physicians to facilitate patient-centric care. Some of its features include Automated Medical Information Exchange, Incident Reporting, and Lexicon Utility (standardized reference for clinical terminology). Second, it has a system for registration, enrollment, and eligibility that features admission, discharge, and transfer (ADT), clinical monitoring, enrollment application, hospital inquiry, income verification match, record tracking, and veteran identification card.

Third, it sustains a Health Provider System that helps other healthcare institutions in caring for the veterans by feeding them vital information in the form of care management, clinical procedures, computerized patient record system, dentistry, laboratory, and pharmacy. Fourth, it has Management and Financial Systems that provide billing and patient records management solution such as accounts receivable, automated information collection system, compensation and pension records interchange, incomplete records tracking, personnel and accounting integrated data.

Fifth, it has an information and education systems stressing the need for eHealth to further improve service to the veterans and stakeholders by using the internet to fill applications, make appointments, prescription refills, and access health records. This dimension has an automated safety incident surveillance tracking system, a library, police and security. Despite its complexity, VistA has proven to be an effective health information system both in hospital and clinical-based operations.

With its Computerized Patient Record System (CPRS) physicians can now accurately diagnose and treat the patient correctly and monitor his/her progress without the barriers of time and distance. Whether the patient is within or outside the medical facilities of the Veterans Affairs, his records can still be accessed by other health care providers and be treated properly. With the integration of My HealtheVet in VistA, veterans can access their own medical records through the internet anywhere in the world.

My HealtheVet is a web-based system that empowers veterans with information and tools so that they can improve their health to the maximum extent possible. Participating veterans are given copies of key portions of their electronic health records. (Veterans Affairs, 2003, ¶1). Another factor why VistA is successful because of its Imaging technology that provides multi-media on line about the patient’s medical chart information integrated with medical images.

It is critical during clinical procedures whether in hospitals or in remote areas. VistA Imaging gives physicians captured images of the patient’s x-rays, cardiology exam results, wound photos, dental images, scanned documents, pathology slides and even handles video conferencing. Lastly, with its Bar Code Medication Administration, VistA was able to reduce medication errors for inpatients by electronically validating and documenting all medications.

This system makes sure that all patients receive proper medication in the correct dosage at the right time and alerts medical staff when something is wrong. In hospital-based operations, the number of patients lining up or calling for appointments and inquiries have been greatly reduced because they are now using the internet to do all these activities, which is also beneficial to the veterans because they do not need to travel and spend more time waiting. Patients have also the convenience of ordering their medications online.

Among all the technologies provided by VistA, perhaps the most vital is the Computerized Patient Record System (CPRS) because this is the key to quality healthcare and to the patient’s quick recovery and right medication. CPRS provides a single interface for health care providers to review and update a patient’s medical record as well as to place orders for various services including medications, special procedures, x-rays, patient care notes, diets, laboratory tests, and consultations.

(Hynes, Perrin, Rappaport, Stevens, & Demakis, 2004, ¶12). It gives a precise overview about the patient’s medical conditions before any treatment is performed. It shows timely information about his/her active clinical problems, allergies, current medications, recent laboratory results, vital signs, hospitalization, and outpatient clinic history. CPRS possesses many capabilities to make certain that the best care is given to the patient.

Among them are as follow: (1) Real Time Order Checking System that alerts clinicians of a possible problem could exist during the ordering session, (2) a Notification System that also alerts clinicians on critical events, (3) a Patient Posting System alerting clinician to address the immediate needs of the patient that include crisis notes, adverse reactions, and advance directives, (4) Clinical Reminder System allowing caregivers to monitor and do preventive healthcare to patients as well as guarantee appropriate clinical procedures are initiated, and (5) Remote Data View allowing clinicians to see the medical history of the patient from other Veterans Affairs facilities.

CPRS provides physicians a health summary of the patient for a quicker view of his medical conditions and clinical problems. In addition, it has a tracking system for consultation and requests as well as for adverse drug reaction. As a result of all these technologies, VistA has given the Veterans Affairs the needed design to put together its both clinical and hospital-based operations to the point of affording their patients with the best healthcare delivery in the country.


The White House. (2006). Department of Veterans Affairs. Office of Management and Budget. The Executive Office of the President. Retrieved November 3, 2006 from http://www. whitehouse. gov/omb/budget/fy2005/va. html DVA (Department of Veterans Affairs). (2006). VistA Monograph.

Veterans Health Information Systems and Technology Architecture (VISTA). Retrieved November 3, 2006, from http://www. va. gov/vista_monograph/ Veterans Affairs. (2003). My HealtheVet Pilot. Your Personal Health Journal. Frequently Asked Questions. Retrieved November 3, 2006, from http://www. health-evet. va. gov/faqs. asp Hynes, D. M. PhD, MPH, RN, Perrin, R. A. MA, Rappaport, S. MD, Stevens, J. M. RN, and Demakis, J. G. MD. (2004). Informatics Resources to Support Health Care Quality Improvement in the Veterans Health Administration. American Medical Informatics Association. Retrieved November 3, 2006, from http://www. pubmedcentral. gov/articlerender. fcgi? tool=pmcentrez&artid=516240

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