VA Computerized Patient Record and Telemedicine Budget Code:  
The continued development of the VA computerized patient record will expand availability of patient data and images to health care providers. Computerized records ensure that data will be available at the point of care and accessible throughout the distributed network of VA and Federal health care facilities where patients are treated.

Components of the record will include:
  • PDX - Exchange of patient demographics and health summary data between treating VA facilities;
  • Clinical Lexicon - Integration and application of national and international standard nomenclatures, e.g., NLM's UMLS, to bring precision to the communication of clinical data across different health care organizations;
  • Patient Care Encounter - A framework into which order information can be associated with a given visit. Orders can be linked to a given diagnosis or complaint and eventual outcome, so that the effectiveness of specific orders or order sets can be established;
  • Standards-based inter-application communications - Includes a messaging system, HL7, SQL, and controlled vocabularies. Implementing these national and international standards will permit the exchange of data among the public and private sectors;
  • Telemedicine - In FY 93 the National Library of Medicine funded a High Performance Computing and Communications contract to a consortium of West Virginia University, community, health care provider, and corporate institutions. The purpose of the 3-year award was to apply and evaluate advanced networking technologies to the delivery of health services in both rural and urban areas of West Virginia. At the end of FY 94 Veterans Affairs Medical center (VAMC) Clarksburg joined as a participant in the statewide Mountaineer Doctor TV Network linking rural hospitals in West Virginia for telemedicine and educational purposes.
Budget ($ M)
FY 95 Act 14.00
FY 96 Pres 14.00
FY 96 Est 1.40
FY 97 Rqst 1.80
Program Component Areas
  FY 96 FY 97
HECC    
LSN 0.80 1.20
HCS 0.20 0.20
HuCS 0.40 0.40
ETHR    
Agency Ties
DARPA  
NSF  
DOE  
NASA  
NIH Partner
NSA  
NIST Partner
NOAA  
EPA  
ED  
AHCPR Partner
VA  
Milestone Changes  
FY 1995 Actual Milestones FY 1996 Estimated Milestones FY 1997 Agency Requested Milestones
Established WWW pages for publication of information related to Medical Informatics Standards activities. This is a collaborative effort with AHCPR.

Connected Clarksburg VAMC to the HPCC supported statewide Mountaineer Doctor TV Network linking rural hospitals in West Virginia for telemedicine and educational purposes.

Developed and tested the Patient Care Encounter (PCE)-the framework into which order information can be associated with a given visit. PCE links orders to a given diagnosis or complaint and the eventual outcome so that the effectiveness of specific orders or order sets can be established.

Developed and tested the HL7 Package-a basic tool set for use by all applications that will assist in implementing standards based interfaces between clinical applications. 		Develop and test Enhanced PDX- the Enhanced Patient Data Exchange package that will enable directly merging of patient data from multiple treating facilities.

Develop and test DHCP Request Broker which processes messages between the Workstation front end and the Clinical Data Base.

Conversion of customized medical device interfaces to standards based HL7 messages. 		Enhance and test CPR (Computerized Patient Record) System.

Test the integration of Telemedicine Systems with the CPR.

Expand testing of VA Nationwide Authentication, Authorization and Encryption Services to allow secure transmission of medical data across unsecured telecommunication links such as public networks, phone systems and Internet.

Expand evaluation of options to use SQL as a mechanism of accessing medical data contain in disparate systems.

Develop and test an interactive voice response system to enable access to information from existing VA computer systems 24 hours a day, 7 days a week.