The Department of Veteran Affairs (VA) operates the largest centrally-directed health care system in the United States through 171 VA medical centers (VAMC), 362 outpatient clinics, 129 nursing homes, and 35 domiciliaries. The VHA Medical Care Network is converting to 22 VISNs with a large number of access points. VHA automation systems are being adapted to support this business restructuring. The goal is to allow access to appropriate data from any access point independent of the location of that data.
The VA has a coordinated, integrated automation program whose purpose is to improve patient care and administrative operations by introducing advanced automation to deliver the right information to the right person at the right time in an economical manner. More effective administrative operations emphasize automated administrative functions, procurement, and electronic commerce. Improved patient care emphasizes making the correct information and services available electronically to the clinician on the wards where they make decisions. This information is currently drawn from the facility based integrated patient based information system, local area network CD-ROM data bases, and other VA facilities on the VA's Wide Area Network (WAN). Plans include increased accessibility to other WAN resources such as Medline and Internet based digital libraries.
Various aspects of the program focus on integrating technologies to enhance the existing computer based patient record, as well as to improve methods of data capture, data presentation, and inter-facility data exchange. The projects concentrate on the technical areas of workstations, information system architectures, local and wide area networks, and appropriate security and privacy alternatives. Standards based solutions will be necessary to insure continued interoperability and meaningful data exchange. These systems are being developed using a blend of in-house resources, federal sharing initiatives, and private industry support.
FY 97 President's Request by Program Component Area
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| Program Activity | Budget Account Code | Partner/User Agencies | Budget (BA, $ M) | HPCC PCAs by 1997 Pres. Request | |||||||
| FY95 Actual | FY96 Pres. | FY96 Est. | FY97 Rqst. | HECC | LSN | HCS | HuCS | ETHR | |||
| Computerized Patient Record and Telemedicine | NIH, NIST, AHCPR | 14.00 | 14.00 | 1.40 | 1.80 | 1.20 | 0.20 | 0.40 | |||
| Clinical Workstations and Medical Imaging | NIST, AHCPR | 7.66 | 3.61 | 5.20 | 3.00 | 2.00 | 0.60 | 0.40 | |||
| Improve Telecommunications Infrastructure and Internet Connectivity | DARPA, NIST | 0.18 | 0.18 | 0.18 | 0.75 | 0.50 | 0.25 | ||||
| VA Hybrid Open Systems Technology (VA HOST) | NIST, AHCPR | 14.46 | 14.50 | 14.50 | 7.75 | 1.00 | 4.75 | 1.00 | 1.00 | ||
| VA/DoD Sharing | NIST, AHCPR | 1.25 | 3.71 | 0.65 | 1.25 | 1.00 | 0.25 | ||||
| Totals: | 37.55 | 36.00 | 21.93 | 14.55 | 1.00 | 9.45 | 2.30 | 1.80 | |||
Comparison of FY 97 and FY96 Budgets by Program Component Area
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| Program Activity | Budget (BA, $ M) | HPCC PCAs by 1997 Pres. Request | HPCC PCAs by 1996 Estimated | |||||||||||
| FY95 Actual | FY96 Pres. | FY96 Est. | FY97 Rqst. | HECC | LSN | HCS | HuCS | ETHR | HECC | LSN | HCS | HuCS | ETHR | |
| Computerized Patient Record and Telemedicine | 14.00 | 14.00 | 1.40 | 1.80 | 1.20 | 0.20 | 0.40 | 0.80 | 0.20 | 0.40 | ||||
| Clinical Workstations and Medical Imaging | 7.66 | 3.61 | 5.20 | 3.00 | 2.00 | 0.60 | 0.40 | 4.00 | 1.20 | |||||
| Improve Telecommunications Infrastructure and Internet Connectivity | 0.18 | 0.18 | 0.18 | 0.75 | 0.50 | 0.25 | 0.18 | |||||||
| VA Hybrid Open Systems Technology (VA HOST) | 14.46 | 14.50 | 14.50 | 7.75 | 1.00 | 4.75 | 1.00 | 1.00 | 3.00 | 8.50 | 1.50 | 1.50 | ||
| VA/DoD Sharing | 1.25 | 3.71 | 0.65 | 1.25 | 1.00 | 0.25 | 0.65 | |||||||
| Totals: | 37.55 | 36.00 | 21.93 | 14.55 | 1.00 | 9.45 | 2.30 | 1.80 | 3.00 | 14.13 | 2.90 | 1.90 | ||
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