Running head: 1995 Davies Organizational Award Winner

U.S. Department of Veterans Affairs' EHR

Edwin J. Ocasio
National University
COH 680: Health Informatics Case Study
Submitted to Dr. Sary Beidas
January 9, 2015

1995 Davies Organizational Award Winner

U.S. Department of Veterans Affairs' EHR
In 1995, the Department of Veterans Affairs was providing healthcare services for 2.6
million veterans through a system of 171 medical centers, 450 outpatient clinics, 131 nursing
homes, and 35 domiciliary facilities. In order to provide high-quality care to veterans at its
numerous and various facilities, it needed to implement a decentralized electronic health record
(EHR). This EHR would be require to manage about 1.1 million inpatient events, 24 million
outpatient visits, 50 million prescriptions and over 250 laboratory studies based on previous
fiscal years.
To meet this challenge, the VA management decided to develop their EHR on its current
Decentralized Hospital Computer program (DHCP) foundation. The implementation would
follow a phase approach that would first give providers the functionality and the data for
immediate use. It would this module to the foundation for the rest of the comprehensive health
and patient information system. It would migrate from a department-centered structure to an
architecture that would support departmental and patient-centered functionality. This new
approach will make it possible to share and exchange within the VA system, with other
governmental health agencies, and eventually with other and private parties.

1995 Davies Organizational Award Winner

The electronic health record will extend the DHCP clinical functionality in many areas
of health care and health information. The EHR will include a graphical interface for order
entry and results reviewing and reporting. It will have the ability to produce not only a problem
list, but generate a discharge summary and patient-specific health summary. All of this data and
the information derived can now be shared and exchanged throughout the VHA system. The
highlight and the source of most of the clinical data was the patient care encounter (PCE)
module. The PCE captured the longitudinal patient record and included all the data from the
various ancillary packages.
The Department of Veterans Affairs EHR was meeting the goals of what would become
Meaningful Use many years later and impact what would become regulations written to
implement ARRA High Tech Act of 2009. It address some of the Meaningful use Stage 1 goals
for improving quality, efficiency, and reducing health disparities. It allow providers to share and
exchange information to improve care coordination. The comprehensive data and patient
information would be used to improve population and public health in this concentrated
population. It already had an architecture that ensure adequate privacy and security protections
for personal health information and now for the electronic health record.

1995 Davies Organizational Award Winner

References
Davies Organizational Award Winners. (2007). Improving quality and reducing cost with
electronic health records: Case studies from the Nicholas E. Davies Awards. (pp. 23-26).
Chicago, IL: HIMSS.