Network turns around US hospital system

10.05.2006
"Patients were being turned away until clinical referral information arrived. Use your imagination -- anything could happen. X-ray reports could take months. Beyond that, any chart a doctor needed was not available half the time."

That recollection by Dr. William Beer of the South Texas Veterans Health Care System in San Antonio may match some snippet from your last hospital visit, but at the medical centers of the Veterans Health Administration of the U.S. Department of Veterans Affairs, it's ancient history. Today, any VA doctor can call up the full record of any patient.

That's right -- having been a national embarrassment in the post-Vietnam era, as depicted in the movie Born on the Fourth of July -- the VA medical system is now a national model for health care IT.

"They are certainly leading the health care industry in terms of computer technology," said John Friedman, director of communications at the National Committee for Quality Assurance, a health care industry organization that grades and accredits health care plans. "While computerization has about a 10 percent penetration in the health care industry overall, it's 100 percent in the VA." Encompassing 154 medical centers and other clinics, nursing homes and rehabilitation centers, totaling nearly 1,400 sites, the VA served 5.3 million people last year.

"By all the measures we use, the VA offers superior care to what you can get in the general population," Friedman said. "The VA is now one of the premier places to get health care in the country. And we think that computerization has been a contributing factor. Their adoption of IT was part of their re-engineering the delivery of health care, using a systems- and process-based approach, with continuous quality improvement and measurement," Friedman said.

As early as 1996, the VA began integrating various applications into a client/server environment called the Veterans Health Information Systems and Technology Architecture, or Vista. The doctor's interface to it is a graphical system, brought out in 1997, called the Computerized Patient Record System (CPRS), which combines more than 100 different applications. (All the components are available for use by anyone under the Freedom of Information Act.)