Lessons from the VA in Health IT

Gary L. Thompson, Co-founder and CEO, CLOUD, Inc. (aka @CLOUDHealth) wrote an interesting post on HL7Standards.com regarding the physical geography of health care, using the Veterans Administration’s health care system as a model.
I enjoyed this blog post. Although having recently completed my training, it does bring up some thoughts.

I worked for 5 years in a VA hospital during my residency and fellowship training. It was an enjoyable experience although the VA is not without flaws. I have an intimate familiarity with VISTA and CPRS (the graphical representation of VISTA) from a provider point of view. Graphically, the UI and UX of CPRS seems terribly outdated with strong echoes of Windows 95/98. Inputting data is very typewriter-ish although preset and custom templates are available. Copy and paste is rampid despite attempts to restrict it.

That being said, VISTA should be commended in it’s internal HIE between providers. I can view any other provider or staff member’s documentation on my patient. It no longer requires the patient to be the (usually unreliable) hub of their own medical data. I can alert other physicians to data or my own notes on mutual patients. Medication prescribing is very streamlined as nearly all meds can be mailed to a patient within a few days. Alerts and renewals are quite easy to plow through without having 40 paper charts on my desk. Having access to all the bloodwork and diagnostic test done in any networked VA eliminates mountains of duplication and saves costs. Integration of progress notes, outside documents (usually in PDF), radiology, EKGs, and pharmacy data in one software package is VERY convenient for provider and patient.