EHR And The VA: Part I – History

One of the earliest EHR pioneers was the U.S. Department of Veterans Affairs (VA). The VA started its shift from a paper-based to computer-based records system in the 1980s (ideas for it were discussed a decade earlier). Called the Decentralized Hospital Computer Program (DHCP), the system was designed to bring consistent, standardized patient data into a locally centralized repository.

The birth of VistA

With the VA driving improvements to its EHR system, the DHCP evolved into a more robust tool dubbed VistA (Veterans Health Information Systems and Technology Architecture). One of the early major improvements was the addition in 1997 of a Computerized Patient Record System (CPRS), a graphical user interface that greatly improved ease of use. VistA’s many features included an electronic prescription module and decision support in the form of clinical guidelines.

In 2011, the VA enlisted an open-source community called OSEHRA (the Open Source Electronic Health Record Agent) to develop enhancements to VistA. This decision was part of a joint effort with the U.S. Department of Defense (DoD) to store all veterans’ and service members’ health records electronically using a single source.