Large scale implementation of-compatible hospital computer systems within the veterans administration

The United States Veterans Administration provides a medical care delivery system comprising more than 170 hospitals, clinics and domicilliaries. Historically, these institutions have been relatively autonomous in their day-to-day operations and consequently efforts at computerization have been difficult to adequately coordinate. A recent undertaking of the VA has been to establish decentralized coordination of planning and implementation for hospital computer systems. This presents a unique opportunity to promote standard, portable and well-designed solutions to meet the widely variable needs of a large and diverse health care delivery organization. Although computer systems for each hospital will vary with the needs of the hospital, functional program packages can be delivered and maintained in a cost-effective and manpower-efficient manner. Additionally, because all systems will be based on a common data dictionary it will be possible to gracefully expand systems as needed and to study clinical care and delivery methodologies across many institutions.