This book has been a long time in the making. The computerization activi ties described in these pages began in 1977 at the Department of Veterans Affairs (VA), but we devoted most of our focus and efforts to building and then implementing the extensive hospital information system known as the Decentralized Hospital Computer System (DHCP) throughout VA. Deliv ering the product has been our primary goal. We spent relatively little time documenting or describing our experiences or lessons learned. Except for some presentations at national meetings and a relatively few publications, almost none of which were in the standard trade journals read by Chief Information Officers (CIOs) and equivalent top managers in the private and nonprofit sectors, VA's accomplishments remained a well-kept secret. In 1988, Helly Orthner encouraged VA staff to consider writing a book, but the press of day-to-day activities always seemed to take precedence, and the book languished on the back burner.
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This book has been a long time in the making. The computerization activi ties described in these pages began in 1977 at the Department of Veterans Affairs (VA), but we devoted most of our focus and efforts to building and then implementing the extensive hospital information system known as the Decentralized Hospital Computer System (DHCP) throughout VA. Deliv ering the product has been our primary goal. We spent relatively little time documenting or describing our experiences or lessons learned. Except for some presentations at national meetings and a relatively few publications, almost none of which were in the standard trade journals read by Chief Information Officers (CIOs) and equivalent top managers in the private and nonprofit sectors, VA's accomplishments remained a well-kept secret. In 1988, Helly Orthner encouraged VA staff to consider writing a book, but the press of day-to-day activities always seemed to take precedence, and the book languished on the back burner.
Addressed to senior health care administrators, chief executive office rs, and physicians and nurse clinicians involved in management, this b ook describes the evolution of an information systems technology archi tecture capable of supporting a multi-facility system. Contributors fr om within the VA document their involvement in system design and devel opment and describe the principles that have allowed the system to evo lve over time. Focusing on clinical services and deriving management i nformation from them, the VA offers a compelling model for multi-facil ity systems. The book is the first comprehensive description of this m odel in print. Honored in 1995 by the Computer-based Patient Record In stitute (CPRI) for the capabilities of its CPR, the VA is transforming its system into an integrated services network -- adopted for use by several major health systems in North America, Europe, and the Pacific Rim.
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