Telehealth strategies and information technology transform patient care within the u.s. department of veterans affairs

For more than a decade, the U.S. Department of Veterans Affairs (VA) has pursued two linked strategies for the use of information technology (IT) in improving clinical health outcomes among the more than six million active patients under its care. The first strategy, implementation of computerized patient records (CPRS), was largely complete from 1999 onwards at the VA's 173 hospitals and more than 1000 community based outpatient clinics served by the organization in the United States. Many modifications have occurred since then, under the Veterans Health Information Systems and Technology Architecture (VistA), under which CPRS runs. The second major strategic program, taking advantage of CPRS but with its own advantages, has been the use of teleheath technologies. These are used to leverage medical specialty care and overcome the large geographic distances inherent in a health care system serving a widely dispersed population.