Big Data in the Veterans Health Administration: A Nursing Informatics Perspective

Abstract

Purpose This article reviews the missions of the U.S. Department of Veterans Affairs (VA) and the evolution of its electronic health record (EHR), the Veterans Health Information Systems and Technology Architecture (VistA). This system, along with its clinical graphical user interface the Computerized Patient Record System, form a key link in VA health care. A Veteran who receives healthcare through the VA can have their EHR accessed by clinicians at any VA healthcare facility across the United States and its territories. Data aggregated daily at a corporate data warehouse supports VA quality improvement and research. Organizing Construct Serving over 9 million Veterans, the VA is one of the largest integrated healthcare systems in the United States. It has been a leader in the development and use of healthcare informatics, EHR, and big data analytics for over 30 years. Nurses engaged in major roles in the evolution of these developments. Conclusions With over 500 nurses as members, the Office of Nursing Informatics’ Field Alliance demonstrates the VA’s continuing commitment to fostering nursing informatics. The commitment includes investment by the VA to develop nursing informaticists from among its own staff. Clinical Relevance Exemplars of the impact of nursing informatics are shared. Future directions include an EHR that begins during military service and follows the Veteran into VA health care.

Single-Vendor Electronic Health Record Use Is Associated With Greater Opportunities for Organizational and Clinical Care Improvements

“… 37 Similarly, nursing at the VHA has made use of big data to develop the VHA Nursing Outcomes Database to assess a range of variables, including demographic characteristics, financial, nursing-sensitive indicators, and hospital-acquired conditions. 38 , 39 These data sets have promoted QI efforts throughout the VHA system as standardized data fields, and data collection allows for evaluation of quality over time. In turn, this provides an opportunity to compare and evaluate outcomes adequately.…”

“…In turn, this provides an opportunity to compare and evaluate outcomes adequately. 39 , 40 , 41 , 42…”

Digital Medicine System in Veterans With Severe Mental Illness: Feasibility and Acceptability Study

“…Therefore, before testing a DMS in a large randomized controlled trial, we wanted to examine the feasibility and acceptability of a DMS among patients with SMI. As the Veterans Health Administration (VHA) is the largest health care provider for individuals with SMI in the United States [7,8], it provides a conducive setting for a clinical trial comparing DMS and TAU. Thus, the primary purpose of this study was to evaluate the impact of a DMS among Veterans (patients) with SMI as compared with TAU on medication adherence.…”

A Machine-Assisted Gaze Analysis Method for Students’ Psychological Evaluation

“…The other two concepts are process evaluation and result evaluation. Among them, the process evaluation occurs in the project in the operation stage, and the result evaluation involves the project's results to the client and the community [2].…”