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

Area of Science:

• Healthcare Informatics
• Health Information Technology
• Big Data Analytics

Background:

• The U.S. Department of Veterans Affairs (VA) is one of the largest integrated healthcare systems, serving over 9 million Veterans.
• The VA has over 30 years of leadership in healthcare informatics, electronic health records (EHR), and big data analytics.
• Nurses have played significant roles in the evolution of these healthcare technologies within the VA.

Purpose of the Study:

• To review the missions of the U.S. Department of Veterans Affairs (VA).
• To examine the evolution of the Veterans Health Information Systems and Technology Architecture (VistA), the VA's EHR system.
• To highlight the role of VistA and its interface in VA healthcare delivery and data management.

Main Methods:

• Review of VA missions and the historical development of VistA.
• Analysis of the VistA system's architecture and its clinical graphical user interface, the Computerized Patient Record System.
• Examination of data aggregation processes for quality improvement and research.

Main Results:

• VistA enables seamless access to a Veteran's EHR across all VA facilities nationwide.
• Daily data aggregation at a corporate data warehouse supports VA quality improvement initiatives and research.
• The Office of Nursing Informatics' Field Alliance, with over 500 nurses, underscores the VA's commitment to nursing informatics.

Conclusions:

• The VA demonstrates a strong commitment to advancing nursing informatics through initiatives like the Field Alliance.
• Investment in developing nursing informaticists from within the VA staff is a key strategy.
• Future directions include integrating EHRs from military service into the VA system for continuous patient care.