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.

Klappentext

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.

Zusammenfassung
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.

Inhalt
Section 1Networking for Healthcare Delivery.- 1Vision for Change: An Integrated Service Network.- 2The Role of Systems at the Facility and Network Level.- 3Teleinformatics: The Future of Healthcare Quality Management.- Section 2System Design.- 4Creating a Robust Multi-Facility Healthcare Information System.- 5Infrastructure and Tools for Flexibility.- 6Structuring Databases for Data Sharing.- 7Collaborating for Integration.- 8Supporting Systems After Installation.- 9Privacy and Security Protections for Healthcare Information.- Section 3Clinical Information Technology.- 10Integrating a Clinical System.- 11Capturing Data in Ambulatory-Care Settings.- 12Moving to Clinical Workstations.- 13Controlled Representation in Patient Records and Healthcare Delivery Systems.- 14Clinical Decision Support in a Distributed Environment.- 15The CARE Decision Support System.- Section 4Clinical and Support Applications.- 16Meeting Clinical Needs in Ambulatory Care.- 17Surgical Systems.- 18Nursing Use of Systems.- 19Developing Clinical Computer Systems: Applications in Cardiology.- 20Anesthesiology Systems.- 21The Library Network: Contributions to the VA's Integrated Information System.- 22Using Data for Quality Assessment and Improvement.- 23Developing and Implementing the Problem List.- Section 5System Evolution.- 24Conceptual Integrity and Information Systems: VA and DHCP.- 25Hybrid Open Systems Technology.- 26Using DHCP Technology in Another Public Environment.- 27International Installations.- Section 6Telemedicine and Telehealth.- 28Telemedicine: Taking a Leadership Role.- 29Telemedicine at the Veterans Health Administration.- 30Telehealth for the Consumer.- 31DigitalImaging Within and Among Medical Facilities.- Contributors.