Transformation of VHA health data into clinically useful information to provide quality veteran care.

Seth Eisen, MD, MSc;  Joseph Francis, MD The V eterans Health Administration (VHA) is the lar gest integrated healthcare sys tem in the United S tates, caring for nearly 6 million of the nation’s 23 million veterans annually. VHA provides a full range of primary care, mental health, medical specialty, surgical, and rehabilitative services to enrolled veterans. It employs over 240,000 staff (including 65,000 health pro fessionals) and manages ov er 1,400 sites of care (medical centers, outpatient clinics, nursing homes, and counseling centers). The critical need for a comprehensive electronic medi cal record system is demonstrated by the obser vation that approximately 130 mill ion outpatient encounters, 600,000 hospitalizations, over 400 million laboratory tests and radiological procedures, and 170 million prescription fills are provided annually . In addition, nearly 1 billion clinically related free -text notes are recorded annually , representing a small fraction of the total e lectronic data collected over the past two decades.