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History of IT at VA

1970s

1970 - Research begins on the Electronic Health Record (EHR)

Early in the 1970s, the National Center for Health Services Research and Development, a component of the U.S. Public Health Service, began planning for development of what would become Electronic Health Records (EHR).

1977 - MUMPS Developed

VA Massachusetts General Hospital Utility Multi-Programming System (MUMPS), a precursor to VistA, developed by the Computer Assisted System Staff (CASS) Team.

1980s

Open Source begins with VistA

In the early 1980s, VA made its software available without restriction in the public domain to other government and private sector organizations, in compliance with the Freedom of Information Act. VA recognized this opportunity to support widespread EHR adoption and offered use of VistA as the standard-bearer for EHR implementation around the world.

June 1981 - MUMPS becomes VistA

In June 1981, VA MUMPS was renamed the Decentralized Hospital Computer Program (DHCP), and VA Administrator Robert Nimmo joined Rep. G.V. "Sonny" Montgomery to establish DHCP as VA's Medical Information System Development Program to formalize its organization and management.

December 1981 - DHCP written into law

Congressman Sonny Montgomery arranges for the DHCP to be written into law as VA's medical-information systems development program. VA Administrator Robert P. Nimmo followed up on February 18, 1982 with an Executive Order describing how the DHCP was to be organized and managed within VA's Department of Medicine and Surgery.

1985 - Medical Appointment Scheduling

Legacy scheduling module initiated.

1986 - Section 508 added to the Rehabilitation Act of 1973

The original Section 508 dealt with electronic and information technologies, in recognition of the growth of this field. Due to a number of shortcomings, including lack of enforcement mechanisms, the section was updated in 1998 as part of the Federal Electronic and Information Technology Accessibility and Compliance Act.

1990s

DHCP implemented nationally

Upgrading the computer capacity of its medical facilities allows VA to implement DHCP nationally, allowing VA to further promote the use of emerging technologies in all its locations.

VA-Indian Health Service partnership established

Indian Health Service (IHS) developed additional functionality to integrate outpatient clinics into the system. Through this partnership, VA incorporated changes that supported their extensive network of community-based outpatient clinics.

July 1990 - VistA Imaging becomes operational

VistA, VA's first image management system, provided VA physicians with immediate access to patient medical images, regardless of location. VistA first became operational at the Washington, D.C. VA Medical Center (VAMC) to manage radiologic, pathology, gastroenterology, and laparoscopic images, as well as electrocardiograms.

1994 - CPRS development begins

To support VistA's clinical use, VA began developing Computerized Patient Record System (CPRS) — the first clinical user interface for VA's IT architecture.

1994 - DHCP renamed VistA

VA's Under Secretary for Health, Kenneth W. Kizer, M.D., renames DHCP as VistA, the Veterans Health Information Systems and Technology Architecture.

1994 - VA adopts Bar-code technology

VA became one of the first health care organizations to use bar code technology to improve the accuracy of medication administration. This technology ensured Veteran patients received the gold standard for medication administration software.

1995 - 60% patient chart availability

In 1995, patient charts were available only 60 percent of the time at VA facility patient encounters. Currently, patient records are available in electronic form at nearly 100 percent of patient encounters across VA facilities.

1997 - CPRS released

CPRS is released for clinical use.

1999 - CPRS fully implemented

CPRS implemented at all VA medical facilities. CPRS' major functionalities included:

  1. A clinical data repository with privacy protection,
  2. Data retrieval and display,
  3. Document entry with role-based business rules,
  4. Problem lists, medication lists, reports (including radiology) and health summaries,
  5. Provider order entry for all clinical services and departments, and
  6. Clinical decision support with reminders, real-time clinical alert systems, notification systems, order checking, and disease management features.

2000s

2000 - RSA project initiated

VA initiates the Replacement Scheduling Application (RSA) project.

2001 - First Assistant Secretary appointed

May 2002 - FHIE establishes one-way transfer of data from DoD to VA

Federal Health Information Exchange (FHIE) supported the sharing of pharmacy records, laboratory results, radiology reports, and deployment-related health assessments, among other data, from multiple Department of Defense (DoD) health information databases, including the Composite Health Care System.

2002 - Milestone Review Process established

The Milestone Review Process was established for VA IT projects to gain better control of IT expenditures and to provide the ability to stop or redirect a project during the build process.

2002 - IT budget tracking system established

VA established the system to track dollars spent on IT.

2002 -IT Programs centralized

All of VA's IT functions and personnel centralized under the CIO.

March 2003 - World VistA formed

Following VistA's implementation, many VistA professionals banded together in a community to develop a standard knowledge base for VistA development.

October 2003 - CoreFLS deployed

Core Financial and Logistics System (CoreFLS) deployed at Bay Pines VAMC in Bay Pines, Florida to track finances, payments to vendors and inventories.

November 2003 - My HealtheVet launched

VA launches My HealtheVet nationwide on Veterans Day 2003. The personal health record portal now has over 2.5 million registered users.

2004 - IT moves from VHA

IT staff moves from Veterans Health Administration (VHA) to its own department, led by VA Chief Information Officer (CIO) with budget authority.

October 2004 - BHIE enables two-way data exchange between VA and DoD

The Bidirectional Health Information Exchange (BHIE) program enabled the real-time, two-way data exchange for shared patients between VA and DoD. In addition to expanding beneficiary coverage, BHIE added significant capability, including the ability to view inpatient and outpatient notes, among many others.

2005 - CIO given budget authority

Congress created one budget authorization for all VA IT spending, establishing it as an independent entity, and gave VA's CIO sole budget authority.

2007 - IT organizational structure approved

Office of the Assistant Secretary for Information Technology organization structure approved, centralizing IT services at VA.

November 2007 - SPAWAR partnership formed

VA and the Department of Navy's Space and Naval Warfare Systems Center (SPAWAR) created an Interagency Agreement (IAA). Leveraging SPAWAR's expertise in information management and information technology engineering solutions, the IAA provided VA with skilled program management support and knowledge.

December 2007 - Data Repository launched

By 2007, VA and DoD expanded the capabilities for prescription and drug allergy data to include semantic interoperability, allowing for a more complete clinical understanding of data across both systems. This was achieved through the Clinical Data Repository/Health Data Repository, which has reduced the risk of prescribing medications to shared patients with known drug or allergy reactions.

July 2008 - Post 9/11 GI Bill

Post 9/11 GI Bill signed into law and went into effect on August 1, 2009. It provides up to 36 months of education benefits, generally payable for 15 years following a Service member's release from active duty.

February 2009 - HITECH Act

As part of the American Recovery and Reinvestment Act of 2009, the U.S. Congress appropriated $19.2 billion to increase the use of EHRs by physicians and hospitals. This portion of the bill, called the Health Information Technology for Economic and Clinical Health (HITECH) Act, sent a strong message that the U.S. government firmly believed in the benefits of using EHRs and was willing to invest in its use.

March 2009 - RSA development canceled

VA cancels RSA development.

April 2009 - VLER introduced

VA introduced the Virtual Lifetime Electronic Record (VLER) Health program to share select parts of a Veteran patient's medical record electronically, safely, and privately with other approved health care facilities that are members of a secure Internet network known as the eHealth Exchange.

June 2009 - PMAS Initiated

VA announces a change in the way it planned and managed IT projects. Every IT project would now be managed through the Project Management Accountability System (PMAS). Agile Development is a collaboration-based methodology introduced to improve PMAS and support on-time delivery of IT capabilities. Prior to 2009, VA only delivered about one-third of its projects on time and new functionality every three to seven years.

June 2009 - Roger Baker appointed CIO

June 2009 - Governing Magazine Report

Transforming Information Technology at the Department of Veterans Affairs — Governing Magazine.

July 2009 - VistA exceeds 1 billion stored images

September 2009 - VBMS launched

The Veterans Benefits Management System (VBMS) was launched as the primary technology solution of Veterans Benefits Administration (VBA) Transformation.

December 2009 - VA engages in eHealth Exchange

VA engages in the national eHealth Exchange network.

December 2009 - VA/Kaiser Permanente partnership

The VA-Kaiser Permanente partnership was established to develop a health record pilot program that allows for the protected exchange of patient records between Kaiser Permanente HealthConnect and VistA, two of the nation's largest EHR systems.

2009 - VRM initiated

Veterans Relationship Management (VRM) was initiated as an enterprise-wide, multi-year initiative to improve a Veteran's secure access to benefits and services administered by VBA.

2009 - 95% of prescriptions placed electronically

95% of all VA prescriptions were placed through computerized physician order entry. This was regarded as benchmark for EHR success.

2009 - IT Consolidation completed

2010-2014

January 2010 - VRO created

The Virtual Regional Office (VRO) was created to initiate software design processes.

March 2010 - Affordable Care Act

President Obama signs into law the Patient Protection and Affordable Care Act (PPACA). Among the provisions to take effect over a four-year period were those prohibiting denial of coverage/claims based on per-existing conditions, expanding Medicaid eligibility, subsidizing insurance premiums, providing incentives for businesses to provide health care benefits, establishing health insurance exchanges, and supporting medical research.

September 2010 - VRM initiative launched

VRM initiative was launched as a multi-year initiative to improve Veterans' access to health care and benefits information.

2010 Regional reorganization of OI&T

VA begins regional reorganization of its Office of Information and Technology (OI&T).

2010 - Enterprise Visibility implemented

VA Enterprise Visibility gives VA real-time visibility to all devices connected to its network. VA has the ability to view, measure, and secure all IT assets connected to the VA network. This protection, which began implementation in 2010 and completed in 2012, allows VA to protect Veteran information by ensuring devices connected to the network meet VA security standards and are free of vulnerabilities.

2010 - National Data Center Program launched

June 2011 - OSEHRA established

VA establishes the Open Source Electronic Health Record Alliance (OSEHRA) as the central governing body that oversees the community of EHR users, developers, and service providers.

October 2011 - Interagency Program Office established

The Interagency Program Office (IPO) was established to develop and implement an integrated EHR capability for both VA and DoD.

October 2011 - OneVA re-established

Office of Enterprise Architecture (EA) re-established the OneVA EA Program to serve as a strategic planning and management tool that helps VA's leadership chart the course for the Department's transformation into a 21st century organization. Near-term focus was on aligning and integrating the component architectures and transition plans of VHA, VBA, and National Cemetery Administration (NCA), supported by a robust and secure IT infrastructure.

December 2011 - RRTF initiative established

VA CIO established the Ruthless Reduction Task Force (RRTF) initiative and designated the Deputy CIO for Architecture Strategy and Design (ASD) to lead a standing team for ensuring that VA pursues all possible options to reduce IT spending.

March 2012 - CRISP launched

The Continuous Readiness in Information Security Program (CRISP) was launched to transform how VA accesses, protects, and transfers information within and outside the Department. CRISP is a continuous planning methodology to improve information security by planning and tracking functions for security-related activities and makes adjustments to security plans and activities.

May 2012 - FDGS released

Federal Digital Government Strategy (FDGS) provides guidelines for all federal agencies for using modern tools and technology to build a 21st century platform to better serve the American people.

October 2012 - VistA Open Standardization Project implemented

VistA Open Source Standardization Project, aka "Gold Disk" implemented across 133 sites.

2012 - Deloitte Report

An internal review of OI&T by Deloitte showed that IT at VA was understaffed with fewer than 8,000 IT staffers supporting VA's 320,000 employees.

February 2013 - Stakeholder Enterprise Portal

VA begins conducting business with external stakeholders through the Stakeholder Enterprise Portal (SEP). SEP uses a single secure entry portal that provides stakeholders access to Web-based systems needed to assist Veterans, Service members, their families, and survivors, allowing Veterans Service Organizations (VSO) to prepare electronic claims and upload supporting documents safely.

February 2013 - Roger Baker steps down as CIO

April 2013 - High backlog of claims

According to VA figures dated April 20, 2013, the number of claims pending for more than 125 days was 613,469, while the total number of pension and entitlement claims was 886,345.

May 2013 PIV card-based access implemented

VA began Personal Identity Verification (PIV) card-based access enterprise-wide with Homeland Security Presidential Directive 12 (HSPD-12) implementation.

June 2013 - VBMS deployed to regional offices

VBMS deployed to all 56 regional offices, increasing efficiencies for the disability claims process, improving security for Veterans' personal information, and helping ensure timely and accurate delivery of $3.6B in disability benefits paid each month.

July 2013 - Trusted Internet Connection implemented

VA implements Trusted Internet Connection (TIC) and other tools/processes to continuously monitor, evaluate, and address risk status to devices and systems. TIC improves ability to monitor external connections and identify potentially malicious traffic by reducing and consolidating external connections.

July 2013 - JLV developed

Tripler Army Medical Center and VA Pacific Islands Health Care System partnered to develop the Joint Legacy Viewer (JLV), a web application that provides a common view of patients' health information from VA and DoD EHRs.

August 2013 - Risk Vision implemented

RiskVision is a comprehensive risk management platform developed to automate Governance, Risk, and Compliance in agencies subject to regulation, and allows monitoring for information security technical policy compliance, threats and vulnerabilities, and business impact. Based on the near real-time visibility into VA's systems, risk exposure can be immediately identified and efforts to reduce risk can be prioritized allowing the most critical issues to be addressed first, thereby mitigating threats.

October 2013 - Steph Warren appointed CIO

Steph Warren is appointed Executive in Charge, Office of Information and Technology and Chief Information Officer.

October 2013 - VA Point of Service Phase 2 initiated

The VA Point of Service (VPS, aka Kiosks) Project which was completed in 2014, resulting in approximately 5,500 total VPS kiosks deployed to 146 VAMCs nationwide.

November 2013 - My HealtheVet improves accessibility

My HealtheVet accessibility improves from 16 percent to 95 percent.

December 2013 - VistA Evolution launched

VistA Evolution Program, a partnership effort to modernize VistA, launches with a goal of providing essential health information technology to Veterans and clinicians and allows Veterans to have a seamless access to their health record.

2014

January 2014 - VACAA enacted

President Obama signed into law the Veterans Access, Choice, and Accountability Act of 2014 (VACAA).

January 2014 - VBMS processes 1 millionth Disability Benefits Questionnaire

VBMS received and processed its 1 millionth Disability Benefits Questionnaire (DBQ) in collaboration from OI&T and VHA.

February 2014 - Mobile Device project initiated

11,200 mobile devices were distributed to selected VA facilities in support of the VA Mobile Health Provider Program, which aims to put mobile technology into the hands of health care providers to enhance patient care.

March 2014 - VistA Scheduling enhancements deployed

VistA scheduling enhancements were deployed to ensure Veterans do not have to wait for access to care.

July 2014 - Eric Shinseki steps down as VA Secretary

July 2014 - Robert McDonald appointed VA Secretary

September 2014 - JLV deployed to all VAMCs

JLV allows the user to configure displays to support various workflows. JLV maps data to standard national codes in seven clinical domains, making it easier to compare data between systems, understand trends, and develop a more complete picture of a patient's history.

September 2014 - Mobile Health Store opens

September 2014 - Digital Service Experts Team formed

Digital Service Experts (DSE) team formed to re-design and re-build crucial digital interfaces.

September 2014 - VistA Evolution Initial Operability Capability reached

The first of four Feature Sets to modernize VistA and move towards full implementation of VistA 4, a product of VistA Evolution is delivered.

September 2014 - Contract awarded to improve scheduling

VA awards contract for resource management dashboard, aggregated view of clinic profile scheduling grids, and single queue of request lists.

September 2014 - VA-Walgreens partnership established

VA and Walgreens establishes a partnership to provide needed vaccines and education to Veterans to improve immunization rates and keep Veterans healthy.

September 2014 - Telehealth ICU solutions implemented

Telehealth Intensive Care Unit (ICU) solution was implemented at two Veterans Integrated Service Networks (VISNs) with implementation underway at two more. Tele-ICU connects VAMC ICU staff with Tele-ICU central monitoring center staff for real-time interaction and patient monitoring around the clock.

October 2014 - VistA migration completed

VA successfully completes VistA migrations to 25 data centers.

October 2014 - Clinical Video Teleconferencing released

Clinical Video Teleconferencing (CVT) system released nationwide. CVT is a web-based system that allows scheduling staff to perform scheduling for CVT appointments.

Fall 2014 - MASS conceptual architecture delivered

Medical Appointment Scheduling Solution (MASS) target service architecture and conceptual system architecture, based on VistA Evolution design pattern was delivered.

Fall 2014 - MASS RFP released

VA releases Request for Proposal (RFP) for long-term Medical Appointment Scheduling Solution (MASS).

December 2014 - VBMS reaches record number of users

VBMS achieves record number of simultaneous unique end-users (11,388).

2014 - CRISP Control Framework initiated

Specific plans for 21 projects to address continuous improvement of information security at VA.

2014 - Wireless network for VAMC

Secure, robust wireless networks deployed to 126 of 177 VA medical facilities, with the remaining sites scheduled to finish deployment by the end of FY15. This updated infrastructure allows medical center staff more flexible access to VistA and other electronic information systems, as well as enables the wireless transfer of information amongst medical devices such as electrocardiograms carts, vital signs monitors, and infusion pumps.

2015

January 2015 - Open source software evaluation initiated

New policy initiated to evaluate open source solutions (along with larger enterprise solutions) when acquiring or developing new software. This policy requires that the use of open source development practices are considered when VA or a VA support contractor develops software.

January 2015 - Affordable Care Act required interface delivered

VA delivers the Affordable Care Act (ACA) required real-time, IT-based interface with Centers for Medicare and Medicaid Services (CMS) systems. The interface verifies that individuals seeking insurance through healthcare.gov are not enrolled with VA for health care services.

March 2015 - LaVerne Council nominated as Assistant Secretary for IT

April 2015 - CRISP Unauthorized Software Remediation pilot launched

CRISP Unauthorized Software Remediation removes, updates, or replaces unauthorized software.

April 2015 - State Prescription Monitoring Program VistA patch implemented

VA began implementing the State Prescription Monitoring Program VistA patch in phases across VAMCs.

June 2015 - LaVerne Council confirmed as Assistant Secretary for IT by Senate

After an almost three-year vacancy, LaVerne Council is confirmed by the Senate as the next Assistant Secretary for Information & Technology and Chief Information Officer by a voice vote.

July 2015 - LaVerne Council sworn in as Assistant Secretary for IT

LaVerne Council officially sworn in as the new Assistant Secretary for IT and CIO for VA, replacing former CIO Roger Baker and acting interim CIO Steph Warren.

September 2015 - Airborne Hazards and Open Burn Pit Registry projected release

VA OI&T Product Development is developing the Airborne Hazards and Open Burn Pit Registry (AHOBPR), targeted to deploy at the end of Q3 2015.

September 2015 - VistA 4 Feature Set #2 projected release

New feature release will include improved infrastructure and clinical enhancements.

August 2015 - TrAITS

New CIO aligns OI&T core values with VA core values and announce TrAIT

  • Transparency
  • Accountabilityy
  • Innovation
  • Teamwork

Oct 2015 - Major Transformation Initiative Announced

Assistant Secretary for Information and Technology and Chief Information Officer Laverne Council announcees sweeping transformaion iniative with three primary goals:

  1. Stabilize and streamline processes
  2. Eliminate material weaknesses
  3. Institutionalize new capabilities to drive improved outcomes

2016

January 2016 - VIP replaces PMAS

The Veteran-focused Integration Process (VIP) is a Lean-Agile framework that services the interest of Veterans through the efficient streamlining of activities that occur within the enterprise.

VIP is the follow-on framework from Project Management Accountability System (PMAS) for the development and management of IT projects which will propel the Department with even more rigor toward Veteran-focused delivery of IT capabilities. The VIP framework unifies and streamlines IT delivery oversight and will deliver IT products more efficiently, securely and predictably. With VIP, VA takes another generational leap forward in its commitment to serve our nation's Veterans.

April 2016 - Establishment of EPMO

The Enterprise Program Management Office is established to serve as the "Control Tower" for all future OI&T development.

December 2016 - Digital Health Platform announced

DHP is an entirely new approach to healthcare. It leverages public-private partnerships and VA's vast data stores to create a new paradigm for health services delivery and public services delivery across every Federal agency. Additional information about DHP.