Veterans Affairs moves forward with VISTA program

The Department of Veterans Affairs is rolling out a new client/server architecture to its 150-plus medical centers and is testing the first major application to take advantage of the updated infrastructure.

The VA's Veterans Health Information Systems and Technology Architecture (VISTA) supersedes the VA's Decentralized Hospital Computer Program (DHCP). DHCP in use since 1985 was built around host computers and dumb terminals.

VISTA however will propel VA health facilities into the 1990s with fiber-optic local-area networks graphical user interfaces (GUIs) and Internet/intranet connectivity. The VA is tapping equipment from a number of vehicles including the General Services Administration schedule.

"VISTA represents a major step forward for us into the client/server architecture " said Robert Kolodner chief information officer of the Veterans Health Administration. "It marks a major enhancement to our systems - enough so that it really is a different concept to what we've been having before."

Kolodner said DHCP has "served us well" but added that its more than 70 applications now represent only a portion of the total automation needs of VA medical centers. The VA is developing new applications and plans to use commercial off-the-shelf software to flesh out the VISTA architecture.

In addition the VA will re-engineer DHCP applications for the client/server environment. Kolodner said the agency will create GUI front ends for some of the DHCP systems.

LAN Backbone

Fiber-optic LANs provide the backbone for the VISTA initiative. The VA has installed LANs in about one-third to one-half of its medical centers and plans to upgrade the others within the next 12 to 18 months Kolodner said.

The LANs are based on servers running Microsoft Corp.'s Windows NT. The VA plans to use a mix of LAN servers including Digital Equipment Corp. Alpha machines as well as Pentium and Pentium Pro servers.

The LANs in turn are linked to a wide-area network which is also based on Windows NT servers. The VA is expanding the WAN which over time will span 150 000 client PCs.

"We think we are going to have one of the largest NT networks in the world " said John Rucker associate director for customer service at the Veterans Health Administration.

The agency expects to use Windows-based PCs as a standard. Kolodner expects the VA to use Pentium PCs and perhaps Pentium Pro machines if the latter have the right price point. He added that the agency is also looking into ways of including Apple Computer Inc. Macintoshes in the architecture.

From their PCs VA users will tap into applications developed specifically for use in the new architecture. The first application the Patient Care Management Module was launched earlier this year. The module helps VA personnel to structure a clinic's services. The application was created using Borland International Inc.'s Delphi rapid application development tool.

The second larger application is the Computerized Patient Record System. This clinical system is being tested at a VA medical center in Tuscaloosa Ala. and also will be tested at VA facilities in Boston and central Texas. The system also was developed in Delphi and will be released next spring or summer Kolodner said.

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