The Veterans Affairs Central Cancer Registry (VACCR) receives and stores information on cancer diagnosis and treatment constraints compiled and sent in by the local cancer registry staff at each of the 132 Veterans Affairs Medical Centers that diagnose and/or treat Veterans with cancer. The information sent is encoded to meet the site-specific requirements for registry inclusion as established by several oversight bodies, including the North American Association of Central Cancer Registries, the American College of Surgeons' Commission on Cancer, and the American Joint Commission on Cancer, among others. The information is obtained from a wide variety of medical record documents at the local medical center pertaining to each Veterans Health Administration (VHA) cancer patient. The information is then transmitted to the VACCR. Details collected include extensive demographics, cancer identification, extent of disease and staging, first course of treatment, and outcomes. Data extraction is available to researchers with VA approved Institutional Review Board studies, peer review, and Data Use Agreements.

The Veterans Health Administration (VHA) has now collaborated with the Centers for Medicare & Medicaid Services (CMS) to present information to consumers about the quality and safety of health care in VHA. VHA has approximately 50 percent of Veterans enrolled in the healthcare system who are eligible for Medicare and, therefore, have some choice in how and where they receive inpatient services. VHA has adopted healthcare transparency as a strategy to enhance public trust and to help Veterans make informed choices about their health care.VHA currently reports the following types of quality measures on Hospital Compare:Timely and effective care.Behavioral health.Readmissions and deaths.Patient safety.*Experience of care.

The VA National Drug File is a centrally maintained electronic drug list used by the VA hospitals and clinics. Facilities use the VA National Drug File to check drug interactions, to manage orders, and to send outpatient prescriptions to regional automated mail-out pharmacies. The VA National Drug File includes information on clinical drugs, drug classes, ingredients and National Drug Code (NDC) Directory codes.

The VA National Clozapine Registry tracks the health and demographics of patients who have been prescribed clozapine by the VA. Clozapine, or the brand name Clozaril, is a drug used to treat the most serious cases of schizophrenia. Unfortunately, clozapine may also affect portions of the blood, lowering the body's resistance to infection and sometimes creating life-threatening circumstances. Realizing the severity of the problem, the Food and Drug Administration (FDA) established guidelines for analysis of White Blood Cells and Neutrophils and set strict minimum limits. The FDA also mandated that any manufacturer of clozapine must maintain a Clozapine Registry. These registries are to track the location and the health of clozapine patients and to ensure 'weekly White Blood Cell testing prior to delivery of the next week's supply of medication'. To date, the clozapine manufacturer registries have been unable to develop sufficient controls to meet these requirements, especially the ability to prevent dispensing clozapine when blood results are abnormal. However, because of the unique structure of Veterans Health Information Systems and Technology Architecture, the Veterans Health Administration obtained permission from the FDA and clozapine manufacturers to use its in-place computer network to gather and evaluate weekly patient information, then export this data to manufacturer clozapine registries. The VA assigned functional administration of this effort to the National Clozapine Coordinating Center (NCCC) located in Dallas, Texas. Weekly data on each VA clozapine patient is processed at two locations. Facility Level --When a clozapine prescription is written, a computer program in each facility's internal computer system retrieves white blood cell count, neutrophil count, and clozapine dose and evaluates the information according to FDA guidelines. If an adverse blood condition is found, the computer may warn to trigger a physician reevaluation, or lock out entirely to prevent dispensing, depending on the severity. Weekly, this information, along with certain patient demographic information, is gathered locally and transmitted to Hines Office of Information & Technology Field Office for centralized storage. This data can only be accessed by the NCCC. Raw data is downloaded from the Hines OI Field Office database on a weekly basis. An ancillary computer program reformats the data and evaluates the information for inconsistencies and data gathering errors. The computer-corrected data is manually compared with hand-written facsimile information sent to the NCCC by each site. This manually corrected data is again reformatted for data storage in MS Access format at the NCCC. The corrected data is also reformatted into American Standard Code for Information Interchange fixed-length fields and transmitted via modem to the manufacturers' Clozapine Registry and, in turn, to the FDA.

The VA National Formulary is a listing of products (drugs and supplies) that must be available for prescription at all VA facilities, and cannot be made non-formulary by a Veteran Integrated Service Network (VISN) or individual medical center. Regarding chemical or biological entities that by law must be submitted to the United States (U.S.) Food and Drug Administration (FDA) for pre-marketing approval, only those entities that actually have been approved by FDA using New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or biologics license, may be added to the VA National Formulary.

The VA National Bed Control System records the levels of operating, unavailable and authorized beds at each VAMC, and it tracks requests for changes in these levels. For changes in operating, unavailable and authorized bed levels, the Director of a Medical Center or his/her authorized delegate enters a bed change request into the Bed Control Database. A Bed Control Database trigger automatically notifies the respective Veterans Integrated Support Network (VISN) director. The VISN director's designated staff reviews the request and either approves, disapproves, or cancels it through the Bed Control Database. If a medical center request is approved by the VISN director, a Bed Control Database trigger notifies staff in the Assistant Deputy Under Secretary for Health for Operations and Management (10N) to review and take action, followed by the appropriate VHA Program Office and then the Under Secretary for Health. Once a request has been approved, cancelled, or disapproved by either the Deputy Under Secretary for Health for Operations and Management, VHA Program Office, or the Under Secretary for Health, the medical center director and the appropriate VISN director are automatically notified of the action. The approval process is tracked and visible to the authorized user of the system. When changes are approved, the database updates its bed level information accordingly. Pertinent justification and documents associated with each bed change request are stored in the database.

My HealtheVet (www.myhealth.va.gov) is a Personal Health Record portal designed to improve the delivery of health care services to Veterans, to promote health and wellness, and to engage Veterans as more active participants in their health care. The My HealtheVet portal enables Veterans to create and maintain a web-based PHR that provides access to patient health education information and resources, a comprehensive personal health journal, and electronic services such as online VA prescription refill requests and Secure Messaging. Veterans can visit the My HealtheVet website and self-register to create an account, although registration is not required to view the professionally-sponsored health education resources, including topics of special interest to the Veteran population. Once registered, Veterans can create a customized PHR that is accessible from any computer with Internet access.

A system of records is a file, database, or program from which personal information is retrieved by name or other personal identifier. The Privacy Act provides a number of protections for your personal information. These typically include how information is collected, used, disclosed, stored, and disposed.As part of our privacy policy, VA conducts an annual review of our Privacy Act system of record notices to make sure that they are current and republishes those that require changes or updates.Please select the link to download the excel spreadsheet via the link labeled: 'Privacy Act System of Record'.The spreadsheet contains the following fields: SOR #, PUB DATE, CITATION, HYPERLINK TO FEDERAL REGISTER, SYSTEM TITLE, and POC.

The mission of the VA Clinical Assessment Reporting and Tracking (CART) Program for cardiac catheterization laboratories (CART-CL) is to support a national VA reporting system, data repository, and quality improvement program for procedures performed in VA cardiac catheterization laboratories. CART-CL is intended to improve clinical care/communication, support local and national quality improvement, monitor patient safety, capture workload of cardiac catheterization lab procedures, and inform VA system evaluation to maximize operational efficiency and patient outcomes. CART-CL is a collaborative effort between the VA Patient Care Services, Office of Information and Analytics, Ischemic Heart Disease Quality Enhancement Research Initiative (IHD-QUERI), and Office of Information and Technology (OI&T).

The VA Drug Pricing database contains the current prices for pharmaceuticals purchased by the federal government. These listed prices are based on the Federal Supply Schedule (FSS). This database is mandated by Public Law 102-585, the Veterans Health Care Act of 1992, which sets the maximum amount that a drug may be bought for by the Veterans Health Administration (VHA). The source of this information is contained in printed contracts or data files supplied by the drug manufacturers, representing the pricing agreements between VHA and the manufacturers. Price data is input by the National Acquisition Center (NAC) into the database administered by the Pharmacy Benefits Management Strategic Health Care Group. Information from this database is published on the World Wide Web at the following site: http://www.pbm.va.gov. The users of this database include pharmaceutical manufacturers, drug wholesalers, Office of Inspector General (OIG) and those who purchase pharmaceuticals for the VHA and other government agencies.