The Patient Assessment File (PAF) database compiles the results of the Patient Assessment Instrument (PAI) questionnaire filled out for intermediate care Veterans Health Administration (VHA) patients. The PAI is filled out within two weeks of admission. It is also completed semi-annually on April 1st and October 1st for each patient by a registered nurse familiar with the patient. The PAI questions cover medical treatments, conditions, selected diagnoses, activities of daily living, behaviors, some rehabilitation therapies, and chronic respiratory support. The database is managed by the Geriatrics & Extended Care Strategic Health Care Group in the Office of Patient Care Services. It is currently running at the Austin Information Technology Center (AITC) and is stored in flat files. PAF's primary customer is the Allocation Resource Center (ARC) in Braintree MA. The ARC receives the data from AITC and combines it with data from the Patient Treatment File (PTF) which contains more detailed demographic and treatment information. The ARC builds ORACLE tables, assigning RUG II (Resource Utilization Group II) scores and weighted work units reflecting the level and type of care needed. The 16 different weighted work units, ranging from 479 to 1800, are a factor in the resource allocation and budget decisions on long-term care, and are used to measure efficiency. The data is also used in other reports to Central Office, the Veterans Integrated Service Networks, and the facilities. Several other units also use PAF information including the Decision Support System (DSS). Currently, PAF is in the process of being replaced by the Resident Assessment Instrument/Minimum Data Set (RAI/MDS). RAI/MDS uses a much more extensive questionnaire as its source of information. The RAI/MDS provides clinical data and care protocols in addition to the newer RUG III scores, and is required by the Centers for Medicare and Medicaid Service funded hospitals.

Occupational Health Record-keeping System (OHRS) is part of the Clinical Information Support System (CISS) portal framework and the initial CISS partner system. OHRS is a web-based application that enables employee occupational health staff to create, maintain, and monitor medical records for VA employees and generate national, Veterans Integrated Service Network (VISN), and site-specific reports.The focus of OHRS is to collect clinical data for wellness, medical surveillance, and appropriate treatment of work-based injury or illness. OHRS will capture and store information on patient encounters, such as encounter type, purpose, status, provider, and other pertinent clinical data obtained during the patient visit. Users with appropriate security privileges are allowed to add and sign or co-sign the encounter and, if needed, perform scheduled and unscheduled reporting on items such as vaccination rates, vaccination and immunity statuses. The OHRS application does not share patient-specific data, but will collect data elements limited to information deemed critical to the Occupational Health delivery of care processes in the OHRS database. Employee data is obtained from the central Personnel and Accounting Integrated Data System (PAID) while volunteer information is obtained from the Voluntary Service System (VSS). Other Non-Paid and non-VSS data is collected by direct data entry into OHRS at the time of the patient encounter. OHRS is further designed to document, track and report immunizations administered to other Federal Agency employees outside of VA.

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The Nuclear Medicine National HQ System database is a series of MS Excel spreadsheets and Access Database Tables by fiscal year. They consist of information from all Veterans Affairs Medical Centers (VAMCs) performing or contracting nuclear medicine services in Veterans Affairs medical facilities. The medical centers are required to complete questionnaires annually (RCS 10-0010-Nuclear Medicine Service Annual Report). The information is then manually entered into the Access Tables, which includes: * Distribution and cost of in-house VA - Contract Physician Services, whether contracted services are made via sharing agreement (with another VA medical facility or other government medical providers) or with private providers. * Workload data for the performance and/or purchase of PET/CT studies. * Organizational structure of services. * Updated changes in key imaging service personnel (chiefs, chief technicians, radiation safety officers). * Workload data on the number and type of studies (scans) performed, including Medicare Relative Value Units (RVUs), also referred to as Weighted Work Units (WWUs). WWUs are a workload measure calculated as the product of a study's Current Procedural Terminology (CPT) code, which consists of total work costs (the cost of physician medical expertise and time), and total practice costs (the costs of running a practice, such as equipment, supplies, salaries, utilities etc). Medicare combines WWUs together with one other parameter to derive RVUs, a workload measure widely used in the health care industry. WWUs allow Nuclear Medicine to account for the complexity of each study in assessing workload, that some studies are more time consuming and require higher levels of expertise. This gives a more accurate picture of workload; productivity etc than using just 'total studies' would yield. * A detailed Full-Time Equivalent Employee (FTEE) grid, and staffing distributions of FTEEs across nuclear medicine services. * Information on Radiation Safety Committees and Radiation Safety Officers (RSOs). Beginning in 2011 this will include data collection on part-time and non VA (contract) RSOs; other affiliations they may have and if so to whom they report (supervision) at their VA medical center.Collection of data on nuclear medicine services' progress in meeting the special needs of our female veterans. Revolving documentation of all major VA-owned gamma cameras (by type) and computer systems, their specifications and ages. * Revolving data collection for PET/CT cameras owned or leased by VA; and the numbers and types of PET/CT studies performed on VA patients whether produced on-site, via mobile PET/CT contract or from non-VA providers in the community.* Types of educational training/certification programs available at VA sites * Ongoing funded research projects by Nuclear Medicine (NM) staff, identified by source of funding and research purpose. * Data on physician-specific quality indicators at each nuclear medicine service.* Academic achievements by NM staff, including published books/chapters, journals and abstracts. * Information from polling field sites re: relevant issues and programs Headquarters needs to address. * Results of a Congressionally mandated contracted quality assessment exercise, also known as a Proficiency study. Study results are analyzed for comparison within VA facilities (for example by mission or size), and against participating private sector health care groups. * Information collected on current issues in nuclear medicine as they arise. Radiation Safety Committee structures and membership, Radiation Safety Officer information and information on how nuclear medicine services provided for female Veterans are examples of current issues.The database is now stored completely within MS Access Database Tables with output still presented in the form of Excel graphs and tables.

The Veterans Health Administration (VHA) pays for care provided to VA beneficiaries in non-VA hospitals through its contract hospitalization program as mandated by Congress in the late 1980s. The Non-VA Hospital System (NVH) software captures the patient's Demographics, Provider, Hospital Name and Location, Medicare Provider Number, Diagnoses and Procedures for which the patient received care during his/her inpatient stay. The data is received from either the patient or the medical center providing the care (normally on a UB-92 form). The billing office employee enters the information into Veterans Health Information Systems and Technology Architecture and sends information to the Austin Information Technology Center (AITC). The non-VA hospitals are reimbursed at Medicare rates based on the Prospective System (PPS). PPS uses the appropriate Diagnostic Related Groups (DRGs). Each DRG has a different rate-adjusted reimbursement based on the regional and urban/rural designation of the provider non-VA Hospitals. NVH is housed at the AITC and uses software developed by the AITC in conjunction with 3M and the Center for Medicare and Medicaid Services (CMS). It is a batch system written in Common Business Oriented Language, ALC, and Statistical Analysis Software. Processing occurs daily.

The Non-VA Care Medical and Pharmacy System (FEE) automates the Veterans Health Administration (VHA) Fee for Service program. It authorizes and pays private physicians, hospitals, and pharmacists for products and services provided to Veterans approved for the program. Veterans are reimbursed through VistA Fee for medically-related expenses including travel. Information is entered into the VistA Fee system through Veterans Health Information Systems and Technology Architecture (VistA) online menus. VistA Fee is run at the Austin Information Technology Center and interfaces with the Financial Management System (FMS), the Beneficiary Identification and Records Locator System (BIRLS), and the VHA Work Measurement database (VWM), to produce payments, accounting updates, and reports. VistA Fee facilitates money management, master record updating, and input error resolution. Daily reports indicating all payments processed and erroneous input transactions are transmitted to approximately 170 Veterans Affairs Medical Centers (VAMCs). Letters are sent to Veterans on a monthly basis detailing payments made on their behalf to Non-VA Care Service providers. Monthly, quarterly, semi-annual and annual reports are sent to the Veterans Affairs Central Office (VACO) and VAMCs. The Non-VA Care Fee Basis Medical System is commonly referred to as Central FEE.

My HealtheVet (MHV) is VA's award-winning online Personal Health Record (PHR), located at www.myhealth.va.gov. The mission of MHV is to transform the delivery of health and health care for all Veterans, independent of where they receive care, by providing one-stop, online access to better manage their overall health, make informed health decisions, and record and store important health and military history information. MHV provides access to VA health care and information 24/7 through web-based tools that empower Veterans to become active partners in their health care. MHV registrants can click a 'Blue Button' on the website to view, print or download their available personal health information and military service information. They can choose to share that information with other providers, caregivers, family members or job advocates safely, securely, and privately. Web technology combines essential health record information enhanced by online health resources. This enables and encourages patient/clinician collaboration. The online environment maps closely to existing clinical business practices and extends management and delivery of care. MHV allows VA patients to request and receive VA prescription refills and provides a blended history of VA and self-entered medications. Registrants whose personal identities have been verified as VA patients can receive copies of select VA electronic health records, including VA Appointments, Chemistry/Hematology Lab Results, Allergies and Wellness Reminders. Many VA patients are communicating with their participating health care teams through Secure Messaging.