The Environmental Agent Service (EAS) Registries is the information system encompassing the Ionizing Radiation Registry (IRR), the Agent Orange Registry (AOR), and the Gulf War Registry (GWR) which also includes related Depleted Uranium (DU) exams. These registries were originally developed using paper code sheets that were sent to the VA Austin Information Technology Center where typists converted to data files on the mainframe. The Registries have undergone a modernization and simplification effort that allows the entry of data via a web interface at https://vaww.registries.aac.va.gov/eas/ by staff at the VA medical centers. In compliance with the Federal Information Systems Management Act (FISMA) this is considered a single system of records with the three registry components i.e. IRR, AOR, GWR with DU that have been integrated into a single Oracle database. Please see individual Monograph entries for specific details on: Ionizing Radiation Registry (IRR), Agent Orange Registry (AOR), and the Gulf War Registry (GWR).

In 2009, the Department of Defense estimated that approximately 40,000 service members who served in OEF/OIF may have embedded fragment wounds as the result of small arms fire or a blast or explosion caused by an Improvised Explosive Device (IED), rocket propelled grenade (RPG), landmine, grenade, or enemy or friendly fire. Studies have shown that embedded fragments are not inert in the body, but may breakdown slowly over time and potentially affect an individual�s health. The recognition of potential short and long-term health effects of embedded fragments and the large number of soldiers with injuries resulting in embedded fragments led the Presidential Task Force on Returning Global War on Terror Heroes to recommend that the VHA establish a registry and medical surveillance program for Veterans with retained fragments. The Toxic Embedded Fragment Surveillance Center (TEFSC) has been established at the Baltimore VA Medical Center to coordinate this charge. A critical component of the TEFSC medical surveillance program is the development of an Embedded Fragment Registry. This registry provides a mechanism to identify Veterans with embedded fragments, manage clinical data related to embedded fragments, and develop medical and surgical guidelines that will enable the TEFSC staff and VA clinicians to deliver appropriate medical care to these Veterans.

The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software package allows the VA to track emerging pathogens on the national level without additional data entry at the local level. The results from aggregation of data can be shared with the appropriate public health authorities including non-VA and the private health care sector allowing national planning, formulation of intervention strategies, and resource allocations. EPI is designed to automatically collect data on emerging diseases for Veterans Affairs Central Office (VACO) to analyze. The data is sent to the Austin Information Technology Center (AITC) from all Veterans Health Information Systems and Technology Architecture (VistA) systems for initial processing and combination with related workload data. VACO data retrieval and analysis is then carried out. The AITC creates two file structures both in Statistical Analysis Software (SAS) file format, which are used as a source of data for the Veterans Affairs Headquarters (VAHQ) Infectious Diseases Program Office. These files are manipulated and used for analysis and reporting by the National Infectious Diseases Service. Emerging Pathogens (as characterized by VACO) act as triggers for data acquisition activities in the automated program. The system retrieves relevant, predetermined, patient-specific information in the form of a Health Level Seven (HL7) message that is transmitted to the central data repository at the AITC. Once at that location, the data is converted to a SAS dataset for analysis by the VACO National Infectious Diseases Service. Before data transmission an Emerging Pathogens Verification Report is produced for the local sites to review, verify, and make corrections as needed. After data transmission to the AITC it is added to the EPI database.

The Emergency Department Integration Software (EDIS) is a VHA-wide application used to track and manage the delivery off care to patients in the Emergency Care System (ECS). This critical IT solution directly supports the Major Initiative 'Enhance the Veteran Experience and Access to Healthcare (EVEAH). EDIS v1.0 is currently being deployed in each VHA hospital and is scheduled for deployment completion by 7/31/2011. The application improves emergency department care by introducing the systematic collection, display and reporting on patient status information. It is able to integrate with Appointment Management and Patient Care Encounter within VistA. EDIS v2.0 is currently being planned and will provide enhancements, better functionality and improved reports.

The Disaster Emergency Medical Personnel System (DEMPS) is the Veterans Health Administrations main deployment program for clinical and non-clinical staff to an emergency or disaster. The DEMPS Program may be used for an internal VA mission, as well as supporting a mission after a Presidential Disaster Declaration under the National Response Frameworks Emergency Support Function #8 (Public Health and Medical Services). Interested, qualified VHA staff can apply online by submitting a DEMPS Application. DEMPS Coordinators and Administrators can manage volunteer data by accessing DEMPS Administration.The DEMPS Program is made up of the following entities:The DEMPS Volunteers (Full-time VHA employee, or Retiree Emergency Reserve Corps Volunteer (ERC)) VAMC DEMPS Coordinator DEMPS VAMC Facility Support Staff (Fiscal, Payroll, and Travel) DEMPS VISN Points of Contact DEMPS National Program Manager VHA Office of Emergency Management staff (Area Emergency Managers, and Regional Emergency Managers) Deputy Under Secretary for Health for Operations and Management, and The DEMPS database. In order for DEMPS to work successfully, all eight entities above must work together to deploy the DEMPS Volunteer to an emergency or disaster site.The DEMPS database was developed to collect specific information on full-time VHA medical personnel (clinical and non-clinical) and Retiree Emergency Reserve Corps (ERC) Volunteers who have volunteered and been approved by their Medical Center Director to be deployed (full-time staff or ERC Volunteers) in the event of a disaster, or to back fill a medical center (ERC Volunteers). When disasters such as hurricanes, earthquakes, floods, etc., occur and the state and local resources to handle the response/recovery process are overwhelmed, the state in which the disaster occurs may request federal assistance. In this case, a Presidential Disaster Declaration is issued and the National Response Framework (NRF) is activated. Once the damage to the area and needs have been assessed, and it is determined that medical resources are required, the Federal Emergency Management Agency (FEMA) or the Department of Health and Human Services (HHS) may task VA to provide these resources. Generally, these requests are for medical personnel (nurses, physicians, pharmacists, etc.), pharmaceutical (or other medical) supplies, and medical equipment. However, depending on the mission, VHA may deploy non-clinical staff to support the infrastructure of the deployment.

The Drug Accountability database collects information on medication dispensed to both inpatient and outpatient Veterans who receive health care from the VA. Information for the Drug Accountability database is extracted from a number of files found within the Veterans Health Information Systems and Technology Architecture (VistA) environment. Each month the extracted information is sent via MailMan messages from all VistA systems to the VA Pharmacy Benefits Management (PBM) office in Hines, Illinois. At Hines, quality assurance procedures are performed on the data and local pharmaceutical names are converted to common names before the information is entered into the Drug Accountability database. The users of this database include the PBM, Veterans Affairs Medical Centers (VAMCs), the Veterans Integrated Service Networks (VISNs), and the VA Research community.

NOTE: This dataset is Inactive and is no longer supported. Any historical knowledge regarding meta data or it's creation is no longer available. All known information is proved as part of this data set.

The National Cardiac Device Surveillance Program Database supports the Eastern Pacemaker Surveillance Center (EPSC) staff in its function of monitoring some 11,000 Veterans Health Administration (VHA) patients who have implanted pacemakers or cardioverters. The database stores medically useful information about the patients and their pacemaker test results in order to highlight serial changes, which determine whether the pacemaker is still functioning normally, or whether the patient requires further intervention. The EPSC staff performs regular telephonic checkups, in conjunction with less frequent in-hospital clinic checkups, to determine when pacemakers need to be replaced. Patients are scheduled and called by the Pacemaker Surveillance Center, and have their electrocardiogram recorded and analyzed over the phone, using wires attached to their fingers and a VHA-supplied transmitter. Additionally, some patients are monitored via web-based downloads of their device telemetry. The Pacemaker Center also provides in-hospital clinic checkups for local Washington DC VHA pacemaker patients. All information obtained during the checkups is recorded in the EPSC Database. The database also contains records of pacemaker patients being monitored by VHA facilities east of the Mississippi and who are not being monitored directly by their respective VA medical centers. The VHA Department of Medical Services encourages local VHA medical centers to refer their patients for pacemaker follow-up monitoring to either the Eastern Surveillance Center or to the counterpart Western Surveillance Center in San Francisco, whichever is geographically appropriate. However, referral is optional. The database also maintains a registry of all VHA patients, living and deceased, who have had pacemakers implanted at, or who have been monitored by, VHA facilities. The EPSC receives information for the registry directly from the medical centers for patients that it does not monitor, totaling over 80,000 as of 2010.

VA's Managerial Cost Accounting System is the designated Managerial Cost Accounting (MCA) System of the Department of Veterans Affairs. This system is the Department's only means of complying with Public Laws (e.g., PL 101-576 - the Chief Financial Officers Act of 1990) that mandate the use of a MCA system that can assign costs to the product level. MCA cost data is used at all levels of the VA for important functions, such as cost recovery (billing), budgeting and resource allocation. Additionally, the system contains a rich repository of clinical information which is used to promote a more proactive approach to the care of high risk (i.e., diabetes and acute coronary patients) and high cost patients. The data in MCA is also used to calculate and measure the productivity of physicians and other care providers.

The tracking system is for patients identified in the Creutzfeldt Jakob Disease (CJD) lookback notification initiative established in January 1995 as part of the lookback notification of all Department of Veterans Affairs (VA) patients who may have received certain lot numbers of blood derivatives or blood components produced from donors with CJD. Even though the Centers of Disease Control and Prevention characterized the risk of transmission of CJD from blood derivative products as 'small and immeasurable' and 'theoretical', VA believed it had an ethical obligation to inform patients of the exposure to potentially contaminated blood components or plasma derivative products while under VA's care. The patients were notified. The Veterans Health Administration (VHA) established a tracking system for individuals who received these products to determine if there was an increase in VA CJD cases. Every two years, the VHA National Infectious Diseases Service updates the status of patients who had previously been identified through the VA CJD lookback notification initiative. The Creutzfeldt-Jakob Disease Lookback Dataset (CJDLD) is a prospective collection of data; requests for individual reports are not accepted.

Dental Encounter System (DES) is an automated health care application designed to capture critical data about the operations of VA Dental Services. Information on completed procedures is gathered for each patient encounter through the Dental Record Manager software, which is a VA Computerized Patient Record System Class I adjunct application. This DES information is linked and includes encounter date, patient, provider, procedures, diagnosis codes, and additional associated qualifiers. DES productivity is measured using weighted work units known as relative value units (RVUs). RVU values are determined cooperatively by the Dental Coding Committee and Decision Support System (DSS) staff. One RVU is a measure of work effort and represents one minute of the average provider's time (presuming the provider is supported with one dental assistant and one treatment room) and is reported as a value with each procedure reported to DES. DES transactions are sent to the Austin Information Technology Center (AITC) database using standard Health Level Seven (HL7) messaging and the VA Vitria Interface Engine. These batched HL7 messages are parsed at the AITC and placed in a flat database file.