New name for VA's medical systme:VISTA

After 14 years, the Veterans Affairs Department is saying goodbye to the Decentralized
Hospital Computer Program, the software workhorse of veterans hospitals, and hello to

Adopting the name Veterans Health Information Systems and Technology Architecture
reflects the broad changes in computing at VA medical centers in recent years, said Robert
M. Kolodner, chief information officer for the Veterans Health Administration.

"We didn't have a term to encompass this rich set of activities," he said.

So the agency held a contest to select a new name, and it developed a new logo. Both
are being unveiled this week.

Although the name DHCP is disappearing, the 80-plus applications developed for the
clinical and administrative suite since 1982 remain. VA has a massive investment in the
package, now in use at more than 170 VA hospitals and clinics. But VISTA is more than just
your father's software, Kolodner said.

"This is catching us at a time when we're making fundamental changes," he
said. "It is something that people are familiar with and it will continue to be used,
but it is no longer what it was."

In 1985, when DHCP was in use in 195 medical centers, "it was the sum total of
automation," Kolodner said. Today, less than half of the automation is DHCP.

DHCP applications have been written primarily in the M programming language. This
remains a staple, although now they are written also with Borland International Inc.'s
Delphi, and many medical centers have added off-the-shelf software for local use. Most
medical centers still are using dumb terminals and Digital Equipment Corp. VAX computers,
but many have begun the migration to client-server with fiber-optic PC LANs.

VHA released the first DHCP application with a graphical user interface in May. Now it
has begun replacing paper documentation of new applications with on-line versions
available to those hooked up to the department's intranet.

In July, testing began on a patient records system that runs under Microsoft Windows
and can access DHCP databases developed in M.

In short, Kolodner said, "what we've succeeded in doing is evolving DHCP, rather
than let it go into obsolescence."

At some point, the new beast would need a new name, and that time is now, Kolodner
decided. Defining just exactly what the name applies to has confused some, he admitted.

VISTA does not include the commercial products used with and on top of DHCP, but does
include the architecture that allows them to be used. The wiring, PCs, servers, links
across and between centers and the rest of the infrastructure, in addition to DHCP
software, now adds up to VISTA.

DHCP has earned a place in the history of computing. It was written largely by hospital
medical staffs when information systems were the province of glass-house mainframe
programmers and analysts. Many people took part in developing the software, a process that
was informal and often undocumented.

Although many VA physicians and surgeons never used a DHCP terminal, others did,
averting delays and errors in data entry and retrieval. Such hands-on use by medical
professionals was near-revolutionary at the time. At its peak, DHCP was the premier
medical information system in the world.

Kolodner said there was some reluctance based on nostalgia to doing away with the DHCP
label, but this was overcome with the understanding that VISTA is a next step, not a

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