Arden,

I think more than a "forum" for dialog is necessary... for VA and DoD
to share anything would involve someone losing some bureaucratic turf.
 Unfortunately, this protection-of-turf instinct is more important
than cost savings, patient safety, effectiveness of systems, or even
the mission of the agencies.

I had a working model of a VA/DoD shared system operating between VA
Loma Linda and March AFB in 1984.  Rather than use this as a seed
system for further evolution, this system was just left in the dust. 
I had a full network design in MailMan ready to go for CHCS, but this
was removed at the government's request, only to be reinvented years
later.

So, we are dealing with organizational problems, not technologies. 
The reality of the situation is that civil service employees are
rewarded for their inefficiencies.  If they solve a problem with fewer
resources, they could find their job security threatened.  If they
solve it with additional staff and resources, they could find
themselves promoted. (For example, I was demoted for my efforts in
designing DHCP-seems I was working laterally with lots of other
hardhats instead of building up my own supervised team).

As long at these perverse incentives drive things, we are not going to
see more efficient systems emerge.  Quite the opposite.
On Wed, 15 Dec 2004 11:21:47 -0800 (PST), A. Forrey
<[EMAIL PROTECTED]> wrote:
> Nancy and hardhats:
> As many hardhats know DoD developed CHCS from VistA in the late 1980s;
> SAIC was the contractor. There is much commonality in the architectures of
> the two systems but there has been relatively little cross dialog about
> the common conceptual content of the two architectures. In view of the
> federal efforts, a forum for such dialog is sorely needed in order to
> relate to the recent VA Procurement notices recently posted. From the
> notice posted it is unclear how the "digitization" is proceeding in terms
> of the underlying business processes. Heretofore, many healthcare
> enterprises were just creating digital images of paper records but with
> CHCS at WRAMC it would seem that they are doing something else. The WV and
> hardhats efforts would be most interested in further detail.
> 
> On Wed, 15 Dec 2004, Nancy E. Anthracite wrote:
> 
> > I just made two mistakes.  This is the first one.  Walter Reed does use CHCS
> > I.  A big bird just told me.
> >
> > On Wednesday 15 December 2004 12:54 pm, Nancy E. Anthracite wrote:
> >> http://www.modernphysician.com/news.cms?newsId=2931
> >>
> >>  To bad the DOD just didn't put in VistA years ago.  Looks like now they
> >> will be scanning in their records.  It's saddening.
> >
> > --
> > Nancy Anthracite
> >
> >
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