Abstract
Because the Veterans Administration operates the largest health care delivery system in the nation under the aegis of a single administration, having 172 medical centers and the third largest federal agency budget, it should assume a logical role at the forefront of automated health care application development. During the past three years, two quite different approaches to the development of medical application software have proceeded side-by-side within the Veterans Administration. One approach employed modern methods and techniques, requiring only a minimum amount of personnel and equipment resources and using local facility funds. It has produced a bounty of cost-effective automated health care application systems that are now in active use at a number of VA Medical Centers (VAMCs) nationwide. The other approach followed methods and techniques known to be unproductive, and used all of the centrally administered funds, personnel and equipment resources available. It has produced nothing of value; on the contrary, it has delayed the implementation of automated systems that could be providing important clinical services to veterans.
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