Description
The VHA Decision Support System (DSS) is a national automated management
information system based on commercial software to integrate data from
clinical and financial systems for both inpatient and outpatient care.
The commercial software is utilized with interfaces developed to transport
data into the system from the Veterans Health
Information Systems and Technology Architecture (VistA), the National
Patient Care Database (NPCD), the Patient Treatment File (PTF), and
various VA financial information systems. The VHA began implementation
of DSS in 1994. Full implementation was completed in 1999 and DSS is now
used throughout the VA healthcare system.
National software support is provided by the Decision Support Office (DSO),
formerly known as the Bedford Technical Support Office (BTSO), in Bedford,
MA. DSO is part of the DSS Program Office under the VHA Chief Financial
Officer.
DSS data are available to researchers in three levels of aggregation:
Production, National Data Extracts, and Summary Reports.
DSS Production Databases
The DSS is a distributed national software system implemented at the facility
level by staff members who comprise the local DSS Site Team. For each VHA
facility, there is a DSS production database that combines cost data, selected
clinical data such as resource utilization, patterns of care, patient outcomes,
and workload captured at the production level, i.e., by case (encounter),
day, utilization, and laboratory results levels. The DSS production database
software contains a set of tools for reporting, analysis, budgeting, and
modeling. Using these reporting capabilities, DSS Site Teams can produce
a variety of reports such as following a cohort of patients over time,
analyzing patterns of care by day of inpatient stay, associating laboratory
tests ordered with particular diagnoses, etc.
DSS National Data Extracts
The DSS Program Office working with the VHA VISN Support Services Center
(VSSC) has created SAS datasets with data extracted from selected DSS database
fields. These sets of national data are referred to as the National Data
Extracts (NDE). Rollups of production data are now done periodically to
produce the National Data Extracts (NDE). These datasets reflect the status
of processing at each VHA medical center at the time of the creation of
the dataset. Final SAS datasets for a Fiscal Year (FY) are normally produced
in January after the close of a Fiscal Year, which ends on September 30.
Currently, the following extracts are available:
|
Name
|
Description |
Data Available
|
|
Discharge
|
DSS NDE Discharge Datasets for inpatients
became available in FY 1999. Data is sorted by station, scrambled SSN,
admission day and discharge day. |
FY1999 -
FY2008 |
|
Outpatient
|
DSS NDE Outpatient Datasets became available
in FY 1999. Because of the large numbers within this extract, data
files are grouped by VISNs and are divided into Clinic Stop 160 (Pharmacy)
and all other stops. |
FY1999 -
FY2008 |
| Laboratory |
DSS NDE Laboratory Datasets with both inpatient and
outpatient test utilization and costs became available in FY 2002 .
Because of the large numbers within this extract, data files are grouped
by VISNs and separated into inpatient and outpatient files. |
FY2002 -
FY2008 |
| Laboratory Results |
DSS NDE Laboratory Results Datasets for a specific list
of tests became available in FY 2003. Because of the large numbers
within this extract, data files are grouped by VISNs and separated
into inpatient and outpatient files. |
FY2000 -
FY2008 |
| Pharmacy |
DSS NDE Pharmacy Datasets for inpatient and outpatient
utilization and costs became available in FY 2002. They include prescription,
unit dose, and IV pharmacy detail. Because of the size of these extracts,
the data files are grouped by VISNs and separated into inpatient and
outpatient files. |
FY2002 -
FY2008 |
| Radiology |
DSS NDE Radiology Datasets for inpatient and outpatient
utilization and costs of radiological procedures became available in
FY 2002. |
FY2002 -
FY2008 |
|
Treating Specialty
|
DSS NDE Treating Specialty Datasets became
available in FY 1999. Data is sorted by Station, VISN, scrambled SSN,
Treatment Specialty on Admission, and Treatment Specialty on Discharge.
| FY1999 -
FY2008 |
Summary Reports
The VISN Support Services Center (VSSC) provides Web-based reports on the VA
Intranet. The VSSC Web site point-and-click interface enables users to obtain
reports using national DSS SAS datasets in Austin. Many of the VSSC reports are
almost instantaneously available for downloading to a personal computer (PC).
Other reports with longer processing times are routed to the user's account on
the Austin Information Technology Center (AITC formerly: CFD; formerly: AAC)
mainframe computer for download to the user's PC. Examples of reports
available include:
-
Costs by Diagnostic Related Groups (DRGs)
-
Readmissions with Certain Numbers of Days
-
Average Patient Costs
-
Cost Details for Selected Clinic Stops
Descriptions of the VSSC KLF Menu and instructions on obtaining summary reports
are available on the VIReC Web site in two issues of VIReC
Insights Vol.
3, No. 2  and No.
3 .
Location
|
DSS Data
|
Location
|
|
Production Databases:
Local facility or VISN Level
National Level
|
Austin Information Technology Center (AITC formerly: CFD; formerly: AAC)
Special request to DSO
|
|
National Data Extracts
|
AAC
|
|
Summary Reports
|
VSSC Intranet Web site
|
|
