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Review
. 2010 Jan;25 Suppl 1(Suppl 1):72-6.
doi: 10.1007/s11606-009-1130-6.

Strategies from a nationwide health information technology implementation: the VA CART story

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Review

Strategies from a nationwide health information technology implementation: the VA CART story

Tamára L Box et al. J Gen Intern Med. 2010 Jan.

Abstract

The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

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Figures

Figure 1
Figure 1
Seventy-seven Veterans Affairs catheterization lab locations and the VA Cardiovascular Assessment, Reporting, and Tracking (CART) System sites.
Figure 2
Figure 2
Catheterization lab reports generated using the VA Cardiovascular Assessment, Reporting, and Tracking (CART) System, 2004–2008.
Figure 3
Figure 3
Sample screens from the VA Cardiovascular Assessment, Reporting, and Tracking (CART) System (Simulated data).

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