US Department of Veterans Affairs

In 2001, DSHI Systems licensed TriageXpert to the Veterans Healthcare Administration to improve care, increase efficiency, and lower healthcare costs. Engineers at DSHI Systems developed VHG, a web-based triage solution that is used by thousands of VA nurses to send veterans to appropriate care at the right place, and at the right time. VHG standardizes triage decision making, automates documentation and reduces time spent on the telephone.

VHG uses proprietary algorithms to analyze symptoms and past medical history, and then makes a recommendation on how quickly the veteran should be seen by a provider and where. VHG performs the important task of determining which veterans need care in the emergency room, and which have less urgent problems that could be treated in the clinic. VHG also identifies minor illnesses that can be managed at home, and then provides self-care instructions. By directing veterans to the right resources, the application helps the VHA lower healthcare costs, while improving access to care. The VHG clinical record is entered into the VHA electronic medical record through an integration partnership with Document Storage Systems, Inc.

For the past 10 years, the algorithms in TriageXpert have been enhanced through feedback from providers and nurses across the country. DSHI accomplished this by hosting a monthly teleconference with VHA providers and nursing leadership for the purpose of case review. According to a VHA clinical mandate, every VHG clinical record is reviewed by a VHA provider. The combination of evidence-based triage decision-making, physician review, and ongoing QA, has resulted in high clinical accuracy and reliability.

In response to the 2009 H1N1 epidemic, DSHI Systems was contracted by the VHA Office of Public Health Surveillance to configure VHG to provide syndromic surveillance data. Using a pattern-recognition algorithm, VHG automatically flags cases that are high risk for influenza-like illness. This innovation has allowed the VHA to improve the prediction and monitoring of disease outbreaks in the veteran population.