Advancing evidence-based care for diabetes: Lessons from the veterans health administration

The Veterans Health Administration (VHA) is a unique laboratory for using the electronic health record (EHR) to transform health care and accelerate discovery, This is particularly evident in the care of veterans with diabetes, who constitute a quarter of those served by the VHA. Although EHRs have enabled rapid learning, additional factors were necessary, including the lead participation of clinician-investigators, accountability through performance measurement, a delivery system focused on population health, and favorable economic externalities. "Off-the-shelf" technology is unlikely to generate similar benefits if these attributes are not in place.