[Federal Register Volume 69, Number 67 (Wednesday, April 7, 2004)]
[Notices]
[Pages 18436-18441]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-7821]


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DEPARTMENT OF VETERANS AFFAIRS


Privacy Act of 1974; System of Records

AGENCY: Department of Veterans Affairs (VA).

ACTION: Notice of new system of records.

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SUMMARY: The Privacy Act of 1974 (5 U.S.C. 552a(e)(4)) requires that 
all agencies publish in the Federal Register a notice of the existence 
and character of their systems of records. Notice is hereby given that 
the Department of Veterans Affairs (VA) is establishing a new system of 
records entitled ``National Patient Databases-VA'' (121VA19).

DATES: Comments on this new system of records must be received no later 
than May 7, 2004. If no public comment is received during the period 
allowed for comment or unless otherwise published in the Federal 
Register by VA, the new system will become effective May 7, 2004.

ADDRESSES: You may mail or hand-deliver written comments concerning the 
proposed amended system of records to the Director, Regulations 
Management (00REG1), Department of Veterans Affairs, 810 Vermont 
Avenue, NW., Washington, DC 20420; or fax comments to (202) 273-9026; 
or email comments to ``[email protected]''. All relevant 
material received before May 7, 2004 will be considered. Comments will 
be available for public inspection at the above address in the Office 
of Regulations Management, room 1063B, between the hours of 8 a.m. and 
4:30 p.m., Monday through Friday (except holidays).

FOR FURTHER INFORMATION CONTACT: Veterans Health Administration (VHA) 
Privacy Act Officer, Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, telephone (727) 320-1839.

SUPPLEMENTARY INFORMATION:
    Background: VHA is the largest health care provider in the country. 
In order to maintain this organization, VHA collects health care 
information from its local facilities to evaluate quality of services, 
clinical resource utilization, and patient safety, as well as to 
distribute medical information such as alerts or recalls, track 
specific diseases, and monitor patients. National-level information is 
also needed for other activities such as, medical research, the 
development of National Best Clinical Practice Guidelines, and National 
Quality Standards. VHA gathers this information received from a wide 
variety of sources to include data obtained directly from a veteran as 
well as from information systems located at VHA medical centers, 
Veterans Integrated Service Networks (VISN), other VHA facilities such 
as the Health Eligibility Center, and Federal departments and agencies 
such as the U.S. Department of Defense and the Food and Drug 
Administration. As the data is collected, VHA stores it in several 
national patient databases.

I. Description of Proposed Systems of Records

    The proposed system of records contains health information such as, 
patient assessments, diagnoses, treatments, tests, and pharmaceutical 
data. The records include information created or collected during the 
course of normal clinical operations work and is provided by patients, 
employees, students, volunteers, contractors, subcontractors, and 
consultants. Quality assurance (QA) information that is protected by 38 
U.S.C. 5701 and 38 CFR 17.500-17.511 is retrieved by individual 
identifier and therefore not within the scope of the Privacy Act. 
Therefore, QA information is not included in this system of records or 
filed in a manner so that the information may be retrieved by reference 
to an individual identifier.
    VHA uses data stored in national patient databases to prepare 
various management, tracking, and follow-up reports necessary for the 
effective operation of VHA as it plans for and then delivers quality 
health care. This includes evaluating patient eligibility, benefits and 
care services; monitoring the distribution and utilization of resources 
including provider panel management; tracking disease and patient 
outcomes; program review, accreditation and licensing; quality 
assurance audits and investigations; law enforcement investigations; 
and measuring VISN performance. The data may be used to validate labor 
policies and practices and be extracted for use by VA researchers in 
accordance with established protocols. The data in a de-identified form 
may also be used for determining best practices.
    The national databases covered by this system of records are 
identified and listed with their physical location in Appendix 4.

II. Proposed Routine Use Disclosures of Data in the System

    To the extent that records contained in the system include 
information protected by 38 U.S.C. 7332, i.e., medical treatment 
information related to drug abuse, alcoholism or alcohol abuse, sickle 
cell anemia or infection with the human immunodeficiency virus, that 
information cannot be disclosed under a routine use unless there is 
also specific statutory authority permitting disclosure.
    VHA is proposing the following routine use disclosures of 
information to be maintained in the system:
    1. On its own initiative, VA may disclose information, except for 
the names and home addresses of veterans and their dependents, to a 
Federal, State, local, tribal or foreign agency charged with the 
responsibility of investigating or prosecuting civil, criminal or 
regulatory violations of law, or charged with enforcing or implementing 
the statute, regulation, rule or order issued pursuant thereto. On its 
own initiative, the VA may also disclose the names and addresses of 
veterans and their dependents to a Federal agency charged with the 
responsibility of investigating or prosecuting civil, criminal or 
regulatory violations of law, or charged with enforcing or implementing 
the statute, regulation, rule or order issued pursuant thereto.
    VA must be able to comply with the requirements of agencies charged 
with enforcing the law and conducting investigations. VA must also be 
able to provide information to State or local agencies charged with 
protecting the public's health as set forth in state law.
    2. Disclosure may be made to any source from which additional 
information is requested (to the extent necessary to identify the 
individual, inform the source of the purpose(s) of the request, and to 
identify the type of information requested), when necessary to obtain 
information relevant to an individual's eligibility, care history, or 
other benefits.
    3. Disclosure may be made to an agency in the executive, 
legislative, or judicial branch, or the District of

[[Page 18437]]

Columbia government in response to its request or at the initiation of 
VA, in connection with disease tracking, patient outcomes or other 
health information required for program accountability.
    4. Disclosure may be made to National Archives and Records 
Administration (NARA) for it to perform its records management 
inspections responsibilities and its role as Archivist of the United 
States under authority of Title 44 United States Code (USC).
    NARA is responsible for archiving old records no longer actively 
used but which may be appropriate for preservation; they are 
responsible in general for the physical maintenance of the Federal 
government's records. VA must be able to turn records over to these 
agencies in order to determine the proper disposition of such records.
    5. Any information in this system of records may be disclosed to 
the United States Department of Justice or United States Attorneys in 
order to prosecute or defend litigation involving or pertaining to the 
United States, or in which the United States has an interest.
    6. Records from this system of records may be disclosed to a 
Federal agency or to a state or local government licensing board and/or 
to the Federation of State Medical Boards or a similar non-government 
entity which maintains records concerning individuals' employment 
histories or concerning the issuance, retention or revocation of 
licenses, certifications, or registration necessary to practice an 
occupation, profession or specialty, in order for the agency to obtain 
information relevant to an agency decision concerning the hiring, 
retention or termination of an employee.
    7. Records from this system of records may be disclosed to inform a 
Federal agency, licensing boards or the appropriate non-government 
entities about the health care practices of a terminated, resigned or 
retired health care employee whose professional health care activity so 
significantly failed to conform to generally accepted standards of 
professional medical practice as to raise reasonable concern for the 
health and safety of patients receiving medical care in the private 
sector or from another Federal agency.
    8. For program review purposes and the seeking of accreditation 
and/or certification, disclosure may be made to survey teams of the 
Joint Commission on Accreditation of Healthcare Organizations (JCAHO), 
College of American Pathologists, American Association of Blood Banks, 
and similar national accreditation agencies or boards with whom VA has 
a contract or agreement to conduct such reviews but only to the extent 
that the information is necessary and relevant to the review.
    VA health care facilities undergo certification and accreditation 
by several national accreditation agencies or boards to comply with 
regulations and good medical practices. VA must be able to disclose 
information for program review purposes and the seeking of 
accreditation and/or certification of health care facilities and 
programs.
    9. Disclosure may be made to a national certifying body which has 
the authority to make decisions concerning the issuance, retention or 
revocation of licenses, certifications or registrations required to 
practice a health care profession, when requested in writing by an 
investigator or supervisory official of the national certifying body 
for the purpose of making a decision concerning the issuance, retention 
or revocation of the license, certification or registration of a named 
health care professional.
    VA must be able to report information regarding the care a health 
care practitioner provides to a national certifying body charged with 
maintaining the health and safety of patients by making a decision 
about a health care professional's license, certification or 
registration, such as issuance, retention, revocation or other actions 
such as suspension.
    10. Disclosure may be made to officials of labor organizations 
recognized under 5 U.S.C. chapter 71 when relevant and necessary to 
their duties of exclusive representation concerning personnel policies, 
practices, and matters affecting working conditions.
    11. Disclosure may be made to the VA-appointed representative of an 
employee all notices, determinations, decisions, or other written 
communications issued to the employee in connection with an examination 
ordered by VA under medical evaluation (formerly fitness-for-duty) 
examination procedures or Department-filed disability retirement 
procedures.
    12. Disclosure may be made to officials of the Merit Systems 
Protection Board, and the Office of the Special Counsel, or both, when 
requested in connection with appeals, special studies of the civil 
service and other merit systems, review of rules and regulations, 
investigation of alleged or possible prohibited personnel practices, 
and such other functions, promulgated in 5 U.S.C. or as may be 
authorized by law.
    13. Disclosure may be made to the Equal Employment Opportunity 
Commission when requested in connection with investigations of alleged 
or possible discrimination practices, examination of Federal 
affirmative employment programs, compliance with the Uniform Guidelines 
of Employee Selection Procedures, or other functions vested in the 
Commission by the President's Reorganization Plan No. 1 of 1978.
    14. Disclosure may be made to the Federal Labor Relations Authority 
(FLRA), including its General Counsel, when requested in connection 
with investigation and resolution of allegations of unfair labor 
practices, in connection with the resolution of exceptions to 
arbitrator awards when a question of material fact is raised and 
matters before the Federal Service Impasses Panel.
    The release of information to FLRA from this Privacy Act system of 
records is necessary to comply with the statutory mandate under which 
FLRA operates.
    15. Disclosure of medical record data, excluding name and address, 
unless name and address is furnished by the requester, may be made to 
epidemiological and other research facilities for research purposes 
determined to be necessary and proper when approved in accordance with 
VA policy.
    16. Disclosure of name(s) and address(s) of present or former 
personnel of the Armed Services, and/or their dependents, may be made 
to: (a) A Federal department or agency, at the written request of the 
head or designee of that agency; or (b) directly to a contractor or 
subcontractor of a Federal department or agency, for the purpose of 
conducting Federal research necessary to accomplish a statutory purpose 
of an agency. When disclosure of this information is made directly to a 
contractor, VA may impose applicable conditions on the department, 
agency, and/or contractor to insure the appropriateness of the 
disclosure to the contractor.
    17. Relevant information may be disclosed to individuals, 
organizations, private or public agencies, etc., with whom VA has a 
contract or agreement, including subcontractors, to perform such 
services as VA may deem practical for the purposes of laws administered 
by VA, in order for the contractor to perform the services of the 
contract or agreement.
    VA must be able to give a contractor whatever information is 
necessary for the contractor to fulfill its duties. In these 
situations, safeguards are provided in the contract prohibiting the 
contractor from using or disclosing the information for any purpose 
other than that described in the contract.

[[Page 18438]]

    18. Disclosure may be made to a Congressional office from the 
record of an individual in response to an inquiry from the 
congressional office made at the request of that individual.
    Individuals sometimes request the help of a member of Congress in 
resolving some issues relating to a matter before VA. The member of 
Congress then writes VA, and VA must be able to give sufficient 
information to be responsive to the inquiry.

III. Compatibility of the Proposed Routine Uses

    The Privacy Act permits VA to disclose information about 
individuals without their consent for a routine use when the 
information will be used for a purpose that is compatible with the 
purpose for which VA collected the information. In all of the routine 
use disclosures described above, either the recipient of the 
information will use the information in connection with a matter 
relating to one of VA's programs, will use the information to provide a 
benefit to VA, or disclosure is required by law.
    Under section 264, Subtitle F of Title II of the Health Insurance 
Portability and Accountability Act of 1996 (HIPAA) Public Law 104-191, 
100 Stat. 1936, 2033-34 (1996), the United States Department of Health 
and Human Services (HHS) published a final rule, as amended, 
establishing Standards for Privacy of Individually-Identifiable Health 
Information, 45 CFR parts 160 and 164. The Veterans Health 
Administration (VHA) may not disclose individually-identifiable health 
information (as defined in HIPAA and the Privacy Rule, 42 U.S.C. 
1320(d)(6) and 45 CFR 164.501) pursuant to a routine use unless either: 
(a) The disclosure is required by law, or (b) the disclosure is also 
permitted or required by the HHS Privacy Rule. The disclosures of 
individually-identifiable health information contemplated in the 
routine uses published in this amended system of records notice are 
permitted under the Privacy Rule or required by law. However, to also 
have authority to make such disclosures under the Privacy Act, VA must 
publish these routine uses. Consequently, VA is publishing these 
routine uses and is adding a preliminary paragraph to the routine uses 
portion of the system of records notice stating that any disclosure 
pursuant to the routine uses in this system of records notice must be 
either required by law or permitted by the Privacy Rule before VHA may 
disclose the covered information.
    The notice of intent to publish and an advance copy of the system 
notice have been sent to the appropriate Congressional committees and 
to the Director of Office of Management and Budget (OMB) as required by 
5 U.S.C. 552a(r) (Privacy Act) and guidelines issued by OMB (65 FR 
77677), December 12, 2000.

    Approved: March 22, 2004.
Anthony J. Principi,
Secretary of Veterans Affairs.
121VA19

SYSTEM NAME:
    National Patient Databases--VA.

SYSTEM LOCATION:
    Records are maintained at Department of Veterans Affairs (VA) 
medical centers, VA Data Processing Centers, Veterans Integrated 
Service Networks (VISNs) and Office of Information (OI) Field Offices. 
Address location for each VA national patient database is listed in VA 
Appendix 4 at the end of this document.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
    The records contain information for all individuals
    (1) Receiving health care from the Veterans Health Administration 
(VHA), and
    (2) Providing the health care.
    Individuals encompass veterans and their immediate family members, 
members of the armed services, current and former employees, trainees, 
contractors, sub-contractors, consultants, volunteers, and other 
individuals working collaboratively with VA.

CATEGORIES OF RECORDS IN THE SYSTEM:
    The records may include information related to:
    1. Patient medical record abstract information including 
information from Patient Medical Record--VA (24VA136).
    2. The record may include identifying information (e.g., name, 
birth date, death date, admission date, discharge date, gender, social 
security number, taxpayer identification number); address information 
(e.g., home and/or mailing address, home telephone number, emergency 
contact information such as name, address, telephone number, and 
relationship); prosthetic and sensory aid serial numbers; medical 
record numbers; integration control numbers; information related to 
medical examination or treatment (e.g., location of VA medical facility 
providing examination or treatment, treatment dates, medical conditions 
treated or noted on examination); information related to military 
service and status;
    3. Medical benefit and eligibility information;
    4. Patient aggregate workload data such as admissions, discharges, 
and outpatient visits; resource utilization such as laboratory tests, 
x-rays, pharmaceuticals, prosthetics and sensory aids; employee 
workload and productivity data;
    5. Information on services or products needed in the provision of 
medical care (i.e. pacemakers, prosthetics, dental implants, hearing 
aids, etc.); data collected may include vendor name and address, 
details about and/or evaluation of service or product, price/fee, dates 
purchased and delivered; and
    6. Health care practitioner's identification number.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
    Title 38, United States Code, Section 501.

PURPOSE(S):
    The records and information may be used for statistical analysis to 
produce various management, workload tracking, and follow-up reports; 
to track and evaluate the ordering and delivery of equipment, services 
and patient care; for the planning, distribution and utilization of 
resources; to monitor the performance of Veterans Integrated Service 
Networks (VISN); and to allocate clinical and administrative support to 
patient medical care. The data may be used for VA's extensive research 
programs in accord with VA policy. In addition, the data may be used to 
assist in workload allocation for patient treatment services including 
provider panel management, nursing care, clinic appointments, surgery, 
diagnostic and therapeutic procedures; to plan and schedule training 
activities for employees; for audits, reviews and investigations 
conducted by the Network Directors Office and VA Central Office; for 
quality assurance audits, reviews and investigations; for law 
enforcement investigations; and for personnel management, evaluation 
and employee ratings, and performance evaluations.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES 
OF USERS AND THE PURPOSES OF SUCH USES:
    To the extent that records contained in the system include 
information protected by 38 U.S.C. 7332, i.e., medical treatment 
information related to drug abuse, alcoholism or alcohol abuse, sickle 
cell anemia or infection with the human immunodeficiency virus, that 
information cannot be disclosed under a routine use unless there is 
also specific statutory authority permitting disclosure.

[[Page 18439]]

    VA may disclose protected health information pursuant to the 
following routine uses where required by law, or permitted by 45 CFR 
parts 160 and 164.
    1. On its own initiative, VA may disclose information, except for 
the names and home addresses of veterans and their dependents, to a 
Federal, state, local, tribal or foreign agency charged with the 
responsibility of investigating or prosecuting civil, criminal or 
regulatory violations of law, or charged with enforcing or implementing 
the statute, regulation, rule or order issued pursuant thereto. On its 
own initiative, VA may also disclose the names and addresses of 
veterans and their dependents to a Federal agency charged with the 
responsibility of investigating or prosecuting civil, criminal or 
regulatory violations of law, or charged with enforcing or implementing 
the statute, regulation, rule or order issued pursuant thereto.
    2. Disclosure may be made to any source from which additional 
information is requested (to the extent necessary to identify the 
individual, inform the source of the purpose(s) of the request, and to 
identify the type of information requested), when necessary to obtain 
information relevant to an individual's eligibility, care history, or 
other benefits.
    3. Disclosure may be made to an agency in the executive, 
legislative, or judicial branch, or the District of Columbia government 
in response to its request or at the initiation of VA, in connection 
with disease tracking, patient outcomes or other health information 
required for program accountability.
    4. Disclosure may be made to National Archives and Records 
Administration (NARA) for it to perform its records management 
inspections responsibilities and its role as Archivist of United States 
under authority of Title 44 United States Code (USC).
    5. Any information in this system of records may be disclosed to 
the United States Department of Justice or United States Attorneys in 
order to prosecute or defend litigation involving or pertaining to the 
United States, or in which the United States has an interest.
    6. Records from this system of records may be disclosed to a 
Federal agency or to a state or local government licensing board and/or 
to the Federation of State Medical Boards or a similar non-government 
entity which maintains records concerning individuals' employment 
histories or concerning the issuance, retention or revocation of 
licenses, certifications, or registration necessary to practice an 
occupation, profession or specialty, in order for the agency to obtain 
information relevant to an agency decision concerning the hiring, 
retention or termination of an employee.
    7. Records from this system of records may be disclosed to inform a 
Federal agency, licensing boards or the appropriate non-government 
entities about the health care practices of a terminated, resigned or 
retired health care employee whose professional health care activity so 
significantly failed to conform to generally accepted standards of 
professional medical practice as to raise reasonable concern for the 
health and safety of patients receiving medical care in the private 
sector or from another Federal agency.
    8. For program review purposes and the seeking of accreditation 
and/or certification, disclosure may be made to survey teams of the 
Joint Commission on Accreditation of Healthcare Organizations (JCAHO), 
College of American Pathologists, American Association of Blood Banks, 
and similar national accreditation agencies or boards with whom VA has 
a contract or agreement to conduct such reviews but only to the extent 
that the information is necessary and relevant to the review.
    9. Disclosure may be made to a national certifying body which has 
the authority to make decisions concerning the issuance, retention or 
revocation of licenses, certifications or registrations required to 
practice a health care profession, when requested in writing by an 
investigator or supervisory official of the national certifying body 
for the purpose of making a decision concerning the issuance, retention 
or revocation of the license, certification or registration of a named 
health care professional.
    10. Disclosure may be made to officials of labor organizations 
recognized under 5 U.S.C. chapter 71 when relevant and necessary to 
their duties of exclusive representation concerning personnel policies, 
practices, and matters affecting working conditions.
    11. Disclosure may be made to the representative of an employee of 
all notices, determinations, decisions, or other written communications 
issued to the employee in connection with an examination ordered by VA 
under medical evaluation (formerly fitness-for-duty) examination 
procedures or Department-filed disability retirement procedures.
    12. Disclosure may be made to officials of the Merit Systems 
Protection Board, and the Office of the Special Counsel, or both, when 
requested in connection with appeals, special studies of the civil 
service and other merit systems, review of rules and regulations, 
investigation of alleged or possible prohibited personnel practices, 
and such other functions, promulgated in 5 U.S.C. or as may be 
authorized by law.
    13. Disclosure may be made to the Equal Employment Opportunity 
Commission when requested in connection with investigations of alleged 
or possible discrimination practices, examination of Federal 
affirmative employment programs, compliance with the Uniform Guidelines 
of Employee Selection Procedures, or other functions vested in the 
Commission by the President's Reorganization Plan No. 1 of 1978.
    14. Disclosure may be made to the Federal Labor Relations Authority 
(including its General Counsel) when requested in connection with 
investigation and resolution of allegations of unfair labor practices, 
in connection with the resolution of exceptions to arbitrator awards 
when a question of material fact is raised and matters before the 
Federal Service Impasses Panel.
    15. Disclosure of medical record data, excluding name and address, 
unless name and address is furnished by the requester, may be made to 
epidemiological and other research facilities for research purposes 
determined to be necessary and proper when approved in accordance with 
VA policy.
    16. Disclosure of name(s) and address(s) of present or former 
personnel of the Armed Services, and/or their dependents, may be made 
to: (a) A Federal department or agency, at the written request of the 
head or designee of that agency; or (b) directly to a contractor or 
subcontractor of a Federal department or agency, for the purpose of 
conducting Federal research necessary to accomplish a statutory purpose 
of an agency. When disclosure of this information is made directly to a 
contractor, VA may impose applicable conditions on the department, 
agency, and/or contractor to insure the appropriateness of the 
disclosure to the contractor.
    17. Relevant information may be disclosed to individuals, 
organizations, private or public agencies, etc., with whom VA has a 
contract or agreement, including subcontractors, to perform such 
services as VA may deem practical for the purposes of laws administered 
by VA, in order for the contractor to perform the services of the 
contract or agreement.
    18. Disclosure may be made to a Congressional office from the 
record of an individual in response to an inquiry

[[Page 18440]]

from the congressional office made at the request of that individual.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, 
AND DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
    Records are maintained on electronic storage media including 
magnetic tape, disk, laser optical media.

RETRIEVABILITY:
    Records are retrieved by name, social security number or other 
assigned identifiers of the individuals on whom they are maintained.

SAFEGUARDS:
    1. Access to and use of national patient databases are limited to 
those persons whose official duties require such access, and VA has 
established security procedures to ensure that access is appropriately 
limited. Information security officers and system data stewards review 
and authorize data access requests. VA regulates data access with 
security software that authenticates users and requires individually 
unique codes and passwords. VA provides information security training 
to all staff and instructs staff on the responsibility each person has 
for safeguarding data confidentiality.
    2. Physical access to computer rooms housing national patient 
databases is restricted to authorized staff and protected by a variety 
of security devices. Unauthorized employees, contractors, and other 
staff are not allowed in computer rooms. The Federal Protective Service 
or other security personnel provide physical security for the buildings 
housing computer rooms and data centers.
    3. Data transmissions between operational systems and national 
patient databases maintained by this system of record are protected by 
state of the art telecommunication software and hardware. This may 
include firewalls, encryption, and other security measures necessary to 
safeguard data as it travels across the VA Wide Area Network.
    4. In most cases, copies of back-up computer files are maintained 
at off-site locations.

RETENTION AND DISPOSAL:
    Records are maintained and disposed of in accordance with records 
disposition authority approved by the Archivist of the United States.

SYSTEMS AND MANAGER(S) AND ADDRESS:
    Official responsible for policies and procedures; Chief Information 
Officer (19), Department of Veterans Affairs, 810 Vermont Avenue, NW., 
Washington, DC 20420. Official maintaining this system of record; 
Director National Data Systems (192-3), Austin Automation Center, 1615 
Woodward Street, Austin, Texas 78772.

NOTIFICATION PROCEDURE:
    Individuals who wish to determine whether this system of records 
contains information about them should contact the Director of National 
Data Systems (19F4), Austin Automation Center, 1615 Woodward Street, 
Austin, Texas 78772. Inquiries should include the person's full name, 
social security number, location and dates of employment or location 
and dates of treatment, and their return address.

RECORD ACCESS PROCEDURE:
    Individuals seeking information regarding access to and contesting 
of records in this system may write or call the Director of National 
Data Systems (19F4), Austin Automation Center, 1615 Woodward Street, 
Austin, Texas 78772, or call the VA Austin Automation Center Help Desk 
and ask to speak with the VHA Director of National Data Systems at 512-
326-6780.

CONTESTING RECORD PROCEDURES:
    (See Record Access Procedures above.)

RECORD SOURCE CATEGORIES:
    Information in this system of records is provided by veterans, VA 
employees, VA computer systems, Veterans Health Information Systems and 
Technology Architecture (VistA), VA Medical Centers, VA Health 
Eligibility Center, VA Program Offices, VISNs, VA Austin Automation 
Center, the Food and Drug Administration, the Department of Defense, 
and the following Systems Of Records: ``Patient Medical Records--VA'' 
(24VA136); ``National Prosthetics Patient Database--VA'' (33VA113); 
``Healthcare Eligibility Records--VA'' (89VA19); and the VA Veterans 
Benefits Administration automated record systems (including the 
Veterans and Beneficiaries Identification and Records Location 
Subsystem--VA (38VA23)).

                              VA Appendix 4
------------------------------------------------------------------------
             Database name                           Location
------------------------------------------------------------------------
Addiction Severity Index...............  Veteran Affairs Medical Center,
                                          7180 Highland Drive,
                                          Pittsburgh, PA 15206.
Continuous Improvement in Cardiac        Veteran Affairs Medical Center,
 Surgery.                                 820 Clermont Street, Denver,
                                          CO 80220.
Cruetzfelet-Jakob Disease Lookback       Cincinnati VA Medical Center,
 Dataset.                                 3200 Vine St., Cincinnati,
                                          Ohio 45220.
Eastern Pacemaker Surveillance Center    Veteran Affairs Medical Center,
 Database.                                50 Irving Street, NW.,
                                          Washington, DC 20422.
Emerging Pathogens Initiative..........  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Federal Health Information Exchange....  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Former Prisoner of War Tracking          Austin Automation Center, 1615
 Statistical System.                      Woodward Street, Austin, Texas
                                          78772.
Functional Status and Outcome Database.  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Home Based Primary Care................  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Clinical Case Registry.................  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Immunology Case Registry...............  Office of Information Field
                                          Office, 1st Ave., Building 37,
                                          Hines IL 60141.
Mammography Quality Standards VA.......  Veteran Affairs Medical Center,
                                          508 Fulton Street, Durham, NC
                                          27705.
Master Patient Index...................  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.

[[Page 18441]]

 
Medical SAS File (MDP) (Medical          Austin Automation Center, 1615
 District Planning (MEDIPRO)).            Woodward Street, Austin, Texas
                                          78772.
Missing Patient Register...............  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
National Health Care Practitioner        Austin Automation Center, 1615
 Database.                                Woodward Street, Austin, Texas
                                          78772.
National Mental Health Database System.  Veteran Affairs Medical Center,
                                          7180 Highland Drive,
                                          Pittsburgh, PA 15206.
National Patient Care Database.........  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
National Survey of Veterans............  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Patient Assessment File................  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Patient Treatment File.................  Austin Automation Center, 1615
                                          Woodward Street, Austin, Texas
                                          78772.
Radiation Exposure Inquiries Database..  Office of Information Field
                                          Office, 1335 East/West Hwy.,
                                          Silver Spring MD 20910.
Remote Order Entry System..............  Denver Distribution Center, 155
                                          Van Gordon Street, Lakewood,
                                          CO 80228-1709.
Resident Assessment Instrument/Minimum   Austin Automation Center, 1615
 Data Set.                                Woodward Street, Austin, Texas
                                          78772.
VA National Clozapine Registry.........  Veteran Affairs Medical Center,
                                          4500 South Lancaster Road,
                                          Dallas, TX 75216.
Veterans Administration Central Cancer   Veteran Affairs Medical Center,
 Registry.                                50 Irving Street, NW.,
                                          Washington, DC 20422.
KLF Menu...............................  Austin Automation Center, 1615
                                          Woodward Street, Austin, TX
                                          78772.
Decision Support System................  Austin Automation Center, 1615
                                          Woodward Street, Austin, TX
                                          78772.
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[FR Doc. 04-7821 Filed 4-6-04; 8:45 am]
BILLING CODE 8320-01-P