Our planning committees were asked to identify the minimum set of critical functions and information resources that, when implemented, will create the incentive for everyone at VUMC to use the information management infrastructure daily.

• VCARE (VUMC's patient care information system). As order entry and results display and reporting functions are added to existing clinic registration, admission, discharge, and transfer functions, most patient care unit and clinic staff will access VCARE regularly to perform their jobs.
• Electronic Mail. VUMC is making rapid progress in bringing its fiber backbone network within reasonable reach of all internal local area networks. In addition, we have chosen a single e-mail product for medical center-wide application, we are developing strategies for remote access to network resources, and we are providing electronic mail service on shared computer work stations for those who do not have personal computers. As more and more stand-alone computers are networked and as local area networks are connected to the backbone, we will soon have consistent electronic mail service throughout the Medical Center and full-function Internet access for all students, faculty, and staff who require it.
  The planning committees suggested that we want to get to the point where a significant number of documents and messages that are currently distributed on paper can be transmitted solely electronically. Initially, we will combine e-mail and fax. We plan to make sure that everyone has access to e-mail or a fax machine and then to create a directory that routes a document or message to an e-mail address as the first choice or, if an e-mail address is not available for an individual, to a fax machine. As more and more people have easy access to e-mail, we will phase out reliance on fax. The initial application will be mail that requires an R.S.V.P., so that people can see how easy it is to respond to an e-mail message, rather than having to make a phone call or return a fax.

In addition, the committees recommended gathering information about the current degree of penetration of information technology and current patterns of usage. We are using two approaches:

• A census to gather from each department administrator current information about existing networks and the numbers of faculty, staff, and trainees who have certain types of computer access.
• A survey of individuals to gather information about current computer usage and input on desired capabilities.

An initial census was completed in 1994, and we will repeat these information gathering processes periodically to monitor and evaluate our progress.