Using IT consultant company or IT service provider company. Companies of this kind has the advantage of more experienced on IT issues. They can help VA with two types of services, first to redesign the IT infrastructure, or even VA could fully devolved IT matters to them while VA concentrate on medical matters, for the second service type. These alternative was not cheap, San Fransisco VA Medical Center have to spend more money to pay the IT company for processing fee and maintenance fee. But if we look at the advantages of using their services, IT issues in the future can be minimized.