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As VA Puts Epic Scheduling Project on Hold, Veterans’ Access to Care Remains an Issue

April 20, 2016
by Rajiv Leventhal
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A recently-released Government Accountability Office (GAO) report found that not all newly enrolled veterans were able to access primary care from the Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) due to data weaknesses and the lack of a comprehensive scheduling policy.

The GAO report comes just soon after another report from Politico which found that VA has put on hold a $624 million contract with Epic and Lockheed Martin to implement its physician scheduling product while it tests a cheaper upgrade using its own software. If the testing of VA’s homegrown solution goes well, it will sideline any deals with the vendors, Politico reported. VA has of course been the subject of rampant criticism as it has been learned that veterans may have died while awaiting care at a VA hospital in Phoenix in 2014.

According to the GAO report, 60 of the 180 newly enrolled veterans in the agency’s review had not been seen by providers at the time of the review; nearly half were unable to access primary care because VA medical center staff did not schedule appointments for these veterans in accordance with VHA policy. The 120 newly enrolled veterans in GAO's review who were seen by providers waited from 22 days to 71 days from their requests that VA contact them to schedule appointments to when they were seen, according to GAO's analysis. These time frames were impacted by limited appointment availability and weaknesses in medical center scheduling practices, which contributed to unnecessary delays.

Indeed, VHA's oversight of veterans' access to primary care is hindered, in part, by data weaknesses and the lack of a comprehensive scheduling policy. This is inconsistent with federal internal control standards, which call for agencies to have reliable data and effective policies to achieve their objectives, the GAO review found. Specifically, “For newly enrolled veterans, VHA calculates primary care appointment wait times starting from the veterans' preferred dates (the dates veterans want to be seen), rather than the dates veterans initially requested VA contact them to schedule appointments. Therefore, these data do not capture the time these veterans wait prior to being contacted by schedulers, making it difficult for officials to identify and remedy scheduling problems that arise prior to making contact with veterans,” GAO concluded.

GAO recommends that VHA (1) ensure veterans requesting appointments are contacted in a timely manner to schedule one; (2) monitor the full amount of time newly enrolled veterans wait to receive primary care; and (3) issue an updated scheduling policy. VA concurred with all of GAO's recommendations and identified actions it is taking to implement them, according to the report.



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