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OIG confirms EHR wait time wrongdoing in VA system

By Jennifer Bresnick

- An interim report from the Office of the Inspector General (OIG), prompted by allegations of VA misconduct and spurred by a stormy Congressional hearing, has confirmed widespread wrongdoing within the Veterans Affairs health system.  The report helps to illuminate the “convoluted” scheduling process at the Phoenix VA that claimed the job of Undersecretary Dr. Robert A. Petzel and continues to threaten the position of embattled Secretary Eric Shinseki.

After a retiring physician at the Phoenix VA claimed that scheduling staff were subverting established protocols involving the healthcare system’s electronic waiting list (EWL), causing at least 40 veteran deaths and leaving countless others waiting months for basic care, the poorly-hidden practice, flagged again and again by government reports, exploded into the public eye.  In front of an angry Congressional committee, Secretary Shinseki promised a thorough review of the Phoenix VA and other suspect locations, accepting the help of top presidential advisor Rob Nabors and the OIG to dig into the allegations.

“To date, our work has substantiated serious conditions at the Phoenix HCS,” the latest OIG report states. “We identified 1700 veterans who were waiting for a primary care appointment but were not on the EWL. Until that happens, the reported wait time for these veterans has not started. Most importantly, these veterans were and continue to be at risk of being forgotten or lost in Phoenix’s convoluted scheduling process.”

“As a result, these veterans may never obtain a requested or required clinical appointment,” the report continues. “A direct consequence of not appropriately placing veterans on EWLs is that the Phoenix leadership significantly understated the time new patients waited for their primary care appointment in their FY 2013 performance appraisal accomplishments, which is one of the factors considered for awards and salary increases.”

While the investigators note that they do not yet have the right data to determine if patients died while waiting for proper care, they add that their interviews were rife other allegations of misconduct, including bullying by managers, sexual harassment, inappropriate hiring decisions, and other workplace problems.  Additional research will be necessary to substantiate these claims.

The report recommends that the VA Secretary “take immediate action to review and provide appropriate health care to the 1,700 veterans we identified as not being on any existing wait list.”  The agency will provide the names of the patients to VA authorities to facilitate the process.  The OIG also hopes that the VA will initiate a national review of all facilities where veterans may be waiting inappropriately to ensure that they receive timely and adequate care.  A final report will be forthcoming, adds Acting Inspector General Richard J. Griffin, which will request Secretary Shinseki – or his replacement, if he succumbs to increasingly loud calls for his resignation – to provide a timeline and framework for these investigations.

 

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