Shinseki Pledges To Investigate, Address Claims of Improper EHR Use

May 20, 2014 in News

On Thursday, Department of Veterans Affairs Secretary Eric Shinseki told lawmakers on the Senate Veterans’ Affairs Committee that allegations about illegitimate waiting lists that delayed patient care at some VA health facilities had made him “mad as hell,” and he pledged to address the problems, the New York Times reports (Oppel, New York Times, 5/15).

Background

Last month, Sam Foote — a retired physician formerly at the Phoenix VA Health Care System — claimed that employees at the practice inaccurately used the center’s electronic health record system and “deliberately” created a secret waiting list to hide documentation of delays in care, which allegedly led to nearly 40 U.S. veteran deaths. According to Foote, up to 1,600 patients were placed on a secret electronic waiting list at the Phoenix center, sometimes waiting months to over a year to have an appointment scheduled

Current VA rules state that patients who contact veterans’ health centers for an appointment should be seen within 30 days of their request (iHealthBeat, 4/28).

In recent weeks, similar allegations have been made about VA facilities in Texas, Colorado and other states, according to the Times (New York Times, 5/15).

Hearing Details

According to the Washington Post, both Democrats and Republicans on the panel expressed frustration over the situation and cast doubts about Shinseki’s leadership, but stopped short of repeating calls from other GOP lawmakers and some veterans’ groups that he step down.

Sen. Patty Murray (D-Wash.) said the allegations about a system-wide problem should serve as a “wake-up call” for VA, while Sen. Johnny Isakson (R-Ga.) said the problems show that Shinseki has “either been ill-served by his senior leadership — which I think is part of the systematic problem — or has been oblivious to what’s been going on” (Jaffe/Hicks, Washington Post, 5/15).

Some panel members questioned why Shinseki had not fired more VA health center employees over the allegations and whether he was willing to take that step if given clear evidence of wrongdoing (Reichard, CQ HealthBeat, 5/15).

In response, Shinseki said he would act aggressively if the allegations prove to be true. He added that he would refrain from seeking additional authority permitting him to take stronger action against any of the centers and their administrators until a system-wide audit of scheduling practices has been completed (Washington Post, 5/15).

The audit, which Shinseki said should be completed and released within three weeks, includes all VA medical centers and community-based outpatient clinics. The audit is being completed by more than 200 staff members from the Veterans Integrated Service Networks and Veterans Health Administration central office (Dickson, Modern Healthcare, 5/15).

He reiterated his commitment to the Obama Administration to address the health care and welfare of military veterans and pledged to address the problems, dismissing the recent calls for his resignation.

Shinseki also avoided making any pledges for sweeping reform. He noted that despite the allegations, veterans’ overall satisfaction with the medical treatment through the VA health care system is “equal to or better than the rankings for private-sector hospitals” (Washington Post, 5/15).

VA Acting Inspector General Testifies

Meanwhile, VA acting Inspector General Richard Griffin — who also testified during Thursday’s hearing — said that federal prosecutors are participating in the investigations to determine whether any criminal violations occurred at a Phoenix VA center, the Times reports.

Griffin declined to disclose additional details about the ongoing investigation but said the probe so far had examined the cases of 17 veterans who died after their treatment was allegedly delayed, and it “didn’t conclude … that the delay caused the deaths.” He said it is “one thing to be on a waiting list and it’s another thing to conclude that as a result of being on the waiting list, that’s the cause of death” (New York Times, 5/15).

Griffin is expected to release a report on the investigation in August (Modern Healthcare, 5/15).

Senior VA Health Official Resigns

On Friday, VA Undersecretary for Health Care Robert Petzel, who also was questioned by the Senate VA committee, resigned from his position, AP/Yahoo! News reports.

While Petzel was scheduled to retire this year, he had planned to remain in seat until the Senate had confirmed his replacement. However, a department official said that Shinseki requested Petzel resign immediately (Daly, AP/Yahoo! News, 5/17). According to the New York Times, President Obama two weeks ago nominated Jeffrey Murawsky to replace Petzel.

While it is not clear whether the Obama administration pushed for Petzel’s immediate resignation, White House press secretary Jay Carney said Obama supported the move (Oppel, New York Times, 5/16).

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