Federal Report Confirms Alleged VA Electronic Wait List Manipulation

May 29, 2014 in News

Federal officials have found preliminary evidence that a Department of Veterans Affairs health clinic inappropriately used electronic health record systems to facilitate improper scheduling practices, affecting as many as 1,700 patients, according to an interim report from VA’s Office of the Inspector General, the New York Times reports (Oppel/Shear, New York Times, 5/28).

Background

The investigation was prompted in response to an allegation last month by a former employee at the Phoenix VA Health Care System.

Sam Foote — a retired physician at the clinic — claimed that employees at the practice inaccurately used the center’s EHR 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.

In recent weeks, similar allegations have been made about VA facilities in Texas, Colorado and other states (iHealthBeat, 5/21).

Report Details

The report — produced by acting VA Inspector General Richard Griffin — found that at least 1,700 patients were not placed on the official electronic appointment waiting list and might not have ever received care.

The report stated, “A direct consequence of not appropriately placing veterans on [electronic wait lists] 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” (Bresnick, EHR Intelligence, 5/29).

The average wait time for an initial appointment at the Phoenix clinic was 115 days, far longer than the 26 days the hospital claimed and well beyond the agency’s goal of a maximum 14-day wait (Lawder et al., Reuters, 5/29).

Griffin said the agency also was looking into “numerous allegations daily of mismanagement, inappropriate hiring decisions, sexual harassment and bullying behavior by mid- and senior-level managers” at the Phoenix facility.

However, Griffin said the report did not address allegations that 40 patients died while awaiting medical care at the facility, saying that those allegations could only be weighed after analyzing autopsy reports and other documents, which still are under review (New York Times, 5/28).

Griffin added that he is now investigating 42 VA health centers, up from the original 26 (AP/Modern Healthcare, 5/28).

In addition, the inspector general “contacted and [is] coordinating [its] efforts with the Department of Justice” after it found “sufficient credible evidence” that a “potential violation of criminal and/or civil law” occurred (New York Times, 5/28).

Reaction to Report

VA Secretary Eric Shinseki said “the findings are reprehensible to me, to this department and to veterans.” He added that he has ordered the Phoenix facility to provide timely care to those patients who were not included on the official wait list (Kesling, Wall Street Journal, 5/38). According to Reuters, Shinseki is expected to release results from his own review of the situation to President Obama this week (Reuters, 5/29).

White House spokesperson Jessica Santillo said that Obama had reviewed the report and considered the findings “extremely troubling.” The White House said that Obama has called on VA to implement immediate steps to reach out to patients who still are waiting for care (Rampton, Reuters, 5/28).

Meanwhile, a number of Republican and Democratic lawmakers on Wednesday called on Shinseki to resign, just hours after the report was released, the Washington Post‘s “Post Politics” reports (O’Keefe/Lowery, “Post Politics, 5/28).

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