VA Inspector General: Lack of info in Phoenix VA EHRs contributed to inadequate urology care

Significant staffing shortages and missing data from non-Department of Veterans Affairs providers led to delays in treatment and inadequate care in the Phoenix VA Health Care System's (PVAHCS) urology department, according to the VA's Office of Inspector General (OIG).

An OIG report, dated Oct. 15, found that "extreme" staffing shortages negatively impacted patients' availability to receive appropriate urology care. The OIG reviewed 3,321 patient electronic health records that were referred to the urology service and were "lost to follow up." Almost half (45 percent) experienced delays in getting new evaluations or follow up appointments in-house or thru non-VA care coordination. 

Even worse, almost a quarter (23 percent) of the non-VA providers' clinical documents were not available for PVAHCS' providers to review to verify that the patient was seen. As a result, the PVAHCS referring providers many not have addressed potentially important clinical recommendations and follow up care.

The VA has struggled to provide timely treatment even after the scandal last year that revealed inordinate wait times for care. Treatment isn't the only problem: At least one other VA facility's EHR caused improper payments of disability benefits.

The OIG report also found that access to the information from one non-VA provider was delayed because it sent its documentation via a portal to PVAHCS, which was so short staffed that printing and scanning the information into the EHRs was held up.

Where the OIG could review an entire EHR, it found a number of instances of delays that negatively impacted care, and a few where the care itself was unacceptable.

The OIG recommended, among other things, that non-VA providers' clinical information be entered into the PVAHCS EHRs in a timely manner and that the facility ensure that there were sufficient resources in place to provide proper urology care.  Moreover, once the missing documents were added in, the OIG would complete its review of those EHRs.

To learn more:
- read the report (.pdf)