An internal Department of Veterans Affairs (VA) audit of the scandal involving inordinate wait times for veterans seeking medical treatment found many widespread problems with scheduling and access to care, but did not place the fault on VistA, the VA's electronic health record system.
The report, released June 9, revealed many problems with access to care, and focused on problems related to inappropriate use or avoidance of VistA's electronic scheduling system. The problems included VA employees entering false appointment request dates to hide long wait times, the use of secret manual waitlists, and a confusing process, including a 14 day wait time performance target that was "not attainable" due to lack of providers.
The barriers to care outscored any problems with the scheduling software system itself, although it was described as "antiquated" and "problematic," according to the report.
The audit consisted of a system-wide overview comprising more than 3,772 interviews at 731 VA facilities. It revealed that more than 57,000 veterans were still waiting for care 90 days after requesting an appointment.
Of the 18 "immediate action items" to be taken as a result of the audit, none called for scrapping or changing the software system.
The VA has been working to upgrade its EHR system, both on its own and jointly with the Department of Defense. The VA and the DoD initiative to integrate their EHRs was abandoned in 2013. The U.S. House of Representatives last month announced it would withhold 75 percent of the VA's IT funding to upgrade its system until the two agencies address progress in making their EHR systems interoperable. It is expected that DoD will receive the same treatment. The Government Accountability Office also recently chastised the VA and the DoD for their lack of progress in EHR collaboration.