Vital Signs Blog

VA's VistA survives latest audit with little blame

The computerized scheduling system at the Veterans Health Administration didn't receive a clean bill of health from a Veterans Affairs Department audit report released Monday, but among the contributing factors to the VA's highly publicized scheduling woes, problems with computers ranked fairly low.

The auditors' conclusions were based on 3,772 interviews conducted between May 12 and June 3 at 731 VA facilities.

Front-line staff members were asked to score from a range of 1 (never a barrier or challenge) to 5 (always a barrier or challenge) the degree to which various aspects of their jobs posed problems in providing timely care to veterans, a cause célèbre for the past two weeks in Washington that led to the resignation of VA Secretary Eric Shinseki last month.

The lack of open provider slots scored highest with VA staffers as a specific barrier or challenge (with a mean score of 3.0), closely followed by limited clerical staffing (2.8) and the VA target that veterans have an appointment within 14 days of request (2.8).

“When explaining the context of inappropriate scheduling activities respondents describe a numbers-driven system with unrealistic performance measures as having created a highly stressful work environment that limits the focus on serving the veteran,” auditors reported.

Challenges using the scheduling module of the VA VistA electronic health-record system, an electronic waitlist and other computer systems used in the scheduling process, ranked lowest among six choices given by the auditors, tied with training issues (2.0). Interviewees, when they did mention VA technology as an issue, said the software, and to a lesser degree, telephone equipment, “were frequently descried as antiquated and problematic,” auditors said.

Replacing or upgrading the software was not included in 18 action steps in a “near-term plan” that began May 23.

While ongoing debate is likely to continue about replacing VistA as a cure for the VA's scheduling woes, this report doesn't lend ammunition to the anti-VistA forces that would like to see the VA use a commercial system instead.

Follow Joseph Conn on Twitter: @MHJConn


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