Leaders from the Department of Veterans Affairs appeared before the House Committee on Veterans' Affairs on Tuesday to respond to claims a component of the Community Care Program would disrupt appointments of up to 75,000 patients each day.
Earlier this year, ProPublica obtained an independent report that the U.S. Digital Service had prepared for the VA, evaluating a decision-support tool the agency is developing for its expanded Community Care Program, which consolidates and expands services provided by private providers for veterans.
The program sets distance and wait-time standards to determine whether a veteran is eligible to receive treatment from the private sector.
The decision-support tool, which integrates patient data from six existing information systems, is meant to help VA staff determine whether a patient is eligible for referral to a private-sector provider.
"The committee understands that this report was not meant for the public, but it is now in the open," said Chairman Mark Takano (D-Calif.). "As the committee responsible for overseeing the implementation of one of the most significant pieces of veterans legislation, we are compelled to ask questions about it."
The U.S. Digital Service suggested the VA stop its development of the eligibility determination software, called the Decision Support Tool.
Among other issues, the U.S. Digital Service said the software's usability and responsiveness issues would increase appointment times by five to 10 minutes, resulting in physicians seeing three fewer patients each day. Nationwide, that would decrease VA physicians' patient capacity by 75,000 appointments daily.
"This degradation goes against the spirit of the Mission Act to improve the veterans' experience and quality of care," the report reads.
However, VA leaders who testified at the hearing said the agency is still on track to roll out the Community Care Program by the Mission Act's June 6 deadline.
"The VA is planning to develop, test and deploy the decision-support tool by June 6," said Dr. Richard Stone, executive in charge at the Veterans Health Administration. He added that the decision-support tool is not essential for the Community Care Program, although he believes it will improve efficiency at VA facilities.
"In the event any technical challenge occurs, VA will be able to make eligibility decisions using existing and enhanced methods and tools," he continued. "Veteran care will not be disrupted."
Providers and care teams are already using access standards like travel times and wait times to determine whether a veteran is eligible for referral to a private-sector provider, according to Stone. The decision-support system aims to increase efficiency and consistency by automating this process.
"We don't have a great reputation when it comes to IT within the VA," Rep. Julia Brownley (D-Calif.) said during the hearing. "How are you going to give us assurances you are traveling down the right road and able to meet these deadlines?"
Stone cited the U.S. Digital Service's report as evidence of the VA's work to fully assess its IT development. The VA had requested the U.S. Digital Service prepare its review as a standard practice, and not in response to implementation concerns, according to agency leaders at the hearing.
"Your expectation of me is to be transparent, especially when I'm concerned. What I have to say is that I'm very, very pleased that the (VA) team has been working with IT and that we've gotten a third party to take a look at us," Stone said. "Are we concerned about the complexity at work? Absolutely. But I am optimistic we're going to get this done."
