“VA operates the largest integrated healthcare system in the United States, with over 1,200 medical facilities serving more than 9.2 million enrolled veterans. Providing access to timely care at VA facilities continues to be a challenge for VHA, despite increased facility staffing, internal process improvements, and expanded community care and telehealth options.
“Recently, this access challenge has been exacerbated as both VA facilities and community providers have curtailed nonurgent and routine healthcare appointments to avoid placing staff and patients at unnecessary risk of contracting COVID-19 and to preserve limited supplies and equipment. The OIG recognizes the efforts of all VHA personnel who are working in stressful conditions and risking exposure to COVID-19 as they manage the needs of patients and employees.”
“Canceling a significant number of nonurgent appointments over a short period of time increases the risk of facilities losing track of patients who require rescheduled appointments for care. Given the significant and fast-paced changes from standard operations, it is critical for VHA to provide its medical facilities timely, clear, and consistent direction, and to execute a sound strategy to follow up with patients during and after the pandemic…”
What the Review Found
“VHA and its medical facilities took measures to protect patients and employees from COVID-19 by canceling scheduled nonurgent face-to-face appointments. VHA issued its initial guidance to medical facilities for canceling appointments on March 15, 2020, and followed up with a series of memorandums that contained additional guidance or clarification. Beginning March 16, 2020, the number and rate of canceled appointments began to increase substantially. From March 15 through May 1, 2020, VA medical facilities canceled about 7.3 million appointments—about 3.2 million more than were canceled from February 1 through March 14, 20 20. During that time, facilities made significant efforts to see patients virtually or to track patient cancellations for rescheduling, but still have much work to do in following up on the appointments canceled during the COVID-19 pandemic.”
What the OIG Recommended
“The OIG issued three recommendations to the under secretary for health concerning the need for VHA to coordinate a well-defined rescheduling strategy with all facilities, and to provide oversight to facilities that have a significant rate of appointments with no evidence of follow-up or tracking. The OIG also recommended VHA ensure facilities do not solely rely on COVID annotations or ‘canceled by the clinic’ designations when re-scheduling. Finally, the OIG recommended that VA medical facilities take appropriate action on canceled or discontinued consults…”
Access the full 42-page report here.
Source: Appointment Management During the COVID-19 Pandemic – September 1, 2020. VA OIG.
