The Department of Veterans Affairs building in Washington. (Stars and Stripes)
WASHINGTON — A federal watchdog is urging the Department of Veterans Affairs to bring greater focus to improving patient safety, modernizing its medical records and ensuring timely access to community care for the 9.2 million veterans enrolled in VA health care.
The Government Accountability Office identified open recommendations from its audits and investigations considered critical for the VA to reduce the risks of mismanagement, fraud and abuse in operations, according to a report titled “Priority Open Recommendations.’‘
The report was released Monday and identifies five “priority recommendations’’ as well as two dozen other recommendations that have yet to be fully addressed from a prior report in 2024, according to the GAO.
The five recommendations identify broad areas for improvement. They include addressing long wait times for non-VA care, inefficiencies in medical supply purchasing, delays in updating the health records system, chronic medical staff shortages and resolving concerns over patient safety.
“GAO considers a recommendation to be a priority if when implemented it may significantly improve government operations,’’ the report said.
The recommendations require attention from VA Secretary Doug Collins and other VA leaders to ensure compliance with federal law and regulations on how funds are spent, according to the report.
To ease delays for community care, the GAO recommended the VA establish goals for timely scheduling of veterans appointments with community care providers who are pre-approved by the VA to provide care.
The VA should also establish a maximum time a veteran should be expected to wait to see a doctor, the report said.
”The Department of Veterans Affairs must ensure that veterans receive timely care under this program,” the GAO said.
The report also cited problems in medical supply purchasing and management that increase the risks of waste and fraud in the supply chain. The report stated supply chain disruption during the coronavirus pandemic first exposed problems in acquisitions of medical supplies.
The VA needs to develop an “overarching strategy’’ for its medical supply purchasing program, the report said. The agency also needs to establish baseline performance metrics.
The report also cited ongoing delays in the VA’s modernization of its health records system.
The agency needs to update cost estimates for replacing the legacy network for managing medical records. It also needs to undertake complex improvements instead of making incremental changes to the system, according to the GAO.
“We have made numerous recommendations in this area that address root cause issues and can inform ongoing and future efforts to address challenges that have plagued the modernization efforts,’’ the report said.
The VA also must have a better understanding about shortages in medical staffing at its hospitals and clinics. The agency needs to have a process for accurately counting the number of doctors working at each of its hospitals and identifying where gaps exist.
“A strong workforce capable of providing quality and timely care to veterans is critical to the success of VA,’’ the report said.
Patient safety and the overall quality of care continue to pose challenges in the VA’s vast health care system, the report said. The agency operates 170 hospitals and 1,193 outpatient clinics.
The VA needs to implement consistent standards for managing risks and adopting best practices. Its audit, risk and compliance committee needs the authority to “monitor oversight findings’’ and make recommendations for system-wide improvements.
The report also stated Congress can address the GAO’s recommendations through legislation.
“Congress can also use its budget, appropriations, and oversight processes to incentivize executive branch agencies to act on our recommendations and monitor their progress,’’ the report said.
