A recent report from the Department of Veterans Affairs (VA) Office of Inspector General (OIG) revealed limitations with the VA’s patient scheduling system, a component of the agency’s new electronic health record (EHR) system.
Previous VA OIG reports have exposed problems related to the Electronic Health Records Modernization (EHRM) program, but the OIG conducted this review to determine if the Veterans Health Administration (VHA) and Office of Electronic Health Record Modernization (OEHRM) successfully implemented the Cerner patient scheduling system.
“The new scheduling system has the potential to transform VHA scheduling,” the report says. “However, the OIG found that VHA and OEHRM knew of significant system and process limitations before or after implementing the new scheduling system at the Columbus and Spokane facilities without fully resolving them. These limitations reduced the system’s effectiveness and risked delays in patient care.”
The Cerner patient scheduling system was implemented at the Chalmers P. Wylie VA Ambulatory Care Center in Columbus, Ohio in August 2020 and at the Mann–Grandstaff VA Medical Center in Spokane, Washington in October 2020.
According to the report, schedulers reported they did not feel the training for the patient scheduling system adequately prepared them for the new system.
Additionally, the review found scheduling issues that were not addressed before implementation at Columbus. For example, the new scheduling system is not able to mail appointment reminders to patients as it did with the old scheduling system. As of June 2021, schedulers needed to manually mail reminders to patients.
Other issues included schedulers being unable to change appointments types (such as in-person or telehealth) and a lack of guidance on how to track and record patient wait times.
The report also found that key oversight reports and tools were not available in the new system, “impeding Columbus and Spokane from conducting these evaluations after implementation.”
Additional issues arose after implementation as well, such as the system not being configured completely, with some schedulers lacking the permission needed to schedule appointments. Additionally, the report found the data migration to the new system was inaccurate and incomplete, causing schedulers to manually “scrub” data for accuracy. Lastly, schedulers had to disable the appointment reminder calls to patients due to misleading or confusing information.
The OIG issued eight recommendations for VHA and OEHRM to address the problems and improve training and guidance for the scheduling system. Agency officials agreed with the recommendations.