OIG: VHA’s document scanning backlog puts patients at risk

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Veterans Health Administration facilities are woefully behind when it comes to scanning and entering medical documentation into patients’ electronic health records.

According to an audit by the VA’s Office of Inspector General, the agency found significant backlogs across the VHA, potentially putting patient care at risk because of a lack of timely and accurate EHR documentation.

“Based on data provided by the eight facilities visited and the 78 facilities interviewed, the audit team calculated that as of July 19, 2018, VA medical facilities had a cumulative medical documentation backlog of paper documentation that measured approximately 5.15 miles high and contained at least 597,000 individual electronic document files dating back to October 2016,” states OIG’s report.

In addition, auditors revealed that “when medical facility staff scan medical documentation, they are not always performing the appropriate reviews and monitoring to assess the overall quality and legibility of the scanned documents.”

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While VHA facility directors are responsible for establishing policies and processes to ensure all duties associated with health record scanning are conducted in a timely manner, OIG concluded that staffing shortages were a factor in medical documentation backlogs.

“Staffing levels should be proportional to the volume of scanning to be completed; however, staffing levels and productivity standards varied significantly among the facilities reviewed, even between facilities with comparable veteran populations, demonstrating that VHA facility directors are not consistently assessing staffing needs based on scanning demand,” according to auditors.

OIG warned that what could make an already bad situation worse is last year’s enactment of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act, which is meant to consolidate the VA’s community care programs into a new, streamlined and more efficient Veterans Community Care Program.

“The MISSION Act has the potential to significantly increase the volume of documentation VA medical facilities will receive from outside providers for scanning, as well as any related backlog,” added auditors.

To address these shortcomings, OIG made nine recommendations to the VHA in three areas—define and promptly reduce backlogs; assess staffing resources to account for scanning demand; and develop monitoring roles, controls and procedures.

VHA concurred with all of OIG’s recommendations and submitted what auditors described as “acceptable” corrective action plans.

“The OIG will monitor implementation of planned actions and will close the recommendations when VA provides sufficient evidence demonstrating progress in addressing the issues identified,” concluded auditors.

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