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Healthcare Inspection – Alleged Colorectal Cancer Screening and Administrative Issues, VA Palo Alto Health Care System, Palo Alto, California

Report Information

Issue Date
Report Number
14-04754-407
VISN
State
California
District
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Healthcare Inspections
Report Type
Hotline Healthcare Inspection
Recommendations
1
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
The VA Office of Inspector General Office of Healthcare Inspections conducted an inspection at the request of Congresswoman Jackie Speier in response to complaints about the colorectal cancer screening process and other administrative issues at the VA Palo Alto Health Care System (system), Palo Alto, CA. The purpose of this inspection was to determine the merit of the allegations. The complainant alleged that the use of fecal immunochemical test (FIT) was substandard care for colorectal cancer screening, that the nearby community medical groups did not use it, and that FIT was a poor substitute for colonoscopy. We found the system implemented FIT for screening and that the use of FIT was consistent with current literature and VA and community recommendations. The complainant alleged that an erroneous letter implying that FIT and colonoscopy were equal tests was sent to patients with the purported author’s signature block but without the individual’s permission. We substantiated this allegation. Patients no longer receive this letter as of January 2014. The complainant alleged that the FIT machine sensitivity was low and can be manipulated. We did not substantiate this allegation, as the value was pre-set by the manufacturer. The complainant alleged that patients were not given a choice of FIT or colonoscopy for colorectal cancer screening. We did not substantiate this allegation, as primary care providers discussed the risks and benefits of both modalities with patients during clinic encounters before ordering tests. We recommended that the System Director implement procedures to prevent the unauthorized use of individuals’ signature blocks on form letters.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that the System Director implement procedures to prevent the unauthorized use of individuals’ signature blocks on form letters.