Management and Oversight of the Electronic Wait List for Healthcare Services

The OIG received allegations that the Veterans Health Administration (VHA) reported inaccurate data on the VA public website about the electronic wait list for patient appointments. The allegations, made by a VHA employee, stated that the data did not include wait list entries older than two years or administrative entries, such as patients requesting care at a different facility. The resulting OIG audit examined these allegations and two additional issues: whether VHA managed the wait list in accordance with scheduling requirements for veteran care and whether VA medical facilities complied with policies for managing the wait list. Although it substantiated the employee’s allegations, the audit team found that VA’s Office of the Medical Inspector had also identified the issues and made recommendations for corrective action. VHA began including wait list entries older than two years in 2018 and developed procedures to manage administrative wait list entries in a new tracking system in 2019. The OIG audit team further found that wait list entries were not reviewed and validated as required. Patients were not removed from the wait list when appropriate, indicating that employees at medical facilities did not review entries daily and supervisors did not validate the list weekly. Insufficient oversight increases the risk that patients will not receive care in a timely manner or at their preferred facility. It could also lead to excess entries on the wait list, which makes it seem as though veterans are experiencing longer delays for appointments than they are. Although VHA made advances in managing its wait list, the OIG made three recommendations for improvement. These focused on monitoring and routinely reviewing scheduling for patients who are waiting for care and overseeing wait list entries transferred to the new tracking system.