OIG audit: Massive backlog in digitizing VHA medical records

VHA medical facilities have a cumulative medical document backlog equivalent to more than five miles of stacked paper, with nearly 600,000 electronic files dating back to 2016.
By Nathan Eddy
11:11 AM
OIG audit: Massive backlog in digitizing VHA medical records

Veterans Health Administration medical facilities are facing an enormous challenge as they scan and enter medical documentation into patients' electronic health records, according to an audit from the Office of the Inspector General for the Department of Veterans Affairs.

WHY IT MATTERS
Based on provided data, the audit team calculated that VHA medical facilities have a cumulative medical document backlog equivalent to more than five miles of stacked paper, with nearly 600,000 individual electronic document files dating back to October 2016.

The backlog has built up in part because VHA staff had not been scanning and entering documents into the electronic medical record system in a timely manner, though the report also noted staffing shortages have contributed to the challenge.

Further complicating the situation, the audit found, was the fact 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.

This means the VHA must work to improve the management of scanning activities, including importing, indexing and legibility checks, and should also establish and implement a training program for those in charge of the scanning and indexing in medical facilities.

The audit also recognized the scale of the problem, noting specific backlog details such as descriptions of the documents, the size of the backlog and age of unscanned records are not consistently addressed as part of the OIG’s inventory.

Another major challenge described in the report was the discovery that the eight medical facilities visited did not consistently follow training policy, and training by the health information management staff varied from site to site.

The audit recommended the VHA implement standardized quality assurance monitoring procedures and ensure original medical records are retained until it has been verified that those quality assurance standards have been met.

THE LARGER TREND
The OIG audit comes as the VA is undergoing a massive push toward digitalization. In June, the Department of Defense and the VA announced the creation of a special office to help centralize decision making as the VA makes its multibillion-dollar electronic health records upgrade.

But just this past week, Politico reported that the VA's modernization effort is already encountering roadblocks that could delay the project for six months or more.

ON THE RECORD
“The VHA needs to improve its supervision and medical facilities’ management to ensure medical documents are accurately scanned and indexed,” the OIG report noted.

“During audit team site visits, neither the chiefs of HIM nor their designees responsible for supervising scanning activities always had direct knowledge of the scanning processes and backlog information within their facilities,” auditors said.

Nathan Eddy is a healthcare and technology freelancer based in Berlin.
Email the writer: nathaneddy@gmail.com
Twitter: @dropdeaded209

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