Patient Scheduling Debacle Takes Down Exec

Dr. Michael Kussman, undersecretary for health at the Veterans Health Administration, has resigned, effective in 30 days, well-placed sources have told me.

Last month, Kussman wrote a memo detailing the near collapse of an eight-year, $167 million effort known as the Replacement Scheduling Application Development Program.

Kussman said in the memo to Stephen Warren, the VA's acting chief information officer, that the patient scheduling program, in the works since 2001, "still has not developed a single scheduling capability it can provide to the field, nor is there any expectation of delivery in the near future."

The suspension in developing the application, Kussman wrote, is "significant and likely to generate intense congressional and Office of Management of Budget interest," Kussman said. "This is also of concern . . . because of the numerous representations of clear progress we have been making, not only to Congress and OMB, but more importantly to our health care providers, who are eagerly waiting for this capability."

Kussman also dealt with one key issue in his memo that has nothing to do with patient care or safety, but a lot with developing bureaucratic cover: "Finally, we need a clear communication plan for how we tell the story both inside and outside VA," he told Warren.

That communication plan obviously failed, as the memo was leaked to Nextgov before the VA and VHA could notify key congressional Committees. Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, was miffed he had to find out about the patient scheduling debacle in the media, rather than from the VA.

I'm told that Kussman, who is a holdover from the Bush administration and was slated to leave office this summer, became the fall guy for the patient scheduling mess -- and wasn't helped at all by some of the frank language in the memo.

When VA Secretary Eric Shinseki learned of the problems with the program, he told staffers to give him a comprehensive review by Thursday, April 9, and planned a congressional briefing for Friday, according to internal memos.