recommended reading

Eight years in the making, VA patient scheduling system founders

Veterans Affairs Department Secretary Eric Shinseki launched a review of the department's information technology programs on March 23, focusing on the $167 million patient scheduling program, which has failed to deliver a usable system after eight years in development, NextGov has learned.

Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, said at a press briefing on Thursday that either the full committee or the Subcommittee on Oversight and Investigations will schedule a hearing on the near collapse of the Replacement Scheduling Application Development Program, which an internal VA memo said "has not developed a single scheduling capability it can provide to the field, nor is there any expectation of delivery in the near future."

Filner said he wants to hold the hearing before top executives from the Bush administration leave the department at the end of April. The congressman expressed frustration that VA officials did not alert him to problems with the scheduling system, which he first learned about from a March 31 article on NextGov.

Shinseki directed VA staffers provide him with comprehensive review of the scheduling application by April 9, and planned a congressional briefing for April 10, according to internal memos provided to NextGov.

Paul Sullivan, executive director of Veterans for Common Sense, said the scheduling system is needed to reduce long patient wait times at VA facilities. The organization released a report in February that said one-quarter of the 105,000 Afghanistan and Iraq veterans diagnosed with post-traumatic stress disorder had to wait more than 30 days for an appointment at the Veterans Health Administration's 168 medical centers and 800 clinics.

VHA policy says veterans with serious service-related disabilities must be seen by medical staff within 30 days of their requested appointment date. But a September 2007 report by the VA inspector general said 27 percent of the veterans who had to wait more than 30 days for appointments had serious service-related disabilities, such as amputations and panic attacks.

VHA does not have the ability to properly manage canceled appoints, the inspector general said in a December 2008 survey of 10 clinics. This resulted in 4.9 million open appointment slots in 2008 that could have been used by other patients at those clinics, according to the report.

Besides frustrating patients with long wait times, this management dilemma hits VHA in the pocketbook. At the 10 clinics surveyed, the IG determined 830,000 appointments were canceled more than three days in advance, and estimated the cost of those unfilled appointments at $151 annually.

Keith Decker, an associate professor of computer science at the University of Delaware, who wrote a paper on patient scheduling, said developing such a system is a complex task, but not one that should take eight years.

He said the need to schedule patients at multiple clinics and then correlate those appointments with staff schedules is a computational challenge with many variables.

Decker said VA should approach the project in phases, with each part fielded and tested before the next bit of software is rolled out. Since the department has a problem maximizing the use of openings that result from canceled appointments, that might be a good place to start, he said.

Dr. Michael Kussman, VHA undersecretary for health, detailed such an incremental approach in a March 20 memo to Stephen Warren, VA acting assistant secretary for information and technology. The goal was to have a less functional but workable scheduling system fielded by September.

But testing this less functional system resulted in significant failures, Kussman said, and the scheduling program has been suspended while VHA examines alternatives, including the use of a commercial patient scheduling system.

Threatwatch Alert

Thousands of cyber attacks occur each day

See the latest threats


Close [ x ] More from Nextgov

Thank you for subscribing to newsletters from
We think these reports might interest you:

  • It’s Time for the Federal Government to Embrace Wireless and Mobility

    The United States has turned a corner on the adoption of mobile phones, tablets and other smart devices, outpacing traditional desktop and laptop sales by a wide margin. This issue brief discusses the state of wireless and mobility in federal government and outlines why now is the time to embrace these technologies in government.

  • Featured Content from RSA Conference: Dissed by NIST

    Learn more about the latest draft of the U.S. National Institute of Standards and Technology guidance document on authentication and lifecycle management.

  • A New Security Architecture for Federal Networks

    Federal government networks are under constant attack, and the number of those attacks is increasing. This issue brief discusses today's threats and a new model for the future.

  • Going Agile:Revolutionizing Federal Digital Services Delivery

    Here’s one indication that times have changed: Harriet Tubman is going to be the next face of the twenty dollar bill. Another sign of change? The way in which the federal government arrived at that decision.

  • Software-Defined Networking

    So many demands are being placed on federal information technology networks, which must handle vast amounts of data, accommodate voice and video, and cope with a multitude of highly connected devices while keeping government information secure from cyber threats. This issue brief discusses the state of SDN in the federal government and the path forward.

  • The New IP: Moving Government Agencies Toward the Network of The Future

    Federal IT managers are looking to modernize legacy network infrastructures that are taxed by growing demands from mobile devices, video, vast amounts of data, and more. This issue brief discusses the federal government network landscape, as well as market, financial force drivers for network modernization.


When you download a report, your information may be shared with the underwriters of that document.