VA watchdog uses AI to help compile healthcare facility audits
J. David Ake/Getty Images
The Office of Inspector General has been using Copilot Chat “to review inspection data such as interview transcripts, documents, questionnaire responses, and physical observations.”
The Department of Veterans Affairs’ watchdog has been using Microsoft Copilot Chat to assist in its audits of VA healthcare sites, with the artificial intelligence tool being leveraged by investigators to review documents, transcripts and other collected data.
The AI-powered assistant has been deployed by the VA Office of Inspector General’s Office of Healthcare Inspections, which evaluates VA medical facilities to ensure veterans are receiving proper medical care and mental health services.
Since March, OIG’s hotline, healthcare facility and mental health inspection reports have included the same boilerplate language disclosing the use of the AI tool, which states that, “during the preparation of this report, the inspection team used peer-reviewed standardized, structured, and evaluated prompts in Copilot Chat (Microsoft) to review inspection data such as interview transcripts, documents, questionnaire responses, and physical observations.”
The standard wording goes on to say that, following use of the tool, watchdog investigators “confirmed fidelity of the generated output to the source material, edited the report, and took full responsibility for the content of the publication,” and that “all references are for original source material, not AI-generated content.”
An April 2025 memo released by the Office of Management and Budget called for agencies to take steps to manage high-impact AI uses, which it defined as instances “when its output serves as a principal basis for decisions or actions that have a legal, material, binding, or significant effect on rights or safety.”
Because VA OIG’s Office of Healthcare Inspections teams “do not use AI as the principal basis for decision-making or actions,” however, the report says the use of Copilot Chat “does not meet the definition of high-impact” outlined in the OMB memo.
A spokesperson for the watchdog said the AI tool only helps the watchdog to more efficiently review the vast amount of data and information that it collects during the course of its healthcare site investigations. They added that “data entered into this tool is not shared with the Department, nor does it leave the VA OIG secure environment.”
In an interview with Nextgov/FCW, former VA OIG Inspector General Michael Missal said the watchdog tested Copilot Chat and purchased it under his watch, with investigators ultimately beginning to use it in 2024.
“We knew VA had used it in some capacity, and what we were trying to do was to use it to make our work more efficient and make it go more quickly,” Missal said about the tool.
Prior to being fired by President Donald Trump in January 2025 — along with more than a dozen other federal agency IGs as part of a controversial mass purge — Missal said his goal was to ultimately expand Copilot Chat’s use to the OIG’s Office of Audits and Evaluations and Office of Investigations.
A review of other OIG-published reports over the past year that were conducted outside the purview of the Office of Healthcare Inspections does not appear to show any other audits disclosing the use of the AI tool. But Missal said Copilot Chat is uniquely suited for use by the watchdog’s Office of Healthcare Inspections, which is why that unit was the first to adopt it.
He noted that OIG personnel conducting site audits of VA medical facilities often investigate the same issues or look into the same on-site areas, so creating standardized prompts for the tool helped provide the office with consistency.
“It's a time-saving way [to conduct inspections], and it's also quality assurance as well because this way everybody's operating with the same prompts, and it just ensures you're not missing something,” he said. “What this does is it prompts you: ‘What about this? What about this? You get this. What about that?’ You know, [it] just takes you through a whole menu of things.”
Both the OIG and Missal said Copilot Chat’s output does not make any final determinations or write any of the final report.
“VA OIG requires human review of AI output to ensure accuracy prior to the inclusion in any published report,” the watchdog’s spokesperson added. “Our inspection and audit teams thoroughly review AI output and confirm accuracy.”
Missal also said investigators using Copilot Chat “check everything with the source, so that you know whatever we put in a report, we made sure it was not AI generated, but actually from the work.”
“It was just easier to see trends and to look at big pictures by using this program, but then ultimately, in what we relied on in the report, we would make sure we would source the actual interview document,” he added.
The watchdog’s 2025 AI use case inventory lists 20 different examples of the emerging capabilities, with one instance — using AI-assisted tools in word processors — being identified as leveraging Copilot Chat.
OIG’s AI strategy, which was similarly released by the watchdog in September 2025 to comply with OMB’s memo, says that it “utilizes AI in meaningful ways that enhance the office’s mission of conducting independent oversight that improves the health and welfare of veterans and their families, caregivers, and survivors by strengthening VA programs and operations.”
As Missal noted, VA has also made Copilot Chat available to its staff, including those within its healthcare unit, the Veterans Health Administration. A June OIG report warned that VHA personnel were using the tool for clinical use, despite the agency not listing Copilot Chat as a high-impact AI use case.