Wait Times Published in the VA Audit Were Subject to Manipulation

Last week the Department of Veterans Affairs published an audit of wait times at VA medical centers nationwide.  But it turns out those figures are not accurate because they were taken directly from the VA scheduling system, the same system which has been compromised by employees trying to artificially minimize wait times.

When the audit was released last week it contained a detailed chart listing wait times at every site the auditors had visited. These wait times, measured in days to two decimal places, were highlighted in the initial AP reports on the audit. In fact, the AP broke out wait times for specific cities and ran individual pieces highlighting those figures. But the audit report did not explain where they got the figures they published.

The audit did make clear, in a fact sheet, that 112 locations (about 20% of all audited
sites) were flagged for further investigation of “suspected willful
misconduct.” Out of the 21 regions in the U.S., only region 2, which
covers upstate New York, had no referrals for further investigation. The
audit also found that 13 percent of schedulers had been specifically
told to manipulate data to make wait times appear shorter
than they were.

Given this manipulation, how did auditors come up with accurate wait times for each location? The simple answer is that they did not. Last Wednesday, Dr. James Robbins, the interim medical director for the Albuquerque VA, told the Albuquerque Journal there was evidence of “improper use” of the scheduling system in his region. Robbins added that such misuse, “does affect these numbers.” Asked how the numbers reported by the VA audit could be trusted under the circumstances, Robbins replied, “That’s a good question.”

Yesterday a VA spokesperson confirmed Dr. Robbins was correct saying, “The data were collected from the VA Scheduling System.” The spokesperson added, “There are certain known limitations which our audit has uncovered relative the validity of certain data.” As a result, “certain wait times (e.g. for established patients) may show increases in wait times.” In other words, we may eventually get a clear picture that doesn’t include data that has been widely manipulated to reduce wait times, but we don’t have it yet.

The situation for new user wait times is less clear. An assistant deputy
undersecretary for the VA told the AP last Friday that actual wait times might be shorter than represented in the audit. The AP reported that the disagreement was based on conflicting measurements in two different systems. The audit data was a snapshot of all appointment requests as of May 15th. By contrast the data VA supervisors prefer only looks at past appointments, not including those cancelled or moved up. The VA suggests there may also be a tendency for the snapshot method to leave
out appointments which happened very quickly, making wait times appear
slightly longer.

On the other hand, the VA’s preferred data (on past appointments) also includes manipulation by staff to make wait times appear shorter. The AP story was clear about this saying “That data may not be reliable either; the VA is investigating widespread manipulation of appointment data by schedulers.” The VA spokesperson contacted by Breitbart News did not comment specifically on the AP’s Friday report but did say that “data reported for patients who are new to a clinic have higher validity, as the software, behind the scenes, automatically captures when the appointment was created.”

What we know for certain now is that the data published by the VA audit came directly from the scheduling system. That means that any gimmicks or workarounds being used by schedulers to make wait times appear shorter than they actually were are likely included. Given that the whole purpose of the audit was to uncover the extend to wait time manipulation, the VA should have been more clear it was presenting, in effect, manipulated data.