VHA’s Lax Health Information Management Created 5-Mile-High Backlog

By Fred Donovan

August 26, 2019 - The Veterans Health Administration’s (VHA) poor health information management of medical record scanning has produced a paper record backlog of 600,000 documents, or a stack of paper more than five miles high, concluded a recent audit by the Department of Veterans Affairs’ (VA) Office of Inspector General (OIG).

To address the backlog, OIG recommended that VHA improve the management of document scanning activities and ensure related resources and staffing are adequate. In addition, VHA should train personnel who are scanning and indexing the document on the proper procedures to improve quality assurance monitoring.

“These actions are necessary to help ensure veterans receive appropriately informed quality care in a timely manner,” the audit stressed.

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Several recent laws have made it easier for veterans to be treated by third-party providers, who send paper medical records to the VA to add to the electronic health records. Since 2014, more than 70 million appointments with non-VA providers have been conducted.

“Incorporating these non-VA medical documents into the patients’ EHRs is critical to supporting patient care because it contributes to more complete, accurate, and readily accessible health records that guide clinicians’ decisions,” the audit stressed.

For the audit, OIG visited eight VA medical facilities and interviewed personnel from 78 other medical facilities.

The OIG related that VHA’s health information management staff conducts an annual inventory on the status of information management operations to decide on future training needs and to identify facilities that need technical assistance.

This annual inventory does not examine specific document backlog information, such as description of documents, size of the backlog at each facility, and/or the age of unscanned medical records, the audit related.

In addition, the VA health information management leaders and the VA medical facility staff do not use the annual inventory to advise facility on how to prevent document backlogs.

While health information management personnel have authority in creating policy, it is the VHA facility directors who are tasked with enforcing that policy.

This divided authority, along with staffing shortages and poor training, has contributed to the document backlog, the audit concluded.

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VHA’s Lax Health Information Management Created 5-Mile-High Backlog

The Veterans Health Administration’s poor health information management of medical record scanning has produced a stack of paper records more than five miles high, concluded a recent OIG audit.

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