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VA OIG: Inefficiencies Abound in Digital Divide Consults Process
Despite some positive results, the Veterans Health Administration's digital divide consults and devices process was not as effective and efficient as it could have been, VA watchdog says.
Although it provided valuable information and new perspectives, the Veterans Health Administration’s (VHA) digital divide consults and devices process "could have made better use of about $14.5 million in program funds with better device monitoring, retrieval controls, and oversight," according to the Department of Veterans Affairs, Office of the Inspector General (VA-OIG).
The digital evolution of healthcare and the immense growth in health-related technology in recent years has produced many novel resources and new ideas for optimizing care.
In August 2020, shortly after the start of the COVID-19 pandemic, the VHA created a process known as 'digital divide consults and devices,' through which patients can receive a video-capable device. The process of determining whether a patient is eligible for the device occurs after they obtain a referral and undergo a socioeconomic assessment.
To optimize the quantity of information collected from the consults and ensure the right technology is provided, various groups from VA offices participate in the process, including the VHA medical staff. The Denver Logistics Center (DLC) also works with the VA offices to supply technological devices.
The VA-OIG reviewed the process to evaluate its efficiency and effectiveness.
The agency found that in the first three quarters of 2021, VHA provided 41,000 patients with devices. However, only 49 percent completed a VA Video Connect (VVC) appointment.
According to the VA-OIG, the main reasons for the low percentage of completed appointments were the lack of clear oversight roles and responsibilities, standard operating procedure updates not being communicated to staff effectively, and the lack of timeliness standards for consult and video device order processing.
The report also shows that 3,119 patients received multiple devices. Additionally, of the 11,000 unused devices that were not collected, 8,300 did not have VVC activity and were not retrieved so they could be given to other patients. The 8,300 devices were valued at about $6.3 million.
Overall, the VHA could have made better use of about $14.5 million in funds it received to deploy the process, the VA-OIG concluded.
Further, the OIG provided recommendations to improve the digital divide consult process. These included reminding clinics of VVC appointments, avoiding the distribution of multiple devices to one patient, and tracking VVC appointments.
Efforts to eliminate the digital divide have increased in recent years. In November 2021, Atrium Health dedicated a significant amount of funding to help eliminate racial health disparities in the Charlotte region. Often, racial minorities experience a digital divide due to a lack of access to technology and low levels of digital literacy. However, the grant from Atrium Health aimed to limit healthcare inequities through a collaboration with the YMCA.
More recently, leaders from federally qualified health centers spoke with mHealthIntelligence about the steps they take to limit these issues, including using telehealth navigators and employing community health workers to overcome staffing issues.
