Understanding Veteran Wait Times
Authors: David Shulkin
Journal: Annals of Internal Medicine (2017)

Ideas and Opinions4 July 2017Understanding Veteran Wait TimesDavid Shulkin, MDDavid Shulkin, MDFrom U.S. Department of Veterans Affairs, Washington, DC.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-0900 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 2014 was a pivotal moment for the U.S. Department of Veterans Affairs (VA). A nonstop drumbeat of media accounts reported an access crisis involving long waitlists for health care and, worse, suggested that some veterans were dying while waiting for care.The extent of the VA's problems, like access issues in many other health care systems, was not immediately clear. However, the VA had difficult-to-understand wait-time measures, outdated scheduling software, and arbitrary and unrealistic scheduling metrics. The confluence of these problems led to allegations of secret waitlists and resulted in veterans losing trust in the VA.In the wake of ...References1. U.S. Department of Veterans Affairs. Fact Sheet: Veterans Access, Choice and Accountability Act of 2014 ("Choice Act"). Washington, DC: U.S. Department of Veterans Affairs. Accessed at www.va.gov/opa/choiceact/documents/choice-act-summary.pdf on 12 April 2017. Google Scholar2. Institute of Medicine. Transforming Health Care Scheduling and Access: Getting to Now. Washington, DC;: National Academies Pr; 2015. doi:10.17226/20220 CrossrefGoogle Scholar3. U.S. Department of Veterans Affairs. Pending Appointment and Electronic Wait List Summary—National, Facility, and Division Level Summaries Wait Time Calculated from Preferred Date. Accessed at www.va.gov/HEALTH/docs/DR66_032017_Pending_and_EWL_Biweekly_Desired_Date_Division.pdf on 12 April 2017. Google Scholar4. Shulkin DJ. How the VA's 'Stand Down' resolved 56,000-plus urgent-care consults. NEJM Catalyst; 14 April 2016. Google Scholar5. U.S. Department of Veterans Affairs. Access and Quality in VA Healthcare. Washington, DC: U.S. Department of Veterans Affairs; 2017. Accessed at www.accesstocare.va.gov on 12 April 2017. Google Scholar6. Martin L, Nelson E, Rakover J, Chase A. Whole System Measures 2.0: A Compass for Health System Leaders. Cambridge, MA: Institute for Healthcare Improvement; 2016. Google Scholar7. O'Hanlon C, Huang C, Sloss E, Anhang Price R, Hussey P, Farmer C, et al. Comparing VA and non-VA quality of care: a systematic review. J Gen Intern Med. 2017;32:105-121. [PMID: 27422615] doi:10.1007/s11606-016-3775-2 CrossrefMedlineGoogle Scholar8. Trivedi AN, Matula S, Miake-Lye I, Glassman PA, Shekelle P, Asch S. Systematic review: comparison of the quality of medical care in Veterans Affairs and non-Veterans Affairs settings. Med Care. 2011;49:76-88. [PMID: 20966778] doi:10.1097/MLR.0b013e3181f53575 CrossrefMedlineGoogle Scholar9. Almenhoff P. A health value scorecard on VA healthcare. Presented at the International Forum on Quality and Safety in Healthcare, London, United Kingdom, 16–19 April 2013. Google Scholar10. Longman P. Best Care Anywhere: Why VA Health Care Would Work Better For Everyone. Oakland: Berrett-Koehler; 2007. Google Scholar Author, Article, and Disclosure InformationAffiliations: From U.S. Department of Veterans Affairs, Washington, DC.Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-0900.Corresponding Author: David Shulkin, MD, U.S. Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420; e-mail, [email protected]gov.Author Contributions: Conception and design: D. Shulkin.Analysis and interpretation of the data: D. Shulkin.Drafting of the article: D. Shulkin.Critical revision of the article for important intellectual content: D. Shulkin.Final approval of the article: D. Shulkin.Collection and assembly of data: D. Shulkin.This article was published at Annals.org on 18 April 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byComparing Complication Rates After Elective Total Knee Arthroplasty Delivered Or Purchased By The VAHow hospitals select their patient safety prioritiesComparing cataract surgery complication rates in veterans receiving VA and community careTrends in Wait Time for Outpatient Colonoscopy in the Veterans Health Administration, 2008–2015Development of a novel metric of timely care access to primary care servicesThe Changing Dynamics of Providing Health Care to Older Veterans in the 21st Century: How Do We Best Serve Those Who Have Borne the Battle?Advanced Data Analytics for Improved Decision-Making at a Veterans Affairs Medical CenterDifferences in Risk Scores of Veterans Receiving Community Care Purchased by the Veterans Health AdministrationMedical Graduates, Truthful and Useful Analytics With Big Data, and the Art of Persuasion 4 July 2017Volume 167, Issue 1Page: 52-54KeywordsForecastingHealth careHealth care providersHealth care sectorHealth surveysResearch designStatistical dataTelemedicineVeteran careVision ePublished: 18 April 2017 Issue Published: 4 July 2017 PDF downloadLoading ...