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Cleveland VA medical center under review for cancellation of patients’ tests

October 4, 2018

Cleveland VA medical center under review for cancellation of patients’ tests

CLEVELAND, Ohio -- The Louis Stokes Cleveland VA Medical Center is among several Veterans Affairs hospitals in the country that are under review for claims they are improperly canceling a large number of patients’ diagnostic tests.

About 300,000 canceled radiology tests at VA medical centers across the United States since 2016 has raised questions about whether some medically important tests were canceled improperly, according to USA Today. Some facilities may not have followed correct procedures when getting rid of outdated and duplicate test orders, the newspaper said.

Cancelling necessary tests could jeopardize the care of veterans who have conditions that need to be watched closely.

The VA declined to comment, said Michael Nacincik, public affairs officer in the Office of Inspector General at the U.S. Department of Veterans Affairs.

In an email, Nacincik confirmed that a national audit is ongoing to look at how radiology requests are processed and how canceled requests are managed. He also confirmed that Cleveland’s VA medical center is part of that audit.

A Cleveland VA spokesperson would not elaborate on specifics of the local audit.

The nationwide audit also includes VA facilities in Bay Pines, Florida; Dallas, Texas; Denver, Colorado; Iowa City, Iowa; Las Vegas, Nevada; Los Angeles, California; Salisbury, North Carolina; and Tampa, Florida, Nacincik said.

A statement from the U.S. Department of Veterans Affairs explained that starting in 2016, the national VA began to look at a backlog of about 300,000 old radiology consults or exam orders, some dating to the 1980s.

The orders accumulated because the national VA didn’t have a system for cancelling tests that were no longer necessary or were duplicates, the Veterans Affairs statement said.

“VA officials at both the regional and national levels have been monitoring the implementation of this policy closely for compliance and have worked with the (Department of Veterans Affairs’ Office of) Inspector General to oversee the process,” a Veterans Affairs statement said.

Nationally, the VA has instituted new procedures calling for health care providers to be notified if a test has not been completed within 60 days of the clinically indicated date. The test will then be canceled, the need for the test will be reassessed, and the patient will be contacted if necessary, the Department of Veterans Affairs said.

What happened in Cleveland?

A physician-led team in Cleveland reviewed all outdated and obsolete orders and “took appropriate action” based on national guidance, said Cleveland VA public affairs specialist Sarah Jane Phillips.

Cleveland, the third-largest VA medical center in the country, handles 3,200 radiology orders weekly, Phillips added.

Cleveland had 21,657 outstanding radiology orders in January 2017, second only to Columbia, South Carolina, which had 29,512, according to Veterans Health Administration numbers published in USA Today. No further information regarding the local 21,657 outstanding orders was available from local sources.

Details are emerging about diagnostic order cancellations in Iowa City and Tampa Bay, both part of the VA’s nationwide audit of radiology practices.

A spokesman for the Iowa City VA hospital acknowledged it did not follow national VA guidelines for diagnostic order cancellations, but added that only a small number of tests were affected, according to USA Today.

U.S. Senators Joni Ernst and Chuck Grassley recently wrote to the Iowa City Veterans Affairs Health Care System with questions about allegations of improperly canceled diagnostic exams, according to the Gazette newspaper in Iowa.

In July, the Tampa Bay Times reported that federal investigators were looking into allegations that the James A. Haley Veterans’ Hospital canceled hundreds of patient radiology exams without following safety guidelines and then tried to cover it up.

The allegations were made by four Haley radiology technicians who filed a sexual harassment and intimidation lawsuit against the hospital. The exams had been left undone for more than 60 days.

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