Tuesday, May 22, 2018
Military News

Pinellas VA hospital used two sets of books for some appointments, testimony shows

SEMINOLE — The C.W. Bill Young VA Medical Center uses what employees call "virtual calendars" to make it appear patients are seen by doctors more quickly than is true, according to testimony and documents filed in a 2009 federal lawsuit.

Plaintiffs said the Department of Veterans Affairs hospital essentially had two sets of books, one with inaccurate numbers on how long patients wait for an appointment and another — the virtual calendars — showing the actual time.

"Much of what the (VA) would claim was an accomplishment involves smoke, mirrors and the hiding of wait lists on virtual calendars," attorney Joe Magri, representing VA employees in the lawsuit, said in a trial motion.

An employee who was a plaintiff in the case said the Seminole hospital was eager to reduce the long waiting lists that VA headquarters uses to measure a hospital's success and efficiency.

"They asked me to go against my moral grain and ethics, asking me to call (other) VAs to request how they hide certain wait lists," testified program management analyst Roxanne Lainhart Bronner, who still works at the Young VA, formerly known as Bay Pines.

Young VA officials deny the hospital misrepresents the time patients wait for appointments.

The trial involved four Young VA employees, including three doctors, who accused the facility of retaliating against them for filing workplace discrimination claims. A federal jury in Tampa awarded them $3.73 million in damages, though the amount was later reduced.

The VA is facing stinging criticism nationally over everything from wrongful deaths to charges by its inspector general that some veteran hospitals gamed statistics showing how long patients wait for appointments.

An audit, ordered by the White House and released Friday, said more than 60 percent of veterans hospitals manipulated wait times and said there is a "systemic lack of integrity" at some VA facilities.

This is how, according to testimony, virtual calendars worked:

Existing patients cannot get an appointment at some Young VA departments more than 30 to 45 days out.

So if a doctor wants to see a patient in six months, or if a long waiting list in a department prevents a patient from being seen within 45 days, the facility does not allow an appointment to be made.

Instead, patients are placed on a "virtual calendar" until it notifies them to make a formal appointment.

Statistics reported to Washington would show a patient got an appointment within 30 days when, in fact, they may have waited six months, plaintiffs' attorneys said.

"On one hand, it's kind of a way of cutting down on (appointment) no-shows or cancellations," testified Steven Burdick, a Young VA patient service assistant who was not involved in the suit. "On the other hand, it's kind of a way of just hiding the large number of people that we're seeing that we don't have facilities to see."

Jason Dangel, a Young VA spokesman, acknowledged "virtual calendar" or "virtual clinic" was the unofficial terminology employees use to describe the VA's recall/reminder software. He denied the software was used to misrepresent the time it takes to schedule appointments.

"We do not use virtual, undocumented calendars as a mechanism to schedule or alert patients about upcoming appointments," he said.

Instead, he said, the hospital's software notifies patients by phone or postcard "when a follow-up appointment is due." Dangel said, "It's not on the books as an appointment per se."

The system is still utilized at Young and other VA hospitals, Dangel said.

"Some VAs use it more than others," he said. "It's a good tool."

Burdick, the VA employee who testified at trial, said the system gave patients "an appointment to call to make an appointment."

Dr. Sally Zachariah, one of the plaintiffs in the suit, said of virtual calendars, "Virtual is virtual. You cannot see it."

She said if VA headquarters wanted to check how many of the hospital's patients are waiting for an appointment, it does not see the patients on the virtual calendar because they are "put in a separate stack" though they may have waited months for an appointment.

Dr. Lithium Lin, then chief of medicine at the Young VA, defended the system, saying it significantly reduced appointment no-shows.

"When a physician's schedule … has a lot of no-shows, it's a wasted opportunity to deliver care to the patients," Lin testified.

"But in terms of what gets reported on to Washington or elsewhere, you don't report those calendars, do you?" a lawyer asked.

"No, you don't," Lin said.

William R. Levesque can be reached at [email protected] or (813) 226-3432.

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