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White House Deputy Chief of Staff Rob Nabors delivered his review of the VA to President Obama Friday. The report’s high points:

  • The VA is the country’s largest health system with 1,700 sites and $150 billion per year in funding.
  • The 14-day patient scheduling standard was unrealistic and encouraged inappropriate behavior.
  • The Veterans Health Administration needs to be restructured because it has little accountability, isn’t responsive, and can’t communicate effectively.
  • One-fourth of all federal government whistleblower complaints involve the VA.
  • Individual VA facilities often ignore VHA’s directives and sometimes express their disagreement via the press.
  • Employees know that the federal government rarely fires anyone, so they don’t try to solve problems.
  • The VA’s VistA system is “cumbersome and outdated,” but is state of the art when it comes to capturing patient documentation to form an integrated health record. The real problem with scheduling patients is a lack of clinicians, support personnel, and space, not deficiencies in IT systems.
  • The VA hasn’t planned well and hasn’t tied its budget requests to specific outcomes.

Reader Comments

From Mcklayoffs: “Re: McKesson layoffs. There were huge ones in April. I heard it happen again on Thursday. I heard even some of the Paragon folks were let go from services. You have to wonder if that’s their go-forward solution.” Unverified.


From Lt. Dan: “Re: cyberwarfare visualization. This real-time map of hacker attacks shows that the US is getting bombarded by pretty much everyone.” The extremely cool display from cybersecurity firm Norse, which looks like one of those 1960s US-Soviet World War III doomsday scenario illustrations, shows who’s being attacked and from where. Some of the information is surprising: at this moment, attacks are being launched from the domain of drug maker Merck in New Jersey as well as the University of Michigan and Cal Berkeley, quite a few attacks are originating from military domains, and the US is by far the most popular intended target with 10 times as many attacks as #2 Hong Kong.

HIStalk Announcements and Requests


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