IOWA CITY — Staff at the Iowa City Veterans Affairs Health Care System inappropriately canceled about a quarter of radiology exams reviewed as part of a federal audit released this week.
The cancellations caused delays for some veterans, but the report does not document health problems for any veterans because of the waits.
The Department of Veterans Affairs Office of Inspector General audited nine VA hospitals after allegations staff canceled thousands of diagnostic tests without doctors’ orders, which some critics said could cause veterans’ tumors or other ailments to be missed.
The 81-page report released Tuesday estimates 17 percent of routine exams and 25 percent of urgent exams were not completed within required time frames. Staff also did not follow policies for canceling outpatient requests due to changing administrative directives, heavy workloads and lax oversight.
“Inappropriate cancellations can lead to delayed or incomplete exams and increase patient wait times,” the report states.
Jeff Dettbarn, a former Iowa City VA X-ray technologist, was one of three witnesses who testified before a U.S. House subcommittee in July about the thousands of canceled radiology orders he saw coming across the office printer in early 2017.
Dettbarn’s concern was a veteran’s exam might be erroneously canceled in the attempt to clean up obsolete orders.
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On June 22, 2017, a patient came to the radiology department for a scan of a mass on his kidney, Dettbarn said. While the veteran had an appointment, there was no order, so the patient had to wait nearly three hours for another order to be issued.
The OIG report found Iowa City VA radiology service staff inappropriately canceled 16 of 69 exam requests during the period audited. Of the 16 requests, 11 veterans received exams later, with an average wait of 63 days from the original diagnostic order, the report states.
Iowa City VA staff were slow to implement national directives to have a radiologist or ordering provider review the exam requests before they were canceled, the audit found.
The OIG did not substantiate an allegation Iowa City diagnostic exams were canceled by unqualified people because, at the time, there was no policy on who could cancel requests, the report states.
The Iowa City VA responded to the audit Wednesday.
“This OIG report focuses on events that date to more than two years ago,” VA spokesman Bryan Clark said in an email. “It found that no patients were negatively impacted, and all recommended follow-up care based on exam results occurred in a timely manner.”
Still, the hospital reported it has updated its practices, and the VA overall has addressed who may review and cancel requests. The hospital in October 2018 acknowledged some exams were canceled without following policies.
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