VA New England Healthcare System

Veterans' Healthy Living, Fall 2014

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How is VA Central Western Massachusetts Healthcare System (VA CWM HCS) increasing access to quality care for Veterans?

Here are examples of the outstanding work being conducted at VA CWM HCS:

• Leadership approved 6.5 positions to improve Specialty Care capacity.
• The contracted urologist added extra clinic days to assist in backlog.
• A new scheduled hire for Primary Care has a cardiology background and will assist in addressing the cardiology backlog.
• The endocrinologist added Clinical Video TeleHealth practices to increase capacity, and increased Primary Care staff will permit the endocrinologist to shift her Primary Care patients, adding capacity to the Endocrine Clinic.
• In addition to the Specialty Care hiring authorities, 16 positions have been approved across the healthcare system.
• Senior management continues to meet weekly with involved staff, reviewing all clinics with wait times greater than 30 days.
• Fee services have been authorized where appropriate and where capacity in the community exceeds internal (VA) capacity.

How is VA Maine Healthcare System increasing access to quality care for Veterans?

Here are examples of the outstanding work being conducted at VA Maine Healthcare System:

• Specialty Care will improve once providers have been replaced. VA Maine Healthcare System is ensuring Veteran care needs are being met through the utilization of Non-VA Care referrals. Community access is beyond 30 days in many of these same specialties. Veteran preference is negotiated, as are appointment dates.
• Other specialties currently experiencing provider coverage gaps include Podiatry, ENT, and Dermatology. Recruitment is in process. Non-VA Care referrals are being utilized to ensure Veterans receive the care and services needed in these specific areas.
• Loss of a physiatrist impacted timely access, but Veterans contacted prefer to stay within VA for their care. Recruitment to replace the provider is underway; TeleHealth services have been initiated between VA Boston Healthcare System and Maine locations, including the main campus and the Caribou CBOC.
• Retirement of one cardiologist and reduction to part-time for another contributed to longer wait times; Veterans waiting 60+ days are offered referral to a Non-VA Care community provider, but most opt to stay within VA system. Reduction in provider availability pending retirement resulted in less clinic slots and increased wait times. Non-VA Care referrals were initiated in July to compensate for lack of internal access in this specialty; recruitment to replace the provider is underway.
• Reduction in provider availability resulted in less clinic slots and increased wait times. Non-VA Care referrals have been utilized to compensate for lack of internal access in this specialty. This capacity has always been limited to part-time provider coverage.
• Loss of two pulmonologists significantly reduced the availability of specialty access. All pulmonary referrals are currently handled through Non-VA Care referrals, except for Sleep Studies. One pulmonologist handles sleep studies, so overflow is sent to the community. Provider recruitment is underway. Loss of three general surgeons significantly impacted access in this specialty. Non-VA Care referrals are being utilized to ensure access to care, and new surgeons will be on board in September and October.
• There was a slight increase in wait times due to one urologist resignation, but recruitment is underway. Meantime, increased clinic slots by remaining providers will support access improvement.
• Provider vacancy resulted in reduced access, but we are actively recruiting for replacement; non-VA Care referrals are being utilized to ensure access to care is timely.

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