Improving Access to External VA Care through Enhanced Scheduling Technology

House Subcommittee on Technology Modernization

2025-05-05

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Summary

The meeting primarily focused on the External Provider Scheduling (EPS) program, a technology designed to modernize and streamline the scheduling of community care appointments for veterans. Discussions covered the program's significant benefits, its current status, the challenges it faces, and recommendations for its nationwide expansion and continued improvement.[ 00:28:44-00:28:49 ]

[ 00:44:33 ]

Themes

EPS Benefits and Efficiency

The External Provider Scheduling (EPS) program aims to replace the current archaic and time-consuming manual scheduling process at the VA, which involves numerous phone calls and can delay care for weeks.[ 00:29:21 ]

[ 00:33:53 ] EPS allows VA schedulers direct access to community providers' appointment availability, enabling them to book appointments efficiently and quickly.[ 00:29:52 ] The average time to schedule an appointment using EPS is seven minutes, and some schedulers have increased their productivity by up to four times.[ 00:30:08 ] [ 00:30:12 ] This streamlined process helps veterans receive care faster and reduces administrative burdens on VA staff, ensuring more convenient access to care, especially in rural areas.[ 00:32:26 ] [ 00:33:45 ]

Program Status and Expansion

As of May 1st, EPS has been successfully implemented in 36 VA medical centers, with plans to expand to an additional 18 medical centers by the end of the fiscal year, totaling 54 sites. There are currently over 6,000 provider services active across 62 specialties within EPS, and provider participation is considered critical for the program's success.[ 00:30:58 ]

Appointments scheduled through EPS have increased by 121% in the first four months of the year, demonstrating growing momentum and success. Nebraska's rural health association has seen significant engagement, with two major academic medical centers and 50 independent provider groups implementing EPS.

Challenges and Obstacles to Rollout

Despite its proven benefits, EPS is only active at approximately 20% of VA medical hospitals, and its full potential has been hindered by various challenges.[ 00:30:36 ]

[ 00:31:15 ] Concerns were raised about past roadblocks, including pauses in community provider recruitment, deactivation of sites, and canceled expansion plans, which were attributed by one speaker to the Biden administration and "fake budget shortfalls."[ 00:31:30-00:31:46 ] Community care providers have been hesitant to adopt new systems due to concerns about integration with existing workflows and additional training needs. The complexity of onboarding larger academic medical centers, with their multi-layered bureaucracies and sub-specialties, can prolong the implementation process for several months. Additionally, there are interface fees with EHR vendors that can burden smaller providers.[ 01:29:02-01:29:22 ] The current system also lacks the ability to share important provider information, such as cultural competency or specialized training (e.g., for MST or PTSD), with veterans during the scheduling process. Progress on exchanging referrals and authorizations is pending FedRAMP High security authorization.

Recommendations for Improvement

To overcome current limitations, several recommendations were made, including streamlining workflows beyond just scheduling, such as eligibility reviews and clinical documentation transmission, and improving training for referral coordination teams. It was suggested that EPS capabilities be used to provide veterans with an "apples-to-apples" comparison of VA direct and community care wait times to allow for informed decision-making. Recommendations for supporting rural providers include federal appropriations to offset IT staffing and interface burdens, incentivizing academic providers with enhanced payment models, and ensuring EHR vendor alignment for easier integration. The VA was urged to prioritize and accelerate the nationwide expansion of EPS, integrate it fully with EHR systems, and start building integration models now, rather than waiting for security clearance, to expedite the process.[ 01:42:47 ]

Tone of the Meeting

The tone of the meeting was largely concerned yet hopeful, with a sense of urgency regarding the need for accelerated implementation.[ 01:19:04 ]

Speakers expressed frustration with the slow pace of EPS rollout and the bureaucratic hurdles impeding its expansion, highlighting the adverse impact on veterans' timely access to care.[ 00:28:58 ] [ 00:29:05 ] However, there was strong optimism about the proven effectiveness of EPS and a clear consensus that it represents a critical step towards modernizing veteran healthcare. The discussion also reflected a collaborative spirit, with a shared commitment from the VA, WellHive, and community partners to work together for the benefit of veterans.[ 00:44:33 ]