Digital Divide Consults and Devices for VA Video Connect Appointments

In August 2020, the Veterans Health Administration’s (VHA) Office of Connected Care introduced a “digital divide” consult process where patients can receive a video-capable device (iPad) after obtaining a referral and a socioeconomic assessment. The VA Office of Inspector General (OIG) reviewed the efficiency and effectiveness of the process. The review found the program successfully distributed devices to patients but identified gaps in oversight and guidance. VHA issued devices to about 41,000 patients during the first three quarters of fiscal year 2021. The OIG found 51 percent did not use the devices to complete a video appointment. The OIG reviewed VHA’s data and found that 3,119 patients received multiple devices. A November 2021 assessment of the data also showed nearly 8,300 unused devices still did not have VA Video Connect activity and were not retrieved to make them available to other patients. The value of the 8,300 devices was about $6.3 million, and they cost VHA about $78,000 in additional cellular data fees. Moreover, as of December 2021, VHA paid about $8.1 million for the purchase of 9,720 devices, although a backlog of about 14,800 returned devices was pending refurbishment to be available for redistribution. Overall, the OIG determined VHA could have made better use of about $14.5 million in program funds with better device monitoring, retrieval controls, and oversight. The OIG made 10 recommendations to the under secretary for health, including alerting the requesting clinic that a patient can be scheduled, adding procedures on duplicate devices, designating responsible officials to monitor for appointment activity and connected device use, clearly defining lead oversight responsibilities, and establishing an automated report of devices not being used for video appointments. Lastly, VHA should enhance tracking of device packages, implement more detailed refurbishment reporting, and use such data in new device purchases.