Service alignment between CMS and Access to care data

[mmiddaugh]

Description

Data on new/established patient appointment wait time and Veteran satisfaction with access is displayed on the relevant VAMC system and facility pages. This data is provided by VA Access to care (ATC) via Lighthouse.

Mismatches between the VA service taxonomy in CMS and ATC categorization exist, in part due to a recent break down of mental health appointments into specific sub-categories of care.

Per Lighthouse: If a service is available in either ATC or CMS, it will be enabled and the details available will be provided

Per Dave C, in ATC, services are aligned with facilities based on stop codes (billing codes)

Summary of audit observations

• There are services (such as Sleep medicine and Pain management) where the ATC data is not displayed on Va.gov facility pages, despite identically named ATC "clinic types" and VA service taxons
• ATC data for granular sub-categories is not reflected in the parent category of VA.gov facility health services.
• There are instances in which the facility appears in ATC search results but the same health service is not listed as available on that location's VA.gov facility page.
• There are instances in which the facility lists a health service but does not appear in ATC search results.

Mapping

"Clinic type" in ATC	VA service taxonomy	ATC facility example	VA.gov facility example
Behavioral health	This is the patient friendly name for Mental health care	Grove City VA Clinic (28 days (TNAA) new)	Grove City VA Clinic lists Social work and Suicide prevention but not Mental health care
GI procedures	Gastroenterology includes GI procedures	Baltimore VA Medical Center (71 days - new) Washington VA Medical Center (70 days -new)	Baltimore VA Medical Center does not list even Gastroenterology as a health service Washington VA Medical Center has Gastroenterology with data for that specialty	---
Mental Health Group Therapy	Single service: Mental health care	Fort Belvoir VA Clinic (50 days -new) Montgomery County VA Clinic (116 days - new)	Fort Belvoir VA Clinic does not list even Mental health as a health service Montgomery County VA Clinic has Mental health care but no ATC data for that specialty
Mental Health Individual Therapy	Single service: Mental health care	Washington VA Medical Center (10 days -new) Southern Prince George's County VA Clinic (54 days - new)	both Washington VA Medical Center and Southern Prince George's County VA Clinic have Mental health care but no ATC data for that specialty
OB/GYN	Gynecology and Women Veteran care	Richard L. Roudebush Veterans' Administration Medical Center (23 days - new) Brownsburg VA Clinic (55 days - new)	ATC in Gynecology service on Richard L. Roudebush Veterans' Administration Medical Center displays 22 days ATC in Gynecology service on Brownsburg VA Clinic displays 55 days
Occupational therapy	Combined service: Physical therapy, occupational therapy and kinesiotherapy	Benjamin Charles Steele VA Clinic (29 days - new)	Benjamin Charles Steele VA Clinic has health service without ATC data but has attempted to display types of care by facility (see notes in Additional observations section)
Oncology	Hematology/oncology, Radiation oncology, and Surgical oncology	Clement J. Zablocki Veterans' Administration Medical Center (38 days - new)	Clement J. Zablocki Veterans' Administration Medical Center does not have ATC data in Hematology/oncology, Radiation oncology, or Surgical oncology
Pain medicine	Pain management	Sheridan VA Medical Center (27 days-new) Clement J. Zablocki Veterans' Administration Medical Center (27 days-new)	Sheridan VA Medical Center does not include pain medicine in the list of services Clement J. Zablocki Veterans' Administration Medical Center has the health service but does not have ATC data
Physical therapy	Combined service: Physical therapy, occupational therapy and kinesiotherapy	Benjamin Charles Steele VA Clinic (16 days - new)	Benjamin Charles Steele VA Clinic has health service without ATC data but has attempted to display types of care by facility (see notes in Additional observations section)
Primary Care-Mental Health Integrated Care	Single services for Primary care and Mental health care only	Clement J. Zablocki Veterans' Administration Medical Center (11 days - new)	Clement J. Zablocki Veterans' Administration Medical Center displays ATC data in Primary care (19 days new) but the integrated service is not in the taxonomy
PTSD Specific Programs (Group)	Single service: PTSD care	Brooklyn VA Medical Center (17 days-new)	Brooklyn VA Medical Center has PTSD care but no ATC data
PTSD Specific Programs (Individual)	Single service: PTSD care	Washington VA Medical Center (10 days -new) Baltimore VA Clinic (6 days - new)	Washington VA Medical Center does not list PTSD care Baltimore VA Clinic has PTSD care but no ATC data
Sleep medicine	Sleep medicine	Richard L. Roudebush Veterans' Administration Medical Center (67 days - new)	Richard L. Roudebush Veterans' Administration Medical Center has Sleep medicine listed but without ATC data
Substance Abuse Disorder Group Therapy	Single service: Addiction and substance use care	Washington VA Medical Center (10 days -new)	Washington VA Medical Center does not list Addiction or substance abuse care
Substance Abuse Disorder Individual Therapy	Single service: Addiction and substance use care	Washington VA Medical Center (10 days -new) Baltimore VA Medical Center (no wait - new)	Neither Washington VA Medical Center nor Baltimore VA Medical Center lists Addiction or substance abuse care
Women's health	Women Veteran care	Richard L. Roudebush Veterans' Administration Medical Center (42 days - new)	Richard L. Roudebush Veterans' Administration Medical Center (43 days -new)

Additional observations

VA Montana health care indicates different types of physical therapy services are available depending on facility

Care by location

• Physical Therapy – Fort Harrison, David J Thatcher VA Clinic (Missoula), Benjamin Steele VA clinic (Billings), Miles City CBOC.
• Occupational Therapy – Fort Harrison, Benjamin Steel VA clinic (Billings)
• Pelvic Health PT – Fort Harrison
• Cardiac Rehab – Fort Harrison
• Assisted Mobility – Fort Harrison

Although VA Montana health care lists David J Thatcher VA Clinic (Missoula) as a location for Physical Therapy, it is not a search result on the ATC site.

[mmiddaugh]

Dawn P is identifying a Data Warehouse POC for this data and waiting for a response. Trello card

[mmiddaugh]

Working with LH and VHA DM to audit lists of services in ATC compared to Drupal to inform LH decision making about ATC as data source