The US Department of Veterans Affairs has been accused of misusing $51.9 million in government appropriations to fund the development and rollout of its suite of mobile health apps, MeriTalk reported, citing an unreleased preliminary inspector general report. According to MeriTalk, when the VA launched its family caregiver app initiative in 2012, the department had insufficient IT funds, partly because it was also funding an overhaul of its EHR system. So instead it used funds set aside for medical services, according to the report.
Investigators say that members of the VA Finance Office warned that the allocation of funds could be illegal, but the VA leadership brushed off those concerns, citing the FDA's definition of a medical device as justification.
But most of the VA's apps wouldn't meet the FDA's definition of a regulated mobile medical app. Furthermore, according to MeriTalk, the VA spent at least $5 million not on software development, but on the tablets themselves -- which would also not fall into the FDA's regulatory purview since the agency has explicitly stated the off-the-shelf devices mobile medical apps run on generally would not be considered to be a component of the regulated medical app.
MeriTalk also reports, citing unnamed sources, that about 2,000 of those tablets ended up in a warehouse because of compatibility issues that kept them from being deployed as planned.
It's hard to say what this means for the future of the VA's mobile health initiatives. According to MeriTalk, the investigator has recommended that the VA return the misused funds, secure proper funding for its mobile apps, and "determine if appropriate administrative action should be taken against any senior officials."
“At VA now we’re treating four different generations of veterans and each want their healthcare delivered in a different way,” Under Secretary for Health and VA Chief Executive Dr. David Shulkin said at the American Telemedicine Association in Minneapolis last month. “We’re looking at using a veteran-centric approach, asking ‘How do you want your healthcare delivered?’ Obviously now more and more people want it delivered in their mobile apps for convenience, so that’s the direction we’re heading in. We have to continue to meet the veteran where they are right now.”