VA’s Appointment Scheduling Modernization Still Faces Major Gaps, GAO Finds

In its May 2025 report, GAO-25-106851, the U.S. Government Accountability Office examined the Department of Veterans Affairs’ (VA) complex and fragmented systems used to schedule health care appointments for millions of veterans. The report, submitted to congressional requesters, reveals persistent deficiencies in both the scheduling systems themselves and VA’s modernization efforts—gaps that threaten to undercut the VA’s ability to provide timely, accessible health care.

The VA currently uses dozens of scheduling systems cobbled together over time to meet evolving demands such as online scheduling, virtual care, and community provider appointments. This system sprawl has created challenges for both VA staff and veterans. Schedulers must navigate a maze of disparate software tools, which increases the likelihood of errors, delays, and inefficiencies. Veterans, meanwhile, face difficulties in making online appointments, often receiving no confirmation once their request is processed. Multiple overlapping reminder systems also result in redundant notifications.

To address these shortcomings, the Veterans Health Administration (VHA) and the Office of Information and Technology (OIT) launched a modernization initiative. Central to that initiative is the development of an Integrated Scheduling Solution (ISS) intended to streamline scheduling into a single, modern platform. Additional tools under development include the Clinic Capacity Search Tool (CCST), designed to show appointment availability across multiple locations, and the Clinic Configuration Manager (CCM), which standardizes clinic scheduling profiles. However, deployment of these tools remains incomplete, and in many cases, VA lacks a clear implementation timeline. While ISS 1.0 was reportedly complete as of early 2025, critical functions like provider-based scheduling are delayed and have no defined release date.

One of the most serious findings in the GAO report concerns VA’s failure to meet best practices in project scheduling. The master schedule for the modernization program lacks full integration of IT development work, making it difficult for VHA and OIT to track tasks and align deadlines. GAO found the schedule only partially met the “comprehensive” and “credible” criteria necessary for reliable planning. Furthermore, VA does not assign resources to all activities within its schedule, effectively assuming an unlimited availability of labor and materials—an unrealistic assumption that increases the risk of project delays.

Requirements management also showed mixed performance. GAO found VA had implemented only half of the six key practices outlined in the Project Management Institute’s guide. Notably, VA had no comprehensive plan to monitor and trace requirements through to delivery. This omission limits the agency’s ability to ensure that scheduling improvements will actually address user needs, such as resolving the online appointment confirmation problem reported by veterans and advocacy groups.

The report highlights both short- and long-term challenges. While VA plans to eventually roll out Oracle Health as a full replacement for its aging VistA system, implementation has been slow and uneven. As of early 2025, only six facilities had transitioned to Oracle Health. Meanwhile, VA is forced to rely on temporary fixes to VistA and piecemeal local solutions developed by individual facilities—creating further inconsistency across the system.

In its conclusion, GAO issues two key recommendations: First, VA should develop a reliable, comprehensive project schedule that includes all IT and programmatic work. Second, it should fully implement key requirements development and management practices. VA concurred with both recommendations.

This report is the latest in a series of GAO investigations highlighting the VA’s ongoing struggles with health IT modernization, a challenge serious enough to have kept VA health care on GAO’s High-Risk List since 2015. While the department’s ambition to improve veteran access to care is commendable, effective execution remains elusive. Without robust schedule planning and requirements tracking, VA risks repeating past missteps and delaying the delivery of the modernized scheduling systems that veterans and providers urgently need.

Disclaimer: This blog post summarizes the contents of GAO-25-106851 and is intended for informational purposes only. It does not guarantee accuracy or completeness and does not constitute legal or policy advice. Readers should consult the full GAO report and official sources for authoritative guidance.