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DOCUMENT RE2L9E
06540 - [B2027046]
Electron Microscopy in Veterans Administraticn fiospitals:
Planning, Distribution, and Control Need Improvement. HRD-78-75;
B-133044. July 19, 1978. 25 pp. + 3 arendices (6 pp.).
Peport to Max Cleland, Administrator, Veterans Administration;
by Gregory J. Ahart, Director, Human Besources Div.
Issue Area: Health Programs: Federal Government Ccntrol cf Costs
Throuqh Direct Delivery Programs (1116).
Contac . Human Resources Div,
Budget Function: Veterans Benefits and Services: Hospital and
Medical Care fcr Veterans (703).
Congressional Relevance: House Committee on Veterans* Affairs;
Senate Committee on Veterans' Affairs.
Authority: (P.L. 89-785; 38 U.S.C. 5053).
The electron microscope (EM) is a devi'ce which produces
highly magnified images used in clinical diagntstic apilications
to examine the microstructure of thin secticns of biological
tissue. Individual EM's in Veterans Idtinistration (VA)
hospitals have cost up to $82,000, and a cc¢plete EN unit,
including remodeled facilities, purchase and installation,
darkroom, and photoqraphic equipment and supplies may cost from
$150,000 to $200,000. EM activities here reviewed at 15 VA
hospitals in 8 of the 28 VA medical districts.
Findinq-./Conclusions: The VA central office has permitted the
establishment of El units in locations without adequately
determining their need. The VA has not followed its stated
policy that specialized medical services, including electron
microscopy, be planned and provided or a LeSiomalized basis to
avoid duplicating or overlapping these costly medical programs,
Some of the VA's EM units are underused; from July 1974 to
Decepber 1976, 15 of 42 diagnostic IN units examined less than
250 specimens annually (the current use staz,3ard). Flans to
instell EPM units have not been formally coordivated at the
national, department, or medical district level. 7he current
practice of assigninq separate Etls tc the Pathology Service and
the Medical Research Service, both witliD ViAs Department of
Medicine and Surgery, impedes the most effect ive use of these
instruments. Recommendations: The Adminintrator of Veterans
Affairs should: direct the Chief Medical tirector tc make a
systemwide study to determine the feasibility of establishing
joint Pathology and Medical Research Services utilizatic
standards for both diagnostic and research electron micrcscGpes;
insure continuing compliance with VA zegulaticns to terminate
electron microscope programs when the programs canmct ke
iustified on the basis of available uczkload; tequire -.hat the
IA's electron microscope inventory he updated to accurately
reflect all electron :microscopes withir the VA system; direct
that VA medical districts be given more responsibility for the
planning, distribution, and utilization of ints; and requite](ViewImageLocal?handle=hein.gao/gaobaaxpo0001&div=1&collection=&method=preview&ext=.png&size=3)