In a June 11 report, the Veterans Administration Office of the Inspector General (OIG) highlighted some issues with the VA’s early AI governance. The report notes that the VA has provided clinical staff with generative AI chat tools for clinical use without implementing oversight or safeguards, creating risks for patient safety and limiting the ability to monitor AI chat tool-related errors. 

VA’s AI efforts for healthcare were coordinated in 2025 by the Veterans Health Administration’s (VHA’s) National AI Institute (NAII) and VA’s Office of Information and Technology’s Chief AI Officer (CAIO) team without a formalized governance relationship.

VA provides two general‑purpose chat tools for work that may involve patient information: VA GPT and Microsoft 365 Copilot Chat. (At the time of the OIG’s review, neither AI chat tool had access to web search; therefore, the chat tools’ knowledge base was not current. VHA has since reported that Copilot Chat web search is enabled.) Users supply a prompt along with clinical information and the AI creates output. In a sample of clinical prompts shared by VA staff, the OIG identified that drafting of clinical notes and summarization of patient care were most common.

The OIG found that VHA staff actively use these tools, but VA has not initially established governance structures or coordinated with the National Center for Patient Safety (NCPS) to address potential risks. “These gaps hinder VA’s ability to ensure safe and effective deployment of AI technologies in clinical settings,” the report said. 

The OIG made recommendations to strengthen oversight, involve patient safety programs, and adopt risk management practices consistent with VA’s approach for other high-impact AI tools.

As a result of the OIG’s preliminary result advisory memorandum, VA took steps to increase communication between NCPS and the VHA’s National AI Institute/VA’s Office of Information and Technology’s Chief AI Officer (CAIO). Additionally, VA engaged with the Defense Health Agency to enable patient safety reporting of AI-related events via the Joint Patient Safety Reporting system.

In response to the recommendations in this report, the Under Secretary for Health provided action plans to develop guidance on requirements for clinical use of general-purpose AI chat tools and corresponding quality assurance processes. The Under Secretary for Health also described ongoing efforts to develop educational resources on AI governance and update patient safety reporting systems.

The OIG said it would monitor implementation and focus its oversight efforts on the effectiveness and efficiencies of programs and services that improve the health and welfare of veterans and their families.