Improving the experience for Veterans scheduling medical appointments online
Digital Service at VA (DSVA) shaped a better online scheduling experience for Veterans needing healthcare appointments. This is how we did it.
In the fall of 2017, a Veteran told her story to the Secretary of Veterans Affairs. She had spent more than an hour trying to schedule a healthcare appointment online. She started by searching “schedule VA appointment” on Google and went down a rabbit hole following false leads, creating accounts, and entering passwords on multiple VA websites before she gave up. Her struggle highlighted a trio of problems many Veterans faced:
- Discoverability of the online scheduling tool.
- Accessibility using existing login credentials.
- Usability of a well-intentioned resource that was not designed with users in mind.
The digital service team was brought in to help map the problem and deliver solutions.
Helping Veterans discover the online scheduling tool
During the discovery sprint, we found that the only access point to the online scheduling tool was on a VA mobile application website. Many web pages across the VA’s 500 sites described appointment scheduling, but none offered a single source of truth for how to schedule a VA health appointment, by phone or online.
The VA’s healthcare portal, MyHealtheVet, included pages that explained how to view appointments that a Veteran already scheduled, but did not go into detail about how to schedule a new appointment, nor did it cover the highly-specific facility rules or login requirements for scheduling appointments online. None of the pages provided a pathway for eligible Veterans to the site where the tool was located. If Veterans found the tool, they found something called “VA Appointment Request,” which confused them as they were looking to schedule an appointment, not request one.
The solution? The team journey mapped pathways into the application from search to login to scheduling. We worked with the Connected Care team at VA to learn the single source of truth — who could schedule an appointment online, how to get into the system, the variable facility rules for using the tool, and which credentials Veterans could use to access the scheduler. We found that only a small subset of Veterans were eligible to use the tool, so we developed language to explain appointment scheduling options for all. Instructions were included to explain what Veterans needed to do in order to gain access to online scheduling. This single source of truth was populated across the pathways Veterans took to find the tool, and all other content was deprecated.
Providing access for Veterans to use good tools
Even after changes were made to help Veterans discover the online scheduling tool and understand, in plain language, their eligibility regarding its use, we found that they could only login using a DS Logon Premium account. Our partners at VA had been trying to overcome this obstacle, which was related to the development process and restrictions on the release cycle. By escalating the problem to the CIO and CTO, we were able to make headway into waiving the process requirements that had been holding our VA partners back. They were then able to work with contractors to enable MyHealtheVet and ID.me credentials to work with the tool.
Designing with users to create a better tool
As this work was initiated by a Veteran’s concern, it was important to the team to involve Veterans throughout the design process. Veterans evaluated the new content that was eventually populated across different VA.gov sites and provided feedback on how to make the language even clearer. The team also tested the different user journeys from Vets.gov, MyHealtheVet, and eBenefits, to make sure that Veterans could determine their eligibility and find and access the front door of the online scheduling tool, or identify their next steps if they found they were not eligible.
Our research with Veterans also showed that while the tool had been built with the best of intentions, it had not been designed with users in mind. Veterans struggled to use the online scheduler because the rules were unclear and the taxonomy matched internal VA processes and not how Veterans understand their healthcare. For example, we found that Veterans had trouble selecting the correct clinic, as facility names were populated by internal VA classifications and did not use the names Veterans knew. Though the tool could also be used to cancel an appointment, that option was not clear from the tool’s dashboard; users had to know to edit an appointment in order to find a way to cancel it. The team worked with Veterans to make sure that the new language recommended changes to the existing tool based on this feedback and tested it further.
The bottom line for Veterans and VA
After working with VA to make discoverability, usability, and accessibility changes to the online scheduling tool we saw an immediate increase in usage that resulted in 5 times more traffic. Since the national rollout there has been a 700% increase in appointments scheduled online. More facilities and appointment types will be added to the tool in the near future, and eventually the functionality will become a part of a unified patient experience at VA.
By following our USDS core values we delivered a better self-service tool for Veterans to access the care they have earned. We were able to break down internal barriers to help our partners achieve their goals. And the team has been able to parlay this success into credibility and momentum for other impactful projects that benefit Veterans.
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