Re-Designing the First Impression: Hacking VA Intake Forms

Simultaneously, in Atlanta and Boston, a coalition of Veterans, VA Employees, Innovators and Designers joined together to re-design VA intake forms

The air is warm. The heat and humidity of summer approaches. The VA Atlanta Medical Center emerges from the rustling leafy trees of Decatur, Georgia.

The Boston sidewalks start to dry after a cool morning rain. There is a familiar chill in the air, more suited to October than early May. Entering the Mad*Pow office provides a comforting warmth.

In Atlanta, Anita, Tom, Kaya and Lena gather around a polished wood table in an unassuming conference room, tucked off the third floor of VA Atlanta Medical Center. In Boston, movable desks are wheeled into ever-changing structures along the exposed brick walls, while a hammock is tucked away behind a projector screen. In both Atlanta and Boston, coffees are sipped and donuts nibbled on for energy. It’s 8:45am on a Saturday. Why are they here?

To design the first impression.

Every day across the country veterans make the decision to seek mental health support. They often have to overcome stigma and challenges of self-awareness to reach this “turning point”. When they do, it marks a significant moment toward a journey for well-being but it’s just the start. Veterans engaging with VA for mental healthcare support (both benefits and care) must fill out paperwork to gain access.

In Atlanta, Veterans and VBA employees review the original forms

This is not an unusual requirement for any service sought — VA or otherwise. However these forms can often be barriers to care, and burdens that veterans feel they must carry on their own. We want to make it clearer and easier (for both veterans and providers); we want to lower barriers to care and remove as many burdens as possible on the path toward gaining support. And so — we decided to redesign some of the key forms with which veterans interact.

A path to improved access to mental health support

Making the decision to seek out mental health services can be challenging enough, accessing those services shouldn’t be a struggle. This insight is one of many identified in VACI’s Veteran Access to Mental Health Services report. By using human-centered design discovery methods to understand Veterans’ needs and experiences throughout their journey of accessing mental health services, the data and Veterans’ experiences illuminated where we need to better support Veterans and their support networks. To focus our inquiry into Veterans’ experiences when accessing mental healthcare, we identified four critical phases for exploration, spanning their time in military service, to the point of receiving mental healthcare. We focused on ‘turning point’ moments, when Veterans decide to seek care and their subsequent experiences seeking care to fit their needs.

What we learned and heard from Veterans, their supporters, caregivers, clinicians, and VA employees, informed opportunities to improve access to care. From quick wins, that would immediately improve access to care, to longer system transformations to establish VA as a model for best entry into healthcare. Re-designing the first impression VA makes — the intake forms — is an immediate opportunity to improve Veterans’ access to care.

Charged with their goal to ‘create a better experience for Veterans seeking mental health support by redesigning confusing and unwieldy forms’, Veterans, VA employees, designers and innovators gathered in both Atlanta and Boston to participate in hackathons (or design-a-thon) to redesign a few VA intake forms (benefits and care). #HackTheForms brought together a community of people eager to support our veterans. In Atlanta, VA employees from the Veterans Benefits Administration (VBA; a core service within VA) collaborated with innovators to design better approaches for capturing the necessary and important (read: legally required) information. In Boston, designers who have seen how mental health affected their family and friends, teamed-up with Veterans to design a more intuitive and encouraging form. Throughout the day, teams eagerly discussed, designed, iterated, and built prototypes of the intake forms.

Innovation in Motion.

Hackathons are an intrinsic innovation for the VA. By engaging Veterans and their community directly and intimately in the design process, we can ensure they hold a meaningful and tangible role in shaping the support they receive and their experience with VA. Hackathons enable the experience and needs of veterans to guide the design and outcomes of VA processes and services. VA employees, often confined to their areas of responsibilities and tasks, are able to step outside the narrow constraints of their role to use their years of experience providing services to Veterans and their caregivers to work collaboratively with those Veterans and design a better solution. The employment of hackathons across VA has been enabled, in part, by the VA Innovators Network Accelerator Program.

A team in Boston works with a Veteran to design a new form

VA forms — like most government forms — are ripe for redesign. Though there are requirements for the information to be obtained, there are no requirements on how to obtain the information. Redesigning VA forms — some of which have gone untouched since the 80s — is an opportunity to design a more Veteran-centered, empathetic form that effectively captures the necessary information and builds trust that VA is there to support, not confuse. Additionally, it’s an opportunity to remove one more barrier on the path toward accessing support. At the end of the day, the teams reconvened to share their prototypes and collaboratively review and refine the designs.

Across both Atlanta and Boston, there were common design features in response to Veterans’ insights: recognizing Veterans’ service and highlighting that these forms are to ensure that Veterans’ receive the care they earned and seek; clearer and cleaner design that is accessible to all and not a struggle to understand; and clear explanations about the privacy of the information and details provided. Veterans who participated in hackathons were impressed by the new design prototypes, and even more so, by how powerful these forms could be for providing a better initial impression for Veterans embarking on the journey to seek mental health care in the VA.

Teams present their redesigned forms

The journey toward improving VA services continues…

Redesigning VA intake forms for mental healthcare support is a step on a longer journey to breaking down barriers to care. #Hacktheforms is nested within a bigger conversation about how VA can become more veteran-centric and empathetic across all touch points, processes, and services that veterans engage with daily.

You only have one opportunity to make a first impression. We are working to make sure that first impression is an encouraging, empowering and supportive one. At the bottom of one of the redesigned forms, one of the teams included an explanation for what happens next, and what Veterans should expect next. Though the text takes only an inch of space on the form itself, knowing and trusting that VA is there to guide the journey is immeasurable.

One of the redesigned forms

Michelle McBee is an Innovation Specialist at Atlanta VA Medical Center. 
Saurabha Bhatnagar is the Medical Director for TBI/Polytrauma at Boston VA Medical Center and an Innovation Specialist.
John Dadamo is an Innovation Specialist at Boston VA Medical Center

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