VEText Direct Scheduling for other Clinics

[shanemelliott]

This could come into play for rescheduling appointments cancelld due to COVID and scheduling routine preventative care appointments.

• [x] Draft of content
• [ ] Draft of UI changes to generalize
• [ ] Collect usability feedback on UI

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Content Draft (carriage returns removed for legibility in table format):

Message Type	NO PHI	YES PHI
2-way routine	We'd like to let you know that you are due for a routine appointment at VA. For more details on the type of appointment, reply DETAILS. Would you like to schedule this appointment via text? Reply YES or NO, then we'll ask you some follow up questions.	We'd like to let you know that you are due for a routine PRIMARY CARE appointment at VA. Would you like to schedule this appointment via text? Reply YES or NO, then we'll ask you some follow up questions.
2-way cancelled due to COVID	We cancelled an important appointment of yours due to COVID-19. We are now able to see you for this appointment. For more details on the type of appointment, reply DETAILS. Would you like to schedule this appointment via text? Reply YES or NO, then we'll ask you some follow up questions.	We cancelled an important PRIMARY CARE appointment of yours due to COVID-19. We are now able to see you for this appointment. Would you like to schedule this appointment via text? Reply YES or NO, then we'll ask you some follow up questions.
1-way routine	We'd like to let you know that you are due for a routine appointment at VA. For more details on the type of appointment, reply DETAILS. To schedule this appointment, call %FACILITY_NUMBER%.	We'd like to let you know that you are due for a routine PRIMARY CARE appointment at VA. To schedule this appointment, call %FACILITY_NUMBER%.
1-way cancelled due to COVID	We cancelled an important appointment of yours due to COVID-19. We are now able to see you for this appointment. For more details on the type of appointment, reply DETAILS. To schedule this appointment, call %FACILITY_NUMBER%.	We cancelled an important PRIMARY CARE appointment of yours due to COVID-19. We are now able to see you for this appointment. To schedule this appointment, call %FACILITY_NUMBER%.

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From: Miller, Jerrica L. Jerrica.Miller@va.gov Sent: Wednesday, March 3, 2021 11:39 AM To: VEText VEText@va.gov Subject: Direct scheduling

Good afternoon, On one of the last open office hours it was asked if we can use direct scheduling for clinics other than COVID vaccines. Just reaching out to see if this happens to be in the works? My station would like to try this with our Airborne hazard exam scheduling.

Thank you, Jerrica L. Miller Health Administration Service Lead MSA - Primary Care (859)233-4511 EXT: 2400 VEText POC Lexington VAMC – Leestown Division

[kjduensing]

per Shane probably not gonna get to this for a while

[shanemelliott]

Here are some initial thoughts on refactoring of the VEText direct-scheduling functionality to support multiple use-cases. The below reflects my discussion with Julia on the new UI for request submission which in turn included some discussion about core functionality.

1. Request Process a. The UI for messaging request submission will be organized in an “accordion-style” interface, where date-entry fields are organized into collapsible panels. User clicks the “Next” button to auto-advance from one panel to the next. User can click on a panel header to access that panel’s data-entry fields for edit/review. i. Request Details
2. Request Name
3. Send Date
4. Available Templates a. Template name, message content, and message type (One-Way, Direct-Schedule, etc) b. Show PHI-Enabled Preview checkbox c. Filter by Topic (topic is a use-case such as primary care, mammograms, etc) ii. Message Details
5. Facility name
6. Phone Number
7. Message Preview iii. Direct Schedule
8. Appointment Date Range (start/end date)
9. Target Clinics
10. Target Clinic Availability (auto-calculated based on selected clinics and date range) iv. Patient List
11. Patient Identifiers File
12. Review Patient Identifiers (preview of patient data, # valid identifiers, # invalid identifiers, etc) v. Review b. Ability to do one-time vs. recurring requests. The latter would only work for automated retrieval of patients, since recurring requests would operate automatically without the need to manually upload patient lists. c. Support for easy repetition of a past request and making recently submitted requests visible to prevent repeat requests. d. Implement as many automated checks in the software as possible to largely take the burden of review off of the VEText team (with the exception of message templates – see below).
13. Message Templates a. VEText team creates initial default templates used for each use-case. At a minimum there would be a one-way and/or a two-way message for each use-case as applicable. b. Each message template has a type (One-Way, Direct-Schedule) and is associated with a particular Topic (i.e. use-case, e.g. primary care, mammograms, etc). c. New and modified message templates may be created by sites for any given use-case on the Message Templates tab. d. Creating/modifying templates would only make those custom templates visible and available to the site that created them and not to other sites. e. Governance of custom message templates is by the VEText team who reviews the custom content and edits the templates as needed and approves. f. Once approved custom templates would appear in the list of message templates available for selection in the request process.
14. Patient Selection a. For some use-cases it may be feasible to implement auto-retrieval of patient lists. For other use-cases there may be more complex query parameters and/or variation among sites/providers such that auto-retrieval isn’t practical. b. We should continue to support manual uploading of patient identifiers to maximize flexibility and to allow providers to make clinically-informed decisions as to which patients to include in any given messaging request.
15. Response Codes a. Since it is possible for patients to receive more than one direct-scheduling message for multiple use-cases, each message will need to utilize unique response codes for appointment acceptance similar to appointment reminders (e.g. “Reply Y1 to accept this appointment date/time”). b. A problem we’ll need to think about involves the appointment date/times that the patient sends in response to a two-way message. If the patient has received two or more such messages for different use-cases then identifying which message the date/time applies to would be challenging. i. One solution would be to only send a patient one message for any use case during the date range for an active message request. ii. Another option might be to assume that the response is for the most recent message sent to the patient.
16. Auto-Reply Messages a. Besides the initial message that gets sent to the patient for a given use-case, there are a number of other messages that are part of the direct-scheduling workflow. b. Confirm Appointment – “A %APPOINTMENT_TYPE% appointment is available with %CLINIC_NAME% at %FACILITY_NAME% on %APPOINTMENT_DATE% at %APPOINTMENT_TIME%.” c. Respond to Schedule Appt – “To schedule this appointment, reply YES. To request a different time, reply OTHER or your preferred date & time (for example, "1100 Oct 15")." d. Appt Scheduled – “Thank you. Your appointment with %CLINIC_NAME% (%CLINIC_LOCATION%) at %FACILITY_NAME% is scheduled for %APPOINTMENT_DATE% at %APPOINTMENT_TIME%. Call %FACILITY_PHONE% if you have questions.” e. Date/Time Unavailable, Propose Alt Appt – “The closest available %APPOINTMENT_TYPE% appointment with %CLINIC_NAME% at %FACILITY_NAME% is on %APPOINTMENT_DATE% at %APPOINTMENT_TIME%.” f. Declined Date/Time, Propose Alt – “A %APPOINTMENT_TYPE% appointment is available with %CLINIC_NAME% at %FACILITY_NAME% on %APPOINTMENT_DATE% at %APPOINTMENT_TIME%.” g. 15-Min Follow-Up – “You have not yet scheduled the %APPOINTMENT_TYPE% appointment on %APPOINTMENT_DATE% at %APPOINTMENT_TIME%. Please send YES to SCHEDULE this appointment." h. 15-Min Follow-Up, Appt Unavailable – “You have not yet scheduled a %APPOINTMENT_TYPE% appointment. The appointment date/time you were offered is no longer available. Send OTHER to request another available date/time." i. Contact Facility – “Thank you for your interest. There are no other appointments available at this time. We will contact you when more appointments are available." j. Cell Phone Unrecognized - “We apologize, but we do not have this cell phone number in our records. It looks like your message may be related to the COVID-19 vaccine. If so, please try again with a cell phone that is on file with VA. Please call the VA facility if you need assistance.“ k. Other – “This is an automated system, and couldn't interpret your response. To request %APPOINTMENT_TYPE% appointment, respond with a date and time. If you do not wish to schedule an appointment at this time, please ignore this message. If this message was sent to the wrong number, please text STOP."

[shanemelliott]

From: McCarty, William William.McCarty@va.gov Sent: Friday, April 30, 2021 9:47 AM To: Durkin, Robert M. Robert.Durkin@va.gov; VEText VEText@va.gov Subject: RE: VEText Appointment Outreach Request

Couple of thoughts.

Seems that for many "use-cases" it could be simply "turned on" after completing a configuration wizard. For example a site wants to enable mammogram notifications: setup clinics, select appropriate template, and vetext would do the right thing to send messages daily/weekly/monthly in an on-going process with no explicit end date, and to any patient matching criteria of use case.

Is this something possible? Or even desired?

If so, a question would be the on-boarding process. How would a site catch up the current date and get into a maintenance mode. Here is where I think the upload process could be made useful. The issue of overlapping messages is an issue and assuming responding to the last message seems problematic. Your proposal for "recurring requests" or my proposal for enabling long lived use-cases could make message overlapping highly likely. The idea of someone that needs to see their primary phisican would almost certainly meet requirements for other potential preventative notifications we might make availabile.