[DESIGN/RESEARCH] Methods for contacting VAMCs

[mmiddaugh]

Issue Description

Previously we added the VA health connect phone number to Facility Locator search results and Contact information on VAMC pages for VISN 8 facilities. This was done as a stop gap measure until a more elegant solution could be determined.

Several factors make returning to this work a priority

• VA health connect will be rolling out nationally.
• December 2021 Executive order emphasizes use of online tools/chat

Previous research found that secure messaging is a trusted and preferred method of communication, preferred over phone calls, and second only to in-person conversation, for established patient Veterans.

Problems to be solved

How might we

• elevate options for contacting VAMC
• help Veterans understand which option should be chosen for a given scenario
• simplify the list of options
• discover meaningful labels which support Veteran use of the various methods

Communication methods

VA health chat (Discovery effort in #27686)

• Chat live with a clinician for issues such as Medical advice for a minor injury or illness, Medication questions, Lab/imaging test results

Secure messaging (Discovery effort in #27687)

• async service for non-urgent, non-emergency health-related questions, such as providing updates on one's condition, requesting VA referrals, test results, and prescription renewals, managing appointments, asking routine administrative questions
  • Response time ~24 hours

VA health connect (Discovery effort in #27688)

• Clinical contact center
• 24 hours live by phone - Regional phone numbers (mapped to health system)

Telehealth

• "remote visits with health care providers - technologies include video conferencing, home telehealth (which lets you send us vital health information, like blood pressure readings, over the phone or internet), and store-and-forward telehealth (which helps you send your health information to experts at VA facilities using secure technology)" from health service on VAMC pages
• for certain specialties, types of care
• could be accessed from home, using VA provided device or at VA locations where technology is available
• more info - VA.gov page

Research findings and recommendations

Key findings from audit

[Link to details for findings](https://github.com/department-of-veterans-affairs/va.gov-team/blob/master/products/facilities/medical-centers/discovery/communication-audit-research-findings.md#key-findings---detailed) - Many labels sound similar and don't clearly indicate their purpose. - Contact information is fragmented across various pages and sections globally and within health systems. - Contact methods are often embedded within lengthy pages of dense text. - Alternatives to phone communication are missing from Contact us pages. - When and how a sub-labels get implemented is inconsistent across VAMC pages.

Recommendations related to research

- Communication method labeling and naming should be simplified; audit and test with Veterans for understandability, interpretability. - How does label naming support the task a Veteran is trying to accomplish? "Make an appointment" more likely matches a Veteran's mental model when trying to complete a task than does "Telephone care". - Conduct Veteran research and review analytics of Veteran communication usage. - Which contact methods do Veterans use most today? Why? - In previous studies, multiple Veterans mention a preference for the "nurse line". For what purpose(s) do they call this number over other numbers? - How do Veterans learn about this number? - How does the information provided on VA.gov match a Veteran's experience outside of the website. Do other mediums offer a different set of contact methods? - How might we cater to first time users while offering shortcuts to existing users?

Relevant work

• Epic: VAMC options for Veterans to communicate with the VA #26770
• FE: FL search results #32552
• Synthesis for VAMC communication options #27689

Success metrics

• Click through rate for options on Facility Locator and VAMC pages
• Veterans are selecting the appropriate method (calls to abc rather than xyz)
• Increased use of these tools generally
• VAMC or Facility Locator as initiation point for use of tool

Relevant pages

It may help to review the following areas where contact information is currently displayed

• Location and contact information on facility page, such as VA Pittsburgh health care > Locations > Pittsburgh VA Medical Center-University Drive
• Inside service accordions on facility level pages, such as VA Pittsburgh health care > Locations > Pittsburgh VA Medical Center-University Drive
• Locations section on the main system page (at least for the main locations - usually 1 or 2 per system), such as Pittsburgh health care
• Contact us page - available on left nav, such as VA Pittsburgh health care > Contact us

Tasks

• [ ] Determine a method for gathering Veteran feedback on communication methods with the goal of learning which option Veterans would choose in a given scenario, how (name/search terms) they would search for it, where (on the VAMC pages) they would expect to find it, and what information they need to know in order to choose it

Acceptance Criteria

• [ ] Research plan and conversation guide

[nicko-amida]

This research plan/conversation guide is being finished up in #38150 !

[mmiddaugh]

Research plan and convo guide