VA mHealth pilot runs into scheduling conflicts

A U.S. Department of Veterans Affairs (VA) mHealth pilot has run into problems with its ability to efficiently schedule appointments. The VA Mobile Health Veteran Appointment Request Pilot is an attempt to provide more than 600 Veterans with the ability to request primary care and mental health care appointments. However, the Appointment Request App does not work with scheduling software across VA medical centers and does not operate within the VA's varying business processes, officials said.

Neil Evans, M.D. (pictured right), Co-Director of the Veterans Health Administration's Connected Health Office, told FierceMobileHealthcare that the vision long term is to "get to the point where we display schedules and allow Veterans to book [appointments] directly," instead of the pilot's current practice of having the VA's scheduling clerks schedule appointments. Evans said the VA is working on this "significant technical challenge," particularly for a "healthcare system with more than 1,400 sites of care and 250,000 plus employees." 

"We developed an application that lets patients tell us their preferences for when they want an appointment," he said. "If the VA can meet those times, the appointment is made [for them] and the Veteran receives a notification that the transaction is finished." 

As part of the pilot, the VA requires its scheduling clerks to review every request and every response sent to them by Veterans via the app. "Appointment clerks work from 9 a.m. to 5 p.m. ET weekdays and will respond to requests as quickly as possible," states the VA's website. "During the pilot phase, requests submitted after 5 p.m. will not be answered until the next business day." Earlier this year, the pilot was launched at the Washington, D.C. VA Medical Center and VA Palo Alto Health Care System in California.

"We intended to run that [Veteran Appointment Request Pilot] longer. We've learned some things from that pilot that makes us think we have to go back and adjust our app based on the feedback that we've received," said Kathleen Frisbee (pictured left), who co-directs the VHA's Connected Health Office with Evans. "What we had originally thought, that didn't work, was that we could go back and forth in an electronic exchange between a scheduler and a mobile app user about sorting out when an appointment should take place. Doing that electronically is less efficient than doing it verbally over the phone."

"The lesson learned is that with the current Veteran Appointment Request App it's often, not always but often, faster still to call and have a conversation with a scheduling clerk, because you can have that back and forth," said Evans. "This is an example where the app hasn't made it simpler yet than the traditional business process."    

"We recognize that probably over the long term it would be far better to be able to actually display a schedule of the provider's availability," he said. "We have some issues that we have to work through with our back-end systems, in particular our scheduling package."

In a separate interview in May, FierceMobileHealthcare spoke with Evans and Frisbee about the VA's mHealth initiatives. Currently, there are 18 VA apps that are available to Veterans, are being piloted, or will be in pilot within the next six months.

To learn more:
- visit the VA's website