Enabling Veterans to schedule COVID-19 vaccinations online
Agency
Department of Veterans Affairs (VA)
The Department of Veterans Affairs (VA) is the largest integrated health provider in the country. As the COVID-19 vaccine became available, the VA needed tools to connect millions of people who rely on the system for healthcare with the vaccine. While in-person interactions would remain as a way for Veterans to schedule a vaccine appointment, the VA chose to build on its existing appointment scheduling infrastructure — known as VAOS, or VA Online Scheduling — to provide an easy, efficient customer experience for Veterans.
Challenges
We knew we might face some difficulties in the process. These included:
Expectations Veterans may have regarding access to all their health data, no matter the application or context
Differences in how VA medical facilities operate, given regional and location constraints on the ground
Constant changes with vaccine inventory due to walk-ins and location factors
Approach
Ad Hoc, as part of a team with prime contractor B3, partnered closely with a task force at the Veterans Health Administration, working with key VA stakeholders, VA doctors, and the Office of Connected Care, to add the vaccine scheduling feature to VAOS.
Given the need to vaccinate as many Veterans as possible and in the shortest time frame possible, our team used an approach that focused on adding value quickly while also minimizing the risks involved in introducing something new to the system.
Content audit
Because it was important to deliver the vaccine scheduling service to Veterans as fast as we could, we began by looking for existing components we could reuse for the application. Our design team audited the content we already had at the VA, targeting content that might best support the goals of the application. By reusing components originally created for a direct scheduling workflow, we were able to save development time.
Rapid prototyping and designing with transparency
To minimize development cycles, the design team built rapid, iterative prototypes, designed to drive the team toward stakeholder alignment on a proposed solution, adding visual polish only once the initial build was set into motion. Beyond development time, reviews and approvals were a primary risk to how quickly we could offer online vaccine scheduling to Veterans. By building working prototypes that showed stakeholders what a realistic Veteran experience looked like, we were able to shorten the time it took to offer this critical service to Veterans during the pandemic.
Lean product thinking
Our team used lean product techniques to allow the VA to remain flexible during this fast-moving project. To stay nimble, we built the online vaccine scheduling steps as a separate workflow within the existing application. This allowed us to adapt to constantly changing requirements while reusing existing VAOS elements. We also built the feature so it could be shown to only a select population of Veterans. This would later help us run an initial pilot of the scheduling feature with five VA facilities without causing a confusing user experience for Veterans at other facilities.
Outcomes
The solution launched successfully within the VAOS ecosystem, allowing Veterans to sign up for vaccination appointments through an existing VA tool they already knew and understood. This new feature reduced the time tax of making an appointment by phone and lowered the burden for VA staff. Self-scheduling for vaccines also helped reduce waste early on when supply was limited and the facilities had to factor in time and quantity of doses to pull from freezers.
After successfully piloting the new tool with five VA facilities, the new functionality was opened up to all VAOS users. Since then, we’ve seen a greater than 95% successful submission rate. As of January 2022, the VA has fully vaccinated 4.3 million people, including 3.8 million Veterans, through tools like VAOS, scheduling by phone, and walk-in appointments.
4.3 million people fully vaccinated including 3.8 million veterans