Introducing a new digital application for health care at VA

Today, less than 10% of applications for VA health care are submitted digitally. This is the story of how the U.S. Digital Service partnered with the Health Eligibility Center to change that, making it possible for anyone with an internet connection to apply anytime, anywhere, from any device.

By: Emily Tavoulareas and Mary Ann Brody

Meet David, a 47 year old Veteran of the Navy. He is divorced with three kids, one in his custody. Over the last few years he has been in and out of homelessness, making minimum wage just outside of Philadelphia. He hasn’t seen a doctor in 8 years. If you ask him if he has applied for health care he will tell you “yea, dozens of times.” The answer is “dozens of times” because the current application process is confusing, frustrating, and often inefficient. Over the past few months, our team has been working to make applying for health care at the VA easier.

“Creating a dependable application process is an important step forward to regain Veterans’ trust and improve access to care as we continue the MyVA Transformation.” — VA Deputy Secretary Sloan D. Gibson.

Applications for health care are processed and eligibility determinations are made by the Health Eligibility Center (HEC), through the “Enrollment System.”

• 73% of Veterans apply in person (meaning Veterans walk into a VA facility and apply)
• 13% of Veterans apply by mail (meaning Veterans fill out a paper form and mail it in)
• Less than 10% of Veterans apply online

*all stats are from a recent survey by the Veteran’s Health Administration

There is an online application (the Veterans Online Application, also known as VOA), but less than 10% of applicants are using it. Why? The answer is fairly straightforward: the online application does not open for most users. It is a fillable PDF. The only browser that defaults to Adobe is Internet Explorer. Even if you are using Internet Explorer, you must be using Adobe 8 or 9 for the application to open. If not, you’ll see this:

More than 70% of U.S. Government traffic comes from Chrome, Safari, or Firefox. None of these browsers default to Adobe and that means over 70% of visitors have trouble accessing the health care application. This isn’t the fault of IE or Adobe — the ecosystem of the internet changes rapidly, so while IE and Adobe are able to adapt, the products we build in government often are not.

As soon as this problem became clear, we endeavored to build a digital application. The goal was simple: enable Veterans to apply for health care online as soon as possible.

Today we celebrate the launch of the new digital application for health care at the VA

Here’s how we did it:

Prioritize users, and engage them early and often. To build something usable and useful as quickly as possible within existing regulatory constraints, we knew we had to get direct input from Veterans early and often. We built the application iteratively, validating our work with Veterans through usability research in the field.

Below are two videos of our early usability work. They feature a 35-year-old Veteran who has been in and out of homelessness with his daughter over the past couple of years. We met him on a sidewalk outside of his job. The videos show him first trying to apply for health care as it was in Spring 2016. The second video shows him trying to apply for health care using an early prototype of the new application on Vets.gov.

Our time with users, and what we learn from them, forms the foundation on which we build our products, services, and experiences.

Work closely with VA stakeholders, at all levels. Our colleagues at the HEC have dedicated their lives to helping Veterans get health care, and are doing the best they can with the resources they have. We worked closely with them to understand the current process, system, challenges, and opportunities. We also partnered with them to test out the application. Together, we ensured that the experience from end-to-end would be seamless, and that data was flowing properly from one point to the next.

We do not do this work alone. In our pursuit to modernize products and services, there are dedicated civil servants who know the processes, systems, regulations, better than we do — and we cannot improve products and services for Veterans without them.

What’s next?

This new digital application is simply a functional, cleaner version of the existing application — it collects the same information. Since the existing digital application doesn’t open for a majority of the public, our priority was to get the application up and working as quickly as we could. While we did a lot of plain language and user experience (UX) work, the experience can still be better. In the next few months we will:

• Add the ability to save an application. This will allow Veterans to work on the application at different times. This is a feature we have heard is necessary from Veterans, VSOs, and VA employees.
• Add the ability to upload documents. This is important to Veterans because they often want to add supporting documentation (like their DD214) that contains information that is relevant to their application.

Ultimately, this application is about improving access to the health care Veterans have earned. We believe the best way to achieve this is by placing our users — Veterans — at the center of our work and developing products in an agile manner to adjust to their needs. Benefits and services should do more than exist. They should be accessible, useful, and usable.

We look forward to rolling out more products like this on vets.gov in the months ahead.

To learn more about the new digital health care application, visit : https://www.vets.gov/healthcare/apply/

Emily Tavoulareas and Mary Ann Brody are members of the U.S. Digital Service at Veterans Affairs.

Learn more about the U.S. Digital Service at VA.