“In-house” at the VA (Veterans Affairs)

Sometimes when people hear that I work on projects with the government their initial response is “oh that must be frustrating” or “slow.” I have found it to be quite the opposite and it has given me the opportunity to work with people who truly care about improving people’s lives. Civtech is a supportive community that encourages each of us to bring sustainable, human-centered design with accessibility beyond compliance to government.

Embedded on a strategic sprint team, I work with government stakeholders at the VA to improve the experience of Veterans and Caregivers applying for health care at the largest health care system in the US.

These thoughts are mine alone, I do not speak on behalf of any organization.

Feature: Sign as a representative

This success was recognized by the CTO of the VA and was called out in a Secretary of the VA press conference in which it was stated that the VA is utilizing research and applied human-centered design to improve the experience of getting benefits for Veteran Caregivers.

The situation

  • Caregivers who want to apply for VA benefits are required to have their Veteran sign their application.
  • Some Veterans have a legal representative who has authority to make medical decisions on their behalf and thus sign the application.
  • These representatives are required to upload documentation confirming their legal authority.

The challenge

  • When we started, only 33% of uploaded documents were being accepted
  • This burdens the VA staff that need to followup with each individual that submits an unaccepted document
  • This delays time to decision for applicants

Our approach

  • Align on a definition of success with our stakeholders- increase the percent of applications with acceptable documents.
  • Leverage research and iterative design to define, prioritize, and pursue the lowest effort, highest potential for impact idea.
  • Build a strong feedback loop by giving ourselves and our stakeholders the time to measure the impact.

The research

We conducted mental model research studies first with our stakeholders and then with Veterans, Caregivers, and Veteran representatives. We quickly realized that all of us, myself included, had a different perspective.

Stakeholders- “We should put more warnings that uploading the wrong document will delay the application.”

Design & content- “We can have applicants select the document type from a list and directly link the document upload with the signature”

Research participants- “We think about legal representative documentation based on what it enables us to do (eg. make medical decisions) rather than the form name itself.”

The solution

  • Visually tie the document upload to the signature, making it clear that having a representative sign was an option, not a requirement for the program.
  • Make it clear that this representative needs to have legal authority to make medical decisions.
  • Design iteratively, while simultaneously running usability testing on the prototypes.

Outcome

One month into implementation we are now at a 60% acceptance rate of applications with uploaded representative documentation. This is above industry standard for upload document features in general, but more importantly, this a huge improvement for both the Veterans and Caregivers applying for this program and the VA staff who process the applications.