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Courtesy: Mesothelioma Veterans Center

This blog post is dedicated to all American Veterans who have put their lives (not to mention their families’ lives) on the front lines to protect their country, people and freedom. It is essential we acknowledge these brave souls who are still sacrificing their lives even after their return from active duty. AppointmentNotify is committed to helping our Veterans get access to care sooner so that they and their families can live healthier lives.

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Photo by Snapwire on Pexels.com

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,243 health care facilities, including 172 VA Medical Centers and 1,062 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program.

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Courtesy: STARS AND STRIPES
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Courtesy: American College of Cardiology

The numbers speak for themselves. The VA health care system’s annual budget is approximately $68 billion. It oversees the delivery of care to more than 9 million enrolled Veterans and employs more than 306,000 full time health care professionals! The My HealtheVet tools allows veterans to access and manage their healthcare information with their VHA care team. The “Our Providers” online directory lists the primary licensed independent practice providers providing treatment to patients at VA medical centers nationwide.

Caring for Veterans, especially older Veterans, no doubt defines America’s future as it is a symbol of motivation for Americans to fight and sacrifice for their country. VHA proudly highlights its values as shown below:

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Courtesy: U.S. Department of Veterans Affairs

However, the past couple of years VHA has been in turmoil with accusations and investigations of poor treatment, long appointment wait times and even falsified record keeping. These allegations do not align well with VHA values and do not help many veterans who come back home from active duty with a varied number of health related ailments. A number of veterans also require faster access to care due to comorbidities or for that matter many chronic medical issues they face due to aging.

Veterans waiting on VHA’s Appointment Wait List

Take the case of the late 71-year-old Navy veteran Thomas Breen, whose wait to see a VA Provider ended much sooner; before his appointment got announced! As reported by @, @scottbronstein on CNN, on September 28, 2013, with blood in his urine and a history of cancer, Breen’s son, Teddy, and his wife, Sally, rushed his father to the Phoenix VA emergency room, where he was examined and sent home to wait. Breen’s emergency room chart clearly stated “urgency” as “one week” for Breen to see a primary care doctor or at least a urologist, for the concerns about the blood in the urine. Breen was sent home from the emergency room. No one called from the VA with a primary care appointment and Breen’s family’s numerous attempts to try to get an urgent care appointment for him were unsuccessful. They were told a seven-month wait on the “waiting list“!

Thomas Breen died on November 30, 2013. The death certificate shows that he died from Stage 4 bladder cancer. The VA called back finally, months after the initial visit, on December 6, 2013 stating: “We finally have that appointment. We have a primary for him.” Breen’s last days are recalled him screaming and crying asking for help: ‘Don’t let me die.

Breen is only one of the many veterans who died waiting for an (perhaps urgent) appointment with a primary or specialty doctor. The reward for an honorable service to our heroes came out to be a disservice by the very system they depended on for their care.

Long wait for appointments is not the only gap in VHA’s healthcare delivery for its Veterans community. The organization has several other problems that need a systematic review and innovative solutions to rectify those problems. Putting band-aids is definitely not a solution to VHA’s problems for sure. Anthony J. Principi, who served as secretary of Veterans Affairs from 2001 to 2005 has some excellent advice for VHA which is worth reviewing if you are interested.
AppointmentNotify: a possible solution to the VHA’s Appointment Wait List Problem

Let’s just jump into how we @AppointmentNotify could potentially rescue VHA to get a handle on its Wait List Problem. Before we delve into it, however, let’s review some metrics from a well-written report on the VEText, an automated interactive text messaging system, deemed as an innovative solution that is transforming VA’s medical scheduling process. According to VA, this system that was launched in March 2018, helped reduce no-show medical visits by more than 100,000 as of ~mid-July 2018. The goal of this innovative technology is to remind Veterans of their upcoming health-care appointments and to allow them to easily confirm or cancel such appointments right from their mobile phone using simple text messages.

According to the Veterans Health Administration’s (VHA) Office of Veterans Access to Care, as of July 9, [2018] more than 3.24 million patients have received VEText messages and canceled 319,504 appointments, freeing up time slots for other Veterans to use.

The report further states:

VEText is integrated with VA’s electronic health-records system and does not require manual action by VA staff. Appointments are automatically scheduled and canceled via text message, freeing staff to provide more personalized care to Veterans.

AppointmentNotify was designed and developed with the following in mind:

  • Can both Patients and their preferred Providers (not just any random Provider) be empowered by a shared exchange of value?
  • Can Patients get notified of “new appointment” availability just like they are notified of “existing appointment” availability?
  • Can Patients converse securely with their Providers or the Front-Desk Staff at a Provider in real-time via text chat rather than using phones? Can Providers do the same with Patients and other Providers?
  • Could this empowerment change user behavior? Of Patient and of their Providers?

These and some other ingredients (think: research facts, user design and experience and participatory approaches to engaging patients with their providers etc.) culminated in the form of a solution which we call the AppointmentNotify Platform. To make it clear, this Platform is NOT a Patient Portal! A simple fact that is useful to know is that in its current state, this Platform does not go into the clinical and medical side of things as its sole purpose is to engage Patients with the Providers they like to seek care from based on a true partner relationship developed by gaining trust in hopes for better health outcomes. There is a lot of #empathy that went into the making of this Platform to change user behavior by offering value; by making appointments valuable to gain valuable health outcomes!

To cut to the chase, the AppointmentNotify Platform is an excellent tool that a large organization like VHA, a healthcare system, a medical group or a single Physician Practice can make use of to build a trust worthy relationship with their Patients. It is not a Portal that simply allows a sneak peak into the Provider-offered and Provider’s EHR vendor-controlled set of clinical and non-clinical data (or a limited and often not used Patient-provided data such as Patient-collected vitals) but instead a two-way channel that let’s Patients do things they still cannot do with a variety of Patient Portals out there. So what are the things that Patients can now do using the AppointmentNotify Platform? Well as a starter, this Platform is only focused on appointments (aka visits) with Physicians or care Providers.

Related to that, Patient users of this Platform can at minimum:

  • get a consolidated, aggregated and analytical view of appointments with Providers across all Provider Facilities,
  • seek a chance at booking “new appointments” when other patients cancel or reschedule their appointments in real-time,
  • get auto-notified when “new appointments” become available in real-time,
  • put themselves on a Provider’s Wait List and have that Wait List be transparent to them and their Providers,
  • avoid having to call a Provider for basic appointment or miscellaneous questions/queries,
  • Add/Edit simple text notes for every appointment/visit with a Provider
  • get notifications of upcoming appointments on different channels including emails, voice and text/sms

Similarly, the Provider users (including Physicians and the Front-Desk staff) can at minimum:

  • automate appointment scheduling (booking, rescheduling, cancellations) so their Front-desk staff don’t have to; resulting in massive efficiency gains,
  • use a single Platform Provider-side account to connect with, manage appointments and communicate with Patients of other Providers; no need to have separate accounts nor any need to gain access to different isolated systems. The Platform can be utilized by any size organization, small or large,
  • text chat securely with Patients and other Providers including the Front-desk staff,
  • significantly reduce cost by preventing no-shows and cancellations as a result of patients using this Platform as a direct result of using a tool that let’s them find value for its use,
  • DIY activation, configuration, management and subscription that can be altered at any time without having to wait days or weeks for a third-party vendor support team to do it for them

These and some other needs resulted in the birth of the AppointmentNotify Platform which acts a the foundation for empowering both Patients as well as Providers to engage them more efficiently and effectively. No wonder we take pride in our motto:

The On-Demand Appointment Marketplace

Improving health outcomes one Patient at a time!

We are looking for healthcare providers like VHA to open themselves up to allow innovators like us to help them help their Veterans and for Veterans advocacy groups like the one runs by Thomas Bandzul, legislative counsel with Veterans and Military Families for Progress, to help draft legislation to protect the rights of Patients including Veteran Patients. Here is a good read if you are interested. For example, learning from VHA’s “secret wait list” debacle a couple of years ago, Veteran advocates could introduce a simple improvisation to healthcare appointments by requiring every healthcare organization to introduce, manage and make transparent an appointment wait list to its Patients. Yes. You got that right. We are proposing HIPAA regulations to be amended to give Patients their fair right to allow them access to their appointment wait list shared with the Patient only so that the Patients have the ability to first of all be put on a wait list (not all providers offer a wait list by the way to patients in reality even though most of them do maintain one to avoid no-shows and empty appointment slots!), have access to that wait list and could track their time waiting before they are able to see their care provider. This simple change in healthcare law could benefit a lot of veterans who needless to say will respect VHA and its mission of providing them not only a promising care but also ease of access to the information related to their care; albeit in this case information related to their appointment wait time! HIPAA could literally impose this regulation on providers across the country to have them provide this simple yet powerful benefit to patients to help equip them better even before their visit with their care provider.

Curious readers need only answer this question:

How many Patient Portals currently offer a Wait List feature to their Patients?

We would be happy to know the answer and know which Patient Portals currently do that..!

Conclusion

The nations 9 million heroes served by VHA deserve respect for all that they have sacrificed for their institutions and the country. The least we can offer them is timely access to care.

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Courtesy: American College of Cardiology

The AppointmentNotify Platform could literally take the 319,504 canceled appointments (cancelled over a period of 5 months or less), not to mention the appointment slots that would have been made available if VHA offered a reschedule appointment option to its veterans, to make them available to other Veterans who would like to seek a sooner appointment or an appointment that matches their schedule preferences. This is the value, in fact, the shared value offered by this Platform built to realize a BIG impact with a LITTLE change.

We salute our veterans and hope they get timely access to the care they deserve without having to wait on any “secret waiting list!

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Courtesy: BRUST FUNERAL HOME

Te veo pronto!

The Team @AppointmentNotify

NOTE: This post uses publicly available information curated with our own interpretation of how we see things from Veterans’ and Patients’-end so they could realize better health outcomes. It is evident that VHA is progressing on its promise as it is piloting another self-scheduling product for Veterans who receive care at selected medical centers who would be able to schedule, reschedule, cancel and request appointments online using the Online Patient Self Scheduling (OPSS) tool.

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