How VA Turns Survey Data into Better Veteran Health Care

A U.S. Army veteran waits for prescription drugs in a pharmacy waiting room inside the Fayetteville Veterans Affairs Medical Center in Fayetteville, N.C.

A U.S. Army veteran waits for prescription drugs in a pharmacy waiting room inside the Fayetteville Veterans Affairs Medical Center in Fayetteville, N.C. Patrick Semansky/AP File Photo

Real-time feedback could help the Veterans Affairs Department direct respondents to task forces for suicide or homelessness.

A new system can flag veterans at risk of suicide based on the surveys they answer about Veterans Affairs Department services they receive.

A veteran filling out a feedback form about VA care might describe symptoms of suicidal thoughts or behaviors that put them at risk of homelessness. The system can then direct those patients to VA task forces specializing in preventing and mitigating those issues. It can also identify cases in which a veteran has been struggling for a long time to schedule appointments.

That survey technology, which sends out feedback forms accessible on any device, is sold to the VA by Silicon Valley tech company Medallia. It could be part of a broader effort to process customer feedback about government services in real-time, allowing those who provide government services to respond quicker, according to Brian Michael, Medallia’s vice president of federal.

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Following President Donald Trump's and Veterans Affairs Secretary David Shulkin’s pledges earlier this month to invest in telehealth—technology that can treat veterans anywhere in the country, potentially by using video chat to connect patients to doctors—Michael sees an opportunity to gather even more information about veteran satisfaction.

The VA is Medallia’s first foray into government, though the company already has established customers in the hotel, retail and insurance industries. The company is beginning to incorporate feedback from social media sites—postings about the VA, for instance—into its analysis about customer satisfaction.

“We’re trying to change the opinion that feedback is academic,” Michael told Nextgov. Each response from a veteran is an “opportunity for engagement,” and a chance to consider, “How do we make a better decision on this product?”

Legislators on Capitol Hill are thinking about ways to help other agencies collect feedback too. Lawmakers in both houses have introduced a version of the Federal Agency Customer Experience Act, which would streamline the months-long survey approval process agencies currently go through. Michael has been meeting with legislative directors about that effort, he said.

Agencies face other challenges in processing citizen feedback. Some require that all surveys are anonymous by design, out of concern that gathering more information from respondents makes them responsible for personally identifiable information. But “if we force anonymity ... we can’t close the loop” on certain customer requests, Michael noted. The VA allows veterans to take the survey either confidentially or anonymously; if they take it confidentially, the system can flag their individual cases to the VA for follow up.

And even though the technology lets agencies collect feedback in real time, large organizations aren’t always equipped to act on that feedback quickly, Michael noted. At the VA, Medallia is able to flag patients at risk of suicide or homelessness simply by routing those cases to VA task forces that already exist. That workflow might not be in place for other veteran issues, so “there’s more work to be done,” he added.

“Everyone wants to make sure we’re not saying…’Do you need help?’... and not following up with them.”