Case Study

Nava worked with the U.S. Department of Veterans Affairs (VA) Board of Veterans’ Appeals (Board) and other vendor partners to increase VA’s capacity to serve Veterans during the pandemic by offering secure, confidential, and convenient virtual tele-hearings.

The urgency of this project increased when the COVID-19 pandemic suspended in-person hearings. With virtual tele-hearings, Veterans can now have hearings wherever they choose, with their representatives and caregivers present. The team was able to rapidly deliver new tools, helping to serve Veterans navigating challenges of the pandemic.

Approach

VA wanted to make it possible for Veterans to attend hearings without traveling to a VA office. A new feature to generate video conference links when scheduling hearings was added to Caseflow to ensure a seamless, unified experience and efficient adoption of remote hearings. Scheduling and rescheduling hearings could all happen within the workflow they were already using. Making it easier for VA staff to use the new system would ultimately make it easier for them to better serve Veterans.

To move quickly and minimize risk, the Board and Nava started with an initial effort focused on virtual tele-hearing scheduling. The early efforts let us address primary issues, uncover additional needs, test new features, and iterate to further improve the new system along the way.

Outcomes

In March 2020, one week after shelter-in-place orders were issued in response to the pandemic, the team rolled out the new feature, enabling a small group of VA staff to test the virtual tele-hearings system within Caseflow.

As a result:

• Coordinators were able to convert 25 percent of previously scheduled hearings to virtual tele-hearings by June, which rose to 33 percent in July.

• During current COVID operations, roughly 95 percent of hearings have a virtual component.

• The new virtual tele-hearings scheduling system puts scheduling and email functions all in one place—what used to be a multi-step process now has been reduced to a two-step process.

• VA is now poised to hold over 1,000 hearings per week in 2021, about 50 percent more than before virtual tele-hearings. Before virtual tele-hearings, hardware constraints required Veterans to travel either to a Regional Office, the Central Office in DC, or approved alternate locations. With virtual tele-hearings, Veterans and their representatives can participate in a hearing from any location with an internet connection and appropriate hardware, allowing VA to schedule and hold many more hearings when no longer constrained by the number of rooms available at a Regional Office.

• Virtual tele-hearings can run alongside other hearing types, increasing overall hearing capacity.

Within two months, virtual tele-hearings helped VA serve Veterans during the crisis, ensuring they received important benefits and services. Now, VA can continue to schedule and conduct virtual tele-hearings more efficiently. Veterans can have hearings at the location of their choice, with their caregivers and representatives present. The experience for both Veterans and VA staff is better.

Caseflow was recognized with a 2020 FedHealthIT Innovation Award.

Process

Continuously innovating

Starting with a small initial effort enabled the team to launch the new system for virtual tele-hearings quickly — and to test, iterate, and improve upon it before deploying across the Board.

As we worked on the initial hearings, we uncovered new goals and opportunities for improving the virtual tele-hearings system. As one example, we quickly learned that VA hearing coordinators need to be able to see the information that Veterans receive about their hearings. Within a couple weeks, we were able to meet this top need and provide VA staff with more information.

In the month that followed, the team provided VA staff with more context by updating Caseflow to display the whole email history to coordinators. Previously, coordinators could not see the emails sent to Veterans about hearing dates and changes, who had sent them, and when. This limitation made it difficult for them to answer questions from Veterans about the emails they received.

Integrating with existing workflows

Adding the new virtual tele-hearings system within the existing Caseflow workflow was essential to our success. It saved VA staffers time because it kept their work in the same place. VA staffers could also immediately see and feel the increase in speed and accuracy of their work thanks to improved features like automated emails. Instead of making staffers manually enter information into a duplicative system, Caseflow automatically, instantaneously sends emails with updated hearing details and populates a virtual hearing email history in realtime. This improvement reduces errors, increases accuracy, and saves VA staffers time—according to one user, about 10-15 minutes per hearing scheduled.

Delivering during a crisis—quickly

While VA already knew it needed to—and could—increase its capacity to serve Veterans remotely with virtual tele-hearings, the onset of the COVID-19 pandemic demanded that changes happen quickly. At the same time, the pandemic could have derailed the project: teams across the country had to adapt to things like new workflows, additional responsibilities, and different means of communication.

The Board and Nava launched quickly, got real-time feedback, and rapidly responded to it. Staying focused on this process helped us work deliberately and ultimately deliver better services for Veterans amidst the crisis.