The effort has put the VA ahead of other federal agencies, where initiatives are underway to slough off old stereotypes about bureaucratic inefficiencies.
By Melanie Warner, Workflow contributor
The first time John Boerstler filed a medical claim as a veteran, he spent several hours at a Veterans Administration (VA) regional office in Houston filling out forms and talking with a service rep. The rep said she would need to send medical records requests to the military and to Boerstler’s previous health insurer. This would take time, she warned.
She wasn’t kidding. Boerstler, a former Marine, didn’t hear back about his claim for almost a year after he filed it in 2009. It was the kind of slow, complicated, paper-based experience many Americans have come to view as a frustratingly normal part of dealing with government services.
Today, Boerstler, who is now the VA’s chief veterans experience officer, has a very different story to tell. Earlier this year, he says he spent less than 15 minutes on VA.gov filing a claim for his chronic sinusitis and rhinitis, caused by the use of burn pits on the base where he was stationed in Iraq. “I was able to push a button and send the PDF forms to the healthcare system, where my claim automatically showed up in the queue for the veteran service representative,” he says. This time, the whole process took a couple months. “Nobody knew who I was. I’m just another veteran applying for sinusitis and rhinitis.”
Boerstler’s experiences offer a glimpse into how the VA’s interactions with the 9 million veterans it serves have changed in recent years. In 2014, a scandal involving medical appointment wait times rocked the VA. Investigations found that veterans were enduring long waits to see doctors, some dying in the process and leading to the resignation of Eric Shinseki, the VA chief at the time. A few years later, when the agency asked veterans about the overall experience it was providing, the results were not encouraging. In 2016, only 55% said they trusted the VA, according to Boerstler. Now, that trust score sits at 79%, putting it in company with leading consumer brands like Starbucks, USAA, and Warby Parker. The proportion of vets who report positive experiences specifically with VA healthcare is even higher: 90%.
How did things change so dramatically for an immense organization of 9 million “customers” and 400,000 employees? Following the wait-time scandal, the Government Accountability Office took the VA to task for failing to provide timely care to patients and for its lumbering, inefficient processes like the ones Boerstler experienced. Taken as a mandate, the agency vowed to modernize systems, simplify operations, and rebuild trust among veterans—in other words, become “the No. 1 customer-service agency in government,” as VA head Robert McDonald put it to Congress in 2016.
Achieving it hasn’t been easy. Boerstler, who joined the VA in early 2021, credits previous leaders with taking the long view. “Early on, they realized customer experience wasn’t going to be a quick fix. It was something that had to be hard-wired into an organization,” he says. He attributes the VA’s success to a combination of a human-centered design and “massive investments” in training, organizational change, new technologies, digital transformation, and systems for continuous feedback.
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