Table 6.

Exemplar quotes of suggestions to improve Secure Messaging.

Theme	Exemplar quotes
Improve ease of navigation and use	It’s not so easy to get that [Secure Messaging] page where you first start doing it ‘cause it seems like every time I do it I have to, I don’t know, like I end up “Googling” My HealtheVet and then I have to look and try and find it and then I have click here and then I have to…I don’t know [laughter].
	So it’s hard to find what I’m looking for because as a patient what I’m looking for is, you know, a priority. You gotta figure most patients are like me and they would want appointments and, uh, appointments, medications, and possibly talk to the doctor, but you got all this other stuff, uh, that is competing for your attention.
	As it is built right now, I think it keeps me from using it and so it would have to streamline, you know, for me to [use]…have to make it user customized…
Features	What I would like to see in the near future, would like to see that Secure Messaging, going probably in some kind of an application in the cell phone, like they’ve been doing, like with the PTSD program. They have some kind of application…but will be great, you know, using the cell phone and having application that can connect you directly. That will be great.
	A Web cam, you know what I mean. You could probably do it with that if you could adjust it… you could click on it and see what it looks like and either gives me a decision of what it or, you know, a picture or whatever.
Screen visualization	Uh, the Secure Messaging [button] is way up in the right hand corner off the screen and I think it should be more in a more recognizable place, ‘cause if you didn’t know it was there you wouldn’t know it’s there, so I would think to place the button in a more visual place on the, uh, screen, on the window.
Access to specialty clinics	Being able to secure message other clinics that I receive care in if there’s other doctors that I see. I see doctors in the stroke clinic, I see doctors in the MOVE clinic, the weight management clinic, um, so I think it would be nice if I could communicate with weight management clinic and the stroke clinic.
Awareness, education, marketing	I think that they should have some kind of tutorial, to show every veteran [Secure Messaging] uses so at least everybody would be knowledgeable. Once you see the home page of My HealtheVet, you think it’s too cumbersome or too much to get involved…people don’t want to go any further than refills. I think there should be a way on the main page to give them a tutorial on how to use [Secure Messaging] to make it useful to each and every vet.
	You don’t get any notification on your email. For instance, like, my email is Hotmail so I don’t get any notification telling me that ‘hey, you’ve got a message on your Secure Messaging, VA has sent you a secure message’ so I don’t get any of that feedback because I’m only on the SM when I need to be…
	I don’t see any problems with [Secure Messaging] so I wouldn’t change anything. It’s just getting the information out to the veterans to let them know that there is a convenient and secure way to communicate with your primary.
	For me, I honestly, I probably wouldn’t drive all the way to the hospital to go to an education class on [Secure Messaging], but if they would put the same education video on the website, I might watch it so I don’t have to learn through trial and error.
	I especially like to read, so if they would just provide information on the website as far as a short piece about how [Secure Messaging] works, what are the benefits, and how to use it, I would definitely read it. I’m not a big fan of paper so I would definitely be happy with something that was online.