Table 1.

MSAs Helping Veterans Obtain Needed Care

Healthcare system challenges	Illustrative excerpts from interview notes
Problems with automated refill system	There’s a number for patients to use an automated system (for prescriptions) but it’s not picking up their information so there’s a glitch. So frustrated patients call in for prescriptions. —Notes from CC MSA interview
Medication refill questions	Patients call and want to speak to their PCP about issues that can be handled by phone, which might be a refill, that MSA can take care of without involving the PCP. —Notes from CC MSA interview
Veterans seeking assistance reaching their specialists	Some patients can’t get through to specialty clinics. It’s not always a scheduling issue. MSA can give the Veteran options, but they want to talk to the actual clinic. The older Veterans want to speak to their doctors, they don’t want to send a message. —Notes from CC MSA interview
Veteran expressing frustration at not being able to speak to their provider	Veterans get angry when they can’t get transferred to their teams… they feel like they are getting the run around. MSA just sits there and lets them unload. —Notes from CC MSA interview
Veteran experiencing callback loops	The PC team might not call the patient back in a timely manner. Some clinics are notorious for that. It’s hard for MSA to take those calls. MSA reports the same people calling so knows which clinics are bad at calling back. —Notes from CC MSA interview
Veterans cancelling and rescheduling appointments	Rescheduling patients is challenging… that is MSA’s main problem, the constant cancellations. —Notes from PC MSA interview
Veterans expressing frustration over clinic cancellations	Providers calling in sick causes issues for patients who come a long way. MSA has figured out a lot of situations to deal with upset patients, patients in pain, and patients upset with the VA in general. —Notes from PC MSA interview
Veterans experiencing problems checking in with kiosks	There are two kiosks for patients to check in, so MSA helps patients use them. MSA works the floor. People don’t fully check in on the kiosks. When MSA is working, it’s not a problem. —Notes from PC MSA interview
Veterans showing up to the wrong clinic	There are issues where patients are in the wrong area. Patients check in for dermatology and then come to primary care, so MSA skypes the health techs to let them know. —Notes from PC MSA interview
Veterans walking into PC clinic.	MSA checks patients in and out, answers questions, relays messages, etc. Patients walk in for everything. MSA tries to get them to use the kiosks. —Notes from PC MSA interview

CC, call center