American Lake VA Medical Center

Access to Care Website Frequently Asked Questions

• Why did VA decide on these changes?

  Providing Veterans with meaningful information to make informed decisions about their health care journeys is a top priority for VA. VA has published average wait times for primary care, mental health, and specialty care appointments at each of its medical centers since 2014, in accordance with federal law. Since that time, VA has received feedback from Veterans, caregivers, veterans service organizations, oversight authorities, and Congress, which led the Department to initiate efforts to revise the wait time metrics presented on the Access to Care website to better reflect the Veteran experience when seeking healthcare in the VHA system. As part of this process, VA conducted focus groups that included a diverse representation of Veterans in categories including age, era, race/ethnicity, utilization type (in-person/telehealth), gender, and geography.

  While there is no perfect way to measure wait times in aggregate, VA is making changes that represent a meaningful improvement in how the Department presents this information to Veterans. In addition to updating the wait time calculations themselves, website updates also provide Veterans with more relevant information to help inform health care decisions, including:

  • Veteran experience information,
  • increased detail on timeliness within health care subspecialties; and
  • the ability to more easily view relevant medical center information.
• What has changed on the Access to Care site?

  Improved User Experience

  VA has incorporated Veteran feedback to drive updates to the Access to Care website, providing additional access information for Veterans to use as they plan their health care journeys. Veterans will find a more user-friendly Access to Care site with more information they have told us matters to them. VA has included Veteran experience information, increased detailed information available about certain health care subspecialties, and streamlined the site to make it easier to navigate.

  Updated Wait Time Methodology

  To further improve user experience, VA has also upgraded the way average wait times are calculated and displayed on the website. Importantly, average wait times are never used to determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Rather, the website represents a guide that can assist Veterans in making informed health care decisions.

  Average wait times for all Veterans Health Administration (VHA) medical centers and clinics (except those that have transitioned to VA’s new Electronic Health Record (EHR)) are now calculated to include additional steps in the appointment process that had not been captured in the past. Averages are representative of general performance and may not represent individual experience, but the upgraded calculation makes the website more reflective of the complete process of requesting and receiving care.

  Notably, averages that reflect a small number of appointments – for example, in a geographic area where only a few Veterans seek a certain type of subspecialty care in any given month - may show average wait times that are skewed high or low due to the small number. The best way to find out when you can be seen is always to contact your local facility or use the online Make an appointment button on this site.

  Additionally, VA is in the process of implementing a new electronic health record (EHR) system, and sites that have fully implemented this new system are using a more modern, industry standard measure of timeliness, called Third Next Available Appointment. Other major health systems also use this measure, and it reflects availability for upcoming appointments, so that Veterans can anticipate what their experience will be when they request care.

  Expanded Display of Mental Health Services

  VA is also updating and expanding information for Mental Health services on the Access to Care website and plans to provide additional subspecialties in the future. By displaying average wait times for health care subspecialties, Veterans can see average break downs for the treatment programs, including Individual and Group Therapy, for General Mental Health, Substance Use Disorder programs, Primary Care-Mental Health Integrated Care, and PTSD Specific Programs.

  If you need to be seen by a provider before your next scheduled appointment, same-day services may be an option. Please contact your local facility. If you or someone you know is in emotional crisis, please call the Veterans Crisis Line 1-800-273-TALK (8255) Press 1 for Veterans. Someone who can help you will answer right away. VCL is also planning for the launch of 988, a new 3-digit-number to reach the National Suicide Prevention Lifeline and the Veterans Crisis Line, which will be fully implemented by July 16, 2022.

  As above, averages that reflect a small number of appointments – for example, in a geographic area where only a few Veterans seek a certain type of subspecialty care in any given month - may show average wait times that are skewed high or low due to the small number. The best way to find out when you can be seen is always to contact your local facility or use the online Make an appointment button on this site. Importantly, average wait times are never used to determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Rather, the website represents a guide that can assist Veterans in making informed health care decisions.

• How do I find out when an appointment will be available at a clinic in my VA medical facility?

  The information displayed on our website represents an average of recent Veteran experiences when seeking care and is meant to be used as a guide. The best way to know when an appointment is available for you is to contact your local VA facility or use the online Make an appointment button on this site.

• What if I need to be seen for an issue that can’t wait until my next scheduled appointment or if I can’t schedule an appointment in a timely manner?

  If you believe you are experiencing a medical or emotional emergency, you should immediately seek care at the nearest emergency department. A medical emergency is an injury, illness or symptom so severe that a delay in seeking immediate medical attention would be reasonably expected to be hazardous to life or health. If you believe your life or health is in danger, call 911 or go to the nearest emergency department right away.

  If you need to be seen by a provider before your next scheduled appointment, same-day services may be an option. Please contact your local facility. If you or someone you know is in emotional crisis, please call the Veterans Crisis Line 1-800-273-TALK (8255) Press 1 for Veterans. Someone who can help you will answer right away. VCL is also planning for the launch of 988, a new 3-digit-number to reach the National Suicide Prevention Lifeline and the Veterans Crisis Line, which will be fully implemented by July 16, 2022.

  For non-life-threatening situations such as scrapes and minor ailments, you can usually go to urgent care. Many VA facilities offer urgent care services and VA also has a large community urgent care network available to eligible Veterans.

  • You can use the VA Facility Locator to find your closest VA urgent care locations or learn more about VA’s urgent care benefit on VA.gov.
  • To better understand whether you need urgent care or emergency care, check out Choosing Between Urgent And Emergency Care | Veterans Affairs (va.gov)

  VA also offers same-day in-person or virtual health care services as well as the ability to communicate with your health care team via secure messaging, phone, or email to answer your health concerns or help refill a prescription. Contact your health care team to see if same-day services are appropriate for your situation.

• Does VA use average wait times to determine whether I am eligible for community care?

  No. Wait time eligibility for community care is always based on the time it takes for an individual Veteran to obtain a specific type of care. Average wait times shared on www.AccesstoCare.VA.gov represent an average experience and are meant to be used as a guide to help you consider your healthcare options. VA does not use average wait times to determine community care eligibility. Information on community care eligibility can be found via the following link: https://www.va.gov/communitycare/programs/veterans/general_care.asp.

• What is VA doing to improve access to care for Veterans?

  Veterans are at the center of everything we do and it’s our mission to deliver timely access to world-class care. VA is providing more care, more benefits and more services to more Veterans than ever. Just a few areas where VA has worked to improve access to care for Veterans include:

  • VA is working to create a more seamless and coordinated experience for Veterans using VA whether they are seeking care from VA or community providers.
  • VA has been a pioneer in telehealth and continues to be a leader in providing virtual care options to Veterans, including new Clinical Contact Centers that are available when Veterans need answers from a nurse, have a prescription that needs to be refilled, want to schedule an appointment or set up a video visit with a provider.

  Outcomes drive everything we do—because Veterans, not us, are the ultimate judges of our success.

• How does VA define New vs. Established patients?

  You are considered a new patient if you have not been seen by a provider or a clinical service at the same medical center for the same, or a related, health care need in the past three years. If you had an appointment in a clinical service at the same medical center for the same or similar health care need in the past three years (either in person or via phone/video), you are considered an established patient.

• How does VA calculate average wait times?

  Average wait times are used at all VA sites except for those that have transitioned to the new electronic health record (EHR). Sites that have transitioned to VA’s new EHR are using a more modern, industry standard measure of timeliness called Third Next Available Appointment (TNAA). Other major health systems also use this measure, and it reflects availability for upcoming appointments, so that Veterans can anticipate what their experience will be when they request care. Importantly, average wait times are never used to determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Rather, the website represents a guide that can assist Veterans in making informed health care decisions.

  For new patient appointments at sites that have not transitioned to the new EHR, average wait time is calculated from the earliest time a request for care is consistently recorded in the scheduling system to the date the appointment is completed – or the date it is scheduled to occur if not yet completed. In many cases, Veterans who need a new type of care will have a referral entered by their provider into the medical record during a visit, and this starts the care coordination process. For appointments with a referral, this referral date is the starting point used for measuring average wait times and the end point is the date care is received or the date it is scheduled to occur if not yet completed.

  For new patient appointments without a referral, the average wait time starts with the earliest recorded date in the process of receiving care - typically the date a scheduler works with a Veteran to coordinate a future appointment - to the date care is received or the date it is scheduled to occur if not yet completed.

  For established patient appointments, average wait times are measured from the date agreed upon between a Veteran and provider for future care and ends on the date care is received, or the date that care is scheduled to occur if it has not yet occurred.

  Note: As above, averages that reflect a small number of appointments – for example, in a geographic area where only a few Veterans seek a certain type of subspecialty care in any given month – may show average wait times that are skewed high or low due to the small number. The best way to find out when you can be seen is always to contact your local facility or use the online Make an appointment button on this site. Importantly, average wait times are never used to determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Rather, the website represents a guide that can assist Veterans in making informed health care decisions.

• It looks like Veterans are actually waiting longer for care. Are they now waiting longer?

  No. Veterans are not waiting longer for care. Average wait times are now more Veteran-centered, better reflecting the full experience of when their care was requested and received. Averages are representative of general performance and may not represent individual experience, but the upgraded calculation makes the website more reflective of the complete process of requesting and receiving care. New average wait times better align with Veteran experience.

• Why is the information different at some locations?

  Sites that have implemented VA's new electronic health record will display wait times using a more standard measure known as Third Next Available Appointment (TNAA). Other major health systems also use this measure and it reflects availability for upcoming appointments so Veterans can anticipate what their experience will be when they request care.

  View VA's new electronic health records locations.

  • EHR Deployment Schedule - VA EHR Modernization

• What is a Third Next Available Appointment?

  TNAA is a measure of appointment availability that displays the number of days between today's date and the date of the third-next appointment available in VA's scheduling system. The technology in our new electronic health record system allows us to use this more standard measure at these sites. Other major health systems also use this measure and it is considered a more accurate measure of elective service availability than the next available appointment or second-next available appointment, which fluctuate too rapidly to be reliable.

  VA is transitioning to use of TNAA for several reasons including that this measure represents a more standard view of the timeliness a Veteran is likely to experience when seeking care and ensures consistency in measuring appointment availability across VA medical centers as the enterprise transitions to a new EHR.

• How often is this wait time data updated?

  Both average wait time and TNAA data are refreshed on a daily basis.

  Note: As above, averages that reflect a small number of appointments – for example, in a geographic area where only a few Veterans seek a certain type of subspecialty care in any given month – may show average wait times that are skewed high or low due to the small number. In these cases, averages may vary widely day to day, as a single appointment can change the average.

  The best way to find out when you can be seen is always to contact your local facility or use the online Make an appointment button on this site. Importantly, average wait times are never used to determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Rather, the website represents a guide that can assist Veterans in making informed health care decisions.

• Can I compare VA wait times to those in the community?

  Not at this time. VA provides wait time data on www.AccesstoCare.VA.gov so that Veterans can make informed decisions about their health care, but we are one of the only systems to do so. Other health care systems do not have a requirement to collect wait time information and generally do not share wait times.

  Importantly, wait time measures represent only one aspect of the Veteran health care experience. Veteran experience, trust and quality are measures that Veterans have told us matter to them.

• What does it mean when the tool provides a response of "No New Appointments" or "No Return Appointments" under Average Wait Time?

  This means there were zero new or return appointments scheduled at that clinic or location in that specialty in the previous month.This is more likely to occur in smaller, lower-volume clinics.