North Charlotte VA Clinic

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), 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.

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)) calculations include additional steps in the appointment process not 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 particular 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 confirm an appointment is 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 their care experience when they request care.

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 also implemented a new 3-digit number (988) to reach the National Suicide Prevention Lifeline and the Veterans Crisis Line.

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. Importantly, average wait times do not determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Instead, the website represents a guide that can assist Veterans in making informed health care decisions.

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 the 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.

Link to YouTube - "Understanding the Third Next Available Appointment"

The information displayed on our website represents an average of recent Veteran experiences when seeking care. 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.

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 also implemented a new 3-digit number (988) to reach the National Suicide Prevention Lifeline and the Veterans Crisis Line.

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.

No. Wait time and TNAA 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 serve as a guide to help you consider your healthcare options. VA does not use average wait times or TNAA 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.

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 to refill, 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.

You are a new patient if a provider or a clinical service has not seen you at the same medical center for the same, or a related, health care need in the past three years. Suppose 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); In that case, you are considered an established patient.

All VA sites use average wait times except for those that have transitioned to the new electronic health record (EHR). Sites that have transitioned to VA's new EHR system 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 their care experience when they request care. Importantly, average wait times do not determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Instead, 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 system, the average wait time calculation uses the earliest time a request for care is consistently recorded in the scheduling system to the date the appointment shows a completed status - or the date scheduled for care 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 endpoint is the date care is received or the date scheduled for care 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 scheduled for care 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 scheduled for care 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 confirm an appointment is to contact your local facility or use the online Make an appointment button on this site. Importantly, average wait times and TNAA do not determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Instead, the website represents a guide that can assist Veterans in making informed health care decisions.

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 the Veteran experience.

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

Both average wait time and TNAA data updates daily.

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 or TNAA 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 confirm an appointment is to contact your local facility or use the online Make an appointment button on this site. Importantly, average wait times and TNAA do not determine eligibility for community care, and none of the changes on the website affect eligibility for community care. Instead, the website represents a guide that can assist Veterans in making informed health care decisions.

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 and TNAA 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.

"No New Appointments" or "No Return Appointments" means that zero new or return appointments occurred at that clinic or location in that specialty in the previous month. This response is more likely to occur in smaller, lower-volume clinics.