The VA’s Best Kept Secret? A Qualitative Exploration of Veteran Experiences and Satisfaction with VA Call Center’s Tele-Triage and Virtual Urgent Care Appointments (Preprint)

BACKGROUND Virtual healthcare models that incorporate registered nurse (RN) triage with rapid access to same-day virtual visits with clinicians represent a growing innovation in healthcare delivery. While traditional telephone advice lines focus primarily on RN-led triage and care navigation, systems such as the Department of Veterans Affairs (VA) are beginning to embed physicians and advanced practice providers directly into these platforms. This hybrid model has potential to enhance clinical responsiveness, reduce unnecessary emergency department (ED) and urgent care visits, and increase patient satisfaction by providing timely care from home. OBJECTIVE The aim of this study was to explore Veterans’ experiences and perceptions of the VA’s integrated virtual triage and urgent care model, specifically through the VA Health Connect platform. We sought to understand how Veterans learned about and interacted with these services and to gather their insights on aspects to preserve or improve. METHODS We conducted in-depth qualitative interviews with 24 Veterans from various geographical regions served by six VA healthcare systems. Participants were recruited from recent respondents to the V-Signals survey, who indicated willingness to discuss their experiences further. Interviews were carried out between June 18 and August 8, 2024. Data were analyzed using a qualitative descriptive approach with constant comparison to identify emergent themes and representative quotes. RESULTS Participants reported high satisfaction with VA Health Connect’s nurse triage and virtual clinical visit (VCV) services. Key benefits included timeliness of care, personal time savings, efficient service organization, and positive interactions with nurses and providers. Veterans appreciated the convenience of resolving health issues quickly and remotely, often citing significant travel burdens avoided. They also highlighted the knowledgeable and personalized clinical advice received. However, several areas for improvement were identified. Some Veterans expressed frustration about being routed to nurse triage instead of directly scheduling with their primary care providers (PCP). Moreover, many were initially unaware of the full range of services available through VA Health Connect and suggested enhanced outreach and communication strategies. CONCLUSIONS Veterans are highly satisfied with the VA Health Connect model, valuing its timeliness, convenience, and the professionalism of clinical staff. Effective promotion and clear communication about the capabilities and limitations of the service could further enhance user experience and uptake. As this integrated care model continues to evolve, its success will depend on effectively integrating virtual services into routine care and ensuring Veterans are well-informed and confident in using these resources. CLINICALTRIAL N/A