Update VEText page with additional types of PHI and short codes

[laurwill]

As part of our work on the MHV appointment reminder emails, we reviewed the VEText appointment reminders. We realized the PHI versions of the text reminders contain more PHI than what we describe on our static page. We also need to add new short codes the texts may use.

Types of PHI:

Short codes:

[laurwill]

Hi @jwowk , here's the ticket where we'll track the page updates. Our content team is OOO next week, so I'll pick this up on 7/8!

[JamieRamsay]

@jwowk @laurwill @shanemelliott we have some updates we're requesting to add to this page ahead of the launch of VEText Federal EHR. Some of the codes need updates as well as some explanation. We are going live tomorrow, is there a way to make these today?

1. Recommendation to use VADS blue alert at top of page to announce the new VEText Federal EHR

2. Update "Getting locations in appointment reminders" section with the new text below:

Receiving basic VEText appointment reminders
Basic VEText reminders include Non-Protected Health Information (Non-PHI). Non-PHI appointment reminders include date, time, and the option to confirm or cancel your upcoming appointment. They do not include the address of your appointment or the name of the facility/clinic, which is considered Protected Health Information (PHI). If you do not want to receive PHI, you do not need to do anything.

To receive facility and clinic locations in your VEText appointment reminders, reply to a VEText appointment reminder with PHI or the 5-digit zip code for your home address. Or text your zip code to 58404.

You will receive instructions on how to begin including your name and the name of the VA health facility in each reminder. The following VA Medical Centers (VAMC) and their associated clinics use VEText Federal EHR: Captain James A Lovell IL FHCC; Chalmers P Wylie OH VA Ambulatory Care Center; Jonathan M Wainwright WA VAMC; Mann-Grandstaff WA VAMC; Roseburg, OR VAMC; and White City, OR VAMC. This change will take effect for future reminders and is not immediate.

To receive locations for all other VA health facility appointments, reply to a VEText reminder with the 5-digit zip code for your home address. Or text your zip code to 53079. VEText appointment reminders will begin to show your name, the name of the facility or clinic whose appointment you are scheduled for, and the physical address of the VA medical center facility or clinic. This change will take effect for future reminders and is not immediate.

To stop receiving locations, reply BASIC to a VEText reminder. You will no longer receive personalized reminders with the facility/clinic name and address.

You can also text BASIC to these numbers to stop including your name and the facility name in your text messages:

• Text BASIC to 58404. (Federal EHR Facilities)
• Text BASIC to 53079. (All other facilities)

3. Update section "How to opt out of VEText - or opt back in" with the following text:

How to opt out of VEText - or opt back in
If you previously received text message appointment reminders at a Federal EHR facility, we will automatically send you text appointment reminders. If you have never received text message appointment reminders at a Federal EHR facility, you must opt-in through your provider. The following facilities and their associated clinics use the Federal EHR: Captain James A Lovell IL FHCC; Chalmers P Wylie OH VA Ambulatory Care Center; Jonathan M Wainwright WA VAMC; Mann-Grandstaff WA VAMC; Roseburg, OR VAMC; and White City, OR VAMC.

At all other facilities, if we have your mobile phone number in our records, we will automatically send you text appointment reminders.

Here’s how to opt out or opt back in at Federal EHR facilities:

• To opt out of all VEText messages, reply STOP to any previous VEText message. Or text STOP to 58404.
• To opt back in to VEText messages, reply START to a previous message or text START to 58404.

Here’s how to opt out or opt back in at all other facilities:

• To opt out of all VEText messages, reply STOP ALL to any previous VEText message. Or text STOP ALL to 53079.
• To opt out of a certain message type, reply STOP to a previous message of that type.
• To opt back in to a certain message type, reply START to a previous message of that type.

You can also text STOP or START to these numbers for certain message types:

• For prescription tracking texts, text 53941.
• For vaccine reminders and emergency texts, text 80728.

Check with your provider to see if your facility sends vaccine reminders and emergency texts.

Or you can call your VA health facility. Ask to connect with the VEText coordinator or medical support assistant.

Find your VA health facility

4. Add three question and answers to the FAQ section:

Does my facility use VEText Federal EHR?

The following facilities and their associated clinics use the Federal EHR: Captain James A Lovell IL FHCC; Chalmers P Wylie OH VA Ambulatory Care Center; Jonathan M Wainwright WA VAMC; Mann-Grandstaff WA VAMC; Roseburg, OR VAMC; and White City, OR VAMC. If you would like to receive VEText text message reminders at these facilities, confirm with your provider that you are opted-in. Ask to connect with the VEText coordinator or medical support assistant.

What if I am not receiving text message appointment reminders?

Call your VA health facility. Ask to connect with the VEText coordinator or medical support assistant. You can also speak with a front desk staff person when you are in your provider’s office to confirm that you are set up to receive text message reminders.

If I opt-in to receive location information in my appointment reminders, will those messages begin immediately?

No. Once you have texted your zip code or the reply code to a message, you will receive instructions to verify that you would like to receive text message appointment reminders. Reminders that include location information will be sent for any appointment reminders that you receive in the future and is not immediate.

[JamieRamsay]

Visual comparison of current and proposed sections on the page for reference:

[laurwill]

Hi @JamieRamsay , we'll need to put these updates through our editorial process to align with the VA style guide, and there's quite a bit of new content here, so it's unlikely we'll be able to publish today. But if the content on the live page will be inaccurate starting tomorrow, we can try to prioritize making these updates as quickly as possible.

I have a few initial questions:

• Is "VEText Federal EHR" a separate notification system from the VEText system we already describe on this page? Or is the same system rolling out to Oracle facilities? (We avoid introducing new branded program names on VA.gov to reduce cognitive load, so unless Veterans need to know the name of the program, we wouldn't use "VEText Federal EHR" in our site content.)
• The way we handle describing different processes for Oracle Health vs. Vista Health facilities elsewhere on the site involves authentication — after a Veteran signs in, we show them Oracle-specific content if we see that they're registered at Oracle facilities. Since this is an unauthenticated page, we'll have to find a different approach here. Is the key difference that the 2 facility types use different short codes? Are there any other differences in functionality between Oracle and Vista facilities?
• Does the launch include direct outreach to Veterans at the facilities that now support VEText, and will those communications link to this VA.gov page? I'm not sure adding an info alert on this page will reach the intended audience, because Veterans who weren't previously able to use VEText probably aren't visiting this page. (And if they come to this page after receiving a direct communication about the change, they already know that their facility uses it now.)

Since this is a timely request, a quick call might make sense to clear some of this up — I'll reach out on slack and see if we can set something up. Thanks!

[JamieRamsay]

Thank you so much for your attention @laurwill . We recognize the editorial process involved and appreciate your prioritizing this request. Happy to meet up this afternoon!

1. VEText Federal EHR is the same system rolling out to Oracle facilities/Federal EHR. However, due to the differences in the EHRs, they are built slightly differently on the backend, which also necessitates a different short code for each, and some different reply codes. So the codes are not interchangeable, although some of the replies are the same.
   We recognize the cognitive load this presents and are open to changing formatting to make this more digestible.

I'm running into meeting and happy to clarify the rest via a call!

[JamieRamsay]

2. If we had a way to authenticate to show content, that would be ideal. It would eliminate needs for the "if this, then do this" type of instructions. Interested in hearing more.
   The functionality is mostly the same, thought VEText VistA has more features that are not yet part of VEText Federal EHR. The initial release of VEText Federal EHR will have basic functionality and more features will roll out over time.

3. Because we were unsure of how quickly this page could get updated, we opted to not include the link to this page in other Comms that are going out about the release. The update to the page was to insure that if a Veteran heard about it, and searched VA for more information that led them to this page, the information would be there.

[laurwill]

Lots of updates here after slack convos:

• I added an info alert to the top of the VEText page that lists the 6 facilities and links to a new Q&A accordion at the bottom of the page
• The new Q&A includes need-to-know info (short code, opt in and opt out, how to ask questions), and says we'll add complete info soon
• @JamieRamsay got approval for the alert and Q&A content
• @megzehn copyedited and published, and I'll confirm when it's live

I'm OOO tomorrow and Friday, but noting next steps to pick up next week:

• Need to update the info about PHI options for both Vista and Oracle
• Need to find a more permanent content solution to provide the different short codes and instructions for Oracle facilities

[laurwill]

Hi @JamieRamsay @jwowk ,

I made some draft updates to the VEText page:

• Changed tense to present tense and removed dates in the info alert and Q&A about My VA Health facilities
• Adjusted the content about getting "locations" to talk about getting facility and clinic information (since the texts can include the clinic name, facility name, and location of facility and clinic) and added a more direct statement that this is personal health information

Could you review the draft updates and let me know if you have any accuracy concerns? Thank you!

Preview of draft updates: http://preview-prod.vfs.va.gov/preview?nodeId=51963

[JamieRamsay]

@laurwill sorry I was out of the office the last two weeks. Is the link still active? I cannot seem to open the preview.

Whoops, nevermind, I can open it, looking at this now!

[JamieRamsay]

I think removing the dates from FEHR sites is a good call at this point. Smart.

As for the "Getting locations update", yes, I think that addition helps clarify.
The current text does not clearly point out that the clinic name is also not included, which is important to point out. I think also adding the "why" (because there names and locations are part of your PHI) helps with transparency.

One update to make for sites that use My VA Health and signing up for PHI messages:
To start getting facility and clinic information in your text reminders, reply PHI to a VEText reminder. Or text your 5-digit zip code for your home address to 54804.

[laurwill]

Hi @JamieRamsay , great, thanks for reviewing! For the "reply PHI" instruction, is that option necessary in addition to the zip code option? We don't use the acronym PHI in any of our Veteran-facing content and I don't think it's a familiar acronym to non-health professionals, so this will just look like a random string of numbers (or maybe a Greek letter!) to most people.

@jwowk have you had a chance to look at the proposed updates? Happy to hop on a call if that's easier. Thanks!

[JamieRamsay]

@laurwill no problem! Agreed that the term "PHI" is probably unfamiliar to folks, but in this case, that is the actual 3 letter code they text (similar to Y1 or N1 to confirm and cancel respectively) in order to opt in to getting locations and their name in text messages (opt in to PHI messages). We have talked about changing the actual 3 letter code they text for opt in, but, currently, it is P-H-I.

[laurwill]

Hey @jwowk , just checking in about these updates — the alert on this page is very outdated now, so I'd like to publish these asap. Let me know if a quick sync would be easier to review! Happy to set something up.

[JamieRamsay]

@laurwill Updates look good

Again, the only addition I would suggest is adding the information in the
"How does VEText work at facilities that use My VA Health"

that in addition to texting their zip code, Users may also reply "PHI" to a reminder to start getting facility and clinic information in their text reminders

[laurwill]

Oh yes! I was planning to add that after your last response, thanks for the reminder. Will do now.

[JamieRamsay]

@laurwill Morning! I do not see your latest version updated online. Do you still need input to make those changes?

[laurwill]

Hi @JamieRamsay , I was waiting for approval from Justin (apologies if your last replies were meant to be from both of you, I thought he needed to approve separately like the last time we updated the page). But I connected with Justin over Slack yesterday, so we'll move this to final copyedit and publishing now. Thanks!

@saratorres2 could you copyedit, prepub, and publish the updates to this page, including the info alert at the top? This is ready to go live when you're finished, and let me know if you have any Qs!

[JamieRamsay]

No worries @laurwill :) I appreciate your diligence in making sure everyone was on board! Please let me know if you need anything else from me and thank you again for keeping page current and most useful!

[saratorres2]

@laurwill I copy edited and published these changes. The updated page is now live. https://www.va.gov/resources/vetext-for-va-health-care-reminders-and-updates/

[laurwill]

Thanks Sara! Moving to validate