VHA takes its forms online

As a Vietnam veteran of the Army Nursing Corps, Mary Stout has seen her share of government forms and paperwork.In her current role as the Veterans Health Administration’s chief of forms, publications and records management, Stout has labored to move the agency from paper to electronic forms.While the project has streamlined processes and saved money, congressional mandates were a big reason the initiative was launched.“It came about primarily because of the Government Paperwork Elimination Act and the Americans with Disabilities Act, which basically say all members of the public need to be able to interact electronically with government agencies,” Stout said.After a broad search, VHA officials selected Adobe products for the project. Electronic forms are created with Adobe Designer and are posted using Adobe Reader Extension. Veterans can complete the forms online or offline using Adobe Reader.Serving about 4.5 million patients at more than 800 health care facilities creates a lot of paperwork.“We have a number of applications that people need to fill out in order to get benefits,” Stout said. “Previously, we had them basically go to a Web site, print out a blank form and fill it out by hand.”Now that can all be accomplished using a PC. About 55 public-use forms have been converted to electronic forms, Stout said.With so many veterans—and their families—and so many forms, a ubiquitous system was required, said Rebecca Chisolm, director of Government Worldwide at Adobe Systems Inc.“One of the things [VHA] wanted was the ability for any veteran—regardless if they are at home, at a VA office, at a library or wherever—to be able to access these forms,” Chisolm said.That’s possible since Adobe Reader is free and exists on most PCs.Another requirement was to find a way to not lose all the work that had been put into its forms before the project. Previously, a system called JetForms was used to design forms and make them available online.Veterans weren’t able to fill those forms out electronically, but the paperwork represented the most up-to-date version of the agency’s forms.“Because we had converted a number of forms already into JetForms, we wanted to be able to use that work, so we needed a product that could convert those forms,” Stout said. “It also had to be of no cost to veterans, so we had to have something that they would not have to buy a filler application for.”Another key part of the project was ensuring that users—including aging veterans—were comfortable with the transition. Paying attention to aesthetics helped address that issue.“We were able to take the VA paper forms that people are used to seeing and replicate the look and feel of those forms,” Chisolm said. “One of the barriers we’ve seen to adopting electronic forms, and the whole movement to true paper elimination, is that people are used to working with paper forms, and if you change that and make [the forms] look different or act differently, that can become a barrier to adoption.”Another way to boost adoption was to make sure the system worked with assistive technology such as screen readers. Section 508 of the Rehabilitation Act Amendments of 1998, which require federal agencies to make their information technology accessible to people with disabilities, was also a factor.Making the form-filling process easier was another key to the success of the project, Chisolm said. Under the paper system, repetition was the norm.“I don’t think there’s anything more frustrating for people than having to constantly type and retype their name, birth date and address,” Chisolm said. “Once they type in their name or Social Security number or ID number, the system—through [Extensible Markup Language]—can go back and pull in the veteran’s data so they don’t have to keep typing it.”Veterans can peruse the completed form and check for errors and make any necessary changes.XML interchangeAny system that is XML-capable can be integrated into Adobe. Adobe basically has two levels: the presentation level and the business logic level underneath that. A developer can design the form to issue XML calls to retrieve information from the data sources. And it can work the other way: Information entered into a form can be placed into the back-end system.“The nice thing about using an XML interchange is that it doesn’t matter necessarily what the back-end system is, as long as it can speak and understand XML,” Chisolm said. “Really, all major application, databases, ERP and CRM kinds of applications can speak XML.”At VHA and other federal agencies, tight integration of forms and back-end systems will lead to even wider adoption of the technology.“As agencies move to modernization of their enterprise resource planning, customer relationship management and financial applications, there will be a natural progression towards more use of electronic forms and electronic process,” Chisolm said. “People will naturally move to electronic forms as legacy paper-based systems go by the wayside.”