Vecna case study · Healthcare service design

Designing the service, not just the kiosk.

Many early VetLink kiosks, although successful, sat unused or created new work around a broken check-in journey. From 2011 to 2016, I led a team that redesigned the patient and staff experience across kiosk flows, accessibility, signage, operational rules, clinical handoff, reducing average check-in from about 40 minutes to about 2.

Role Creative Director

Scope Product strategy, service design, UX/UI, accessibility, signage, and implementation

Collaboration Veterans, front-desk teams, clinicians, VA stakeholders, product, engineering, and implementation

Project span 2011–2016

Average check-in 40 → ~2 min

A service-level measure, not merely a faster screen.

VA rollout 154

Medical centers across the United States.

Deployment scale 6,000+

Kiosks across the wider patient self-service platform.

Patients served 16M+

Reported platform reach.

A person using a VetLink kiosk while a patient waits beneath a queue display — VetLink connected self-service check-in with the waiting room, queue display, staff workflow and clinical handoff.

Problem / Broken journey

The kiosk was only one failure point.

Veterans encountered paper forms, inconsistent instructions, long queues, and kiosks that were hidden, unavailable, or easy to bypass. Staff spent time interpreting the system and recovering failed check-ins.

The original experience treated check-in as a touchscreen task. In practice it began at the entrance, moved through signage and staff direction, continued through identity and appointment rules, and ended only when the clinic knew a veteran had arrived. Fixing the interface alone would have preserved the broken service around it.

Human stakes

Older, disabled, and stressed veterans met complexity at the first moment of care. Confusion consumed time and undermined trust.

Operating constraints

The redesign had to work with VA infrastructure, legacy clinical systems, privacy rules, Section 508 and WCAG requirements, standing reach, and uneven local procedures.

A dense staff-created notice explaining when and how veterans should use the kiosk — Staff-created instructions exposed the policy, timing, and handoff rules the interface failed to explain.

A VetLink kiosk covered by a paper notice saying it is temporarily down — A paper notice over a working screen made the service failure impossible to mistake for a UI-only problem.

Approach / Field research

Map the full service before drawing screens.

I observed the journey from arrival through clinical handoff, documented where system behavior and human behavior diverged, and used operational measures to keep the redesign honest.

Follow the breakdowns

Failures appeared before, during, and after kiosk use—in visibility, instructions, identity, appointment rules, staff response, and downstream queues.

Treat workarounds as evidence

Handwritten signs, paper notices, and repeated staff explanations showed what the formal product and service had left unresolved.

Measure the operation

Average check-in time, queue length, error rate, staff intervention, and feedback mattered more than interface polish in isolation.

A whiteboard journey map tracing patient and staff actions across preregistration, kiosk check-in, and clinical handoff — The journey map made the gaps between patient actions, system state, staff tasks, and clinical handoff visible.

A VA hallway with a large blue floor path directing patients to outpatient surgery — Wayfinding, sightlines, waiting-room layout, signage, and staff placement were part of the interaction model.

Field observations showing one kiosk tucked out of sight without signage and another blocked from view by the reception desk — Field observation made the placement problem concrete: a kiosk could be technically available and still fail because patients could not see it, understand where to go, or reach it before defaulting to the desk.

Execution / Cut to essentials

Reduce the work, then make every state legible.

The check-in flow was reduced from 27 taps to only the steps required to finish. Large targets supported standing users with limited reach, one primary action anchored each screen, and full-screen outcomes replaced ambiguous decoration.

Patient-facing clarityPlain language, visible progress, large touch targets, high contrast, multilingual entry, and a clear path to in-person help.
Operational clarityExplicit success, exception, and handoff states told veterans what happened and staff what to do next.

Execution / Security without confusion

Turn a major failure point into a simple recognition task.

The original date-of-birth control forced users to manipulate six separate spinners. The redesign asked for year, then month, then day—matching how people recall a date and preventing invalid combinations.

Old date-of-birth interface with six separate arrow controls for day, month, and year — Before: six spinner controls made a familiar date difficult to enter and easy to get wrong.

Redesigned date-of-birth interface presenting year, month, and day as large choices — After: year → month → day reduced motor effort and made valid choices visible.

Execution / The other side of the kiosk

Design the staff and system response with the patient flow.

Patient check-in could not succeed unless staff could see arrivals, interpret exceptions, approve updates, manage local rules, and monitor the devices. Training, queue behavior, configuration, signage, and system health were designed as parts of the same service.

A veteran using an express check-in kiosk with coordinated digital signs mounted above the kiosks — The deployed experience coordinated the kiosk interface with visible express check-in signage, making the service understandable before a veteran reached the screen.

What shipped

A connected patient, staff, and operations system.

The shipped work extended beyond the touchscreen into the people, rules, physical environment, and monitoring required to keep check-in working in real facilities.

Patient check-in

Simplified appointment flows, identity, demographic updates, directions, records, balances, and clear exception paths.

Staff operations

Patient queues, arrival states, notes, update approval, local templates, roles, and workflow configuration.

Service environment

Signage, digital displays, wayfinding, hardware cues, staff scripts, training, and a visible path to human help.

System operations

Kiosk groups, device and peripheral health, reporting, rollout support, and tools for resolving failures before they reached patients.

VetLink home screen with large options for appointments, travel, medical records, information, and balance — The patient-facing starting point used large, explicit actions and a predictable hierarchy.

Training example of the staff patient queue showing appointments, notifications, status, notes, and actions — The staff queue connected kiosk activity with appointment context, exceptions, arrival state, and next actions.

Kiosk health dashboard monitoring computers, scanners, card readers, printers, sensors, and touchscreens — System-health tools exposed the status of each kiosk and peripheral so operational failures could be found and resolved.

Impact

Faster check-in at national scale.

40 → ~2 min Average patient check-in time

154 VA medical centers

6,000+ Kiosks across the broader platform

16M+ Patients served across the broader platform

Map of the United States showing three implementation waves for VA medical centers — The VA implementation moved through three national waves beginning in 2011.

The check-in-time reduction and 154-center rollout describe the VA program. The 6,000+ kiosks and 16M+ patients describe reported scale across Vecna’s wider patient self-service platform. Product, engineering, implementation, VA leadership, local staff, and clinical teams all contributed to these outcomes.

What it proved

The reusable pattern.

The enduring lessons came from measuring the real service, designing for human variation, and treating the organization around the interface as part of the product.

Time is an honest KPI

Better UX matters when it visibly reduces waiting, confusion, and staff recovery work at the moment of care.

Accessibility is service quality

Designing for older, disabled, stressed, and standing users produced a clearer and more forgiving experience for everyone.

Design services, not screens

The interface succeeded because kiosk flows, signage, staff workflow, local rules, system health, and clinical handoff were aligned.