Project goals: In partnership with VA's National Emergency Medicine Program Office (EM-PO) and the VA Telehealth/Office of Connected Care, we propose to design, implement, and test innovative virtual solutions to rapidly triage and meet urgent care (UC) needs of Veterans. Using innovative solutions developed by public- private partnerships, our proposed program, the Virtual Urgent Care Network (VUCN), will seek to provide on- demand evaluation and treatment of unscheduled, urgent conditions. Our goal is to make health care accessible to those living in rural communities and make services more readily available for people with limited mobility, time, or transportation options. The objectives of this Phase 1 proposal are to: (1) conduct an environmental scan to identify strengths, weaknesses, opportunities and threats related to providing virtual UC services; (2) assess the feasibility, acceptability, and adoption of three specific virtual health strategies: e-visits, self-service options, and novel spaces (e.g., Walmart); and (3) design a VUCN program and a corresponding evaluation plan. Long-term Aim of Phase 2: If selected, we would use our Phase 1 plan to conduct a hybrid, type II large-scale implementation evaluation. Additionally, we would support our partners, the EM-PO, in their implementation of the VUCN. Specifically, our evaluation would seek to: (1) assess variation in implementation across settings, clinicians, and patient subgroups; (2) determine implementation outcomes (i.e., feasibility, fidelity, acceptability, and sustainability); (3) examine clinical outcomes (i.e., efficiency, safety, effectiveness, timeliness, and utilization); and (4) understand patient, provider, and staff-level barriers and facilitators. Innovation: The EM-PO is highly motivated to build on existing momentum and create a VUCN. The timing of the MISSION Act implementation and launch of the VA's Accessing Telehealth through Local Area Station (ATLAS) program have been instrumental in attracting new partners (VA Telehealth/Office of Connected Care and Office of Community Care). VA Telehealth will partner with us to identify how we can modify/adopt existing virtual solutions that are currently used in other sectors (i.e., primary care and mental health) to provide UC triage, evaluation, or treatment. As the ATLAS program continues to expand to include American Legion posts and Walmart spaces, we have the unique opportunity to be the first to test and assess feasibility and acceptability of incorporating this innovative strategy in our VUCN. Impact: Virtual UC services, from e-visits to use of novel spaces, can substantially improve timely access to UC services for the 3.2 million rural Veterans who live over an hour away from a VA ED or UC center. Since the UC benefit under the MISSION Act became available in June 2019, the Office of Community Care estimates there have already been 90,000 visits to non- VA UC centers. This estimate is predicted to rise dramatica...