title: Nationwide Interdisciplinary E-Consultation on Transgender Care in the Veterans Health Administration.
abstract: Veteran's Health Administration (VHA) requires the provision of quality transgender care for the relatively large number of transgender veterans using VHA services.
  
  
  
  The Office of Patient Care Services has taken a multimethod approach to improving provider knowledge and skill for transgender veteran care. However, unique patient-specific questions can arise. Thus, VHA implemented a 3-year feasibility program to determine if nationwide interdisciplinary e-consultation can offer veteran-specific consultation to providers who treat transgender veterans in VHA.
  
  
  
  Launch of this program is described along with use to date, types of questions submitted by providers, and length of time to complete a response in the veteran's electronic medical record.
  
  
  
  In 17 months, the program responded to 303 e-consults, with consultation provided on the care of 230 unique veterans. Nationwide coverage was achieved 1 year after the launch of the program. Common consult questions have been about medications, including hormones (n = 125); primary care concerns (n = 97); mental health evaluations (n = 63); and psychotherapy (n = 18). Consistent with the interdisciplinary model, multiple disciplines typically responded to each consult (x = 2.27). Average time to completion of a consult was 5.9 calendar days (range = 2.4-7.7 days).
  
  
  
  VHA has established a nationwide interdisciplinary e-consultation program. Additional outreach about the program will be needed if funding is continued.
  
  
  
  E-consultation on transgender health within VHA is feasible and complements the suite of trainings offered within VHA. Other healthcare organizations may benefit from a similar program.
authors.affiliation: 1 Lesbian, Gay, Bisexual and Transgender Program, Office of Patient Care Services, Veterans Health Administration , Washington, District of Columbia.|2 National Center for PTSD, Women's Health Sciences Division , Boston, Massachusetts.|3 VA Boston Healthcare System , Boston, Massachusetts.|4 Boston University School of Medicine , Boston, Massachusetts.
authors.forename: Jillian C
authors.initials: JC
authors.lastname: Shipherd
authors.affiliation: 1 Lesbian, Gay, Bisexual and Transgender Program, Office of Patient Care Services, Veterans Health Administration , Washington, District of Columbia.|5 VA South Central Mental Illness Research, Education, and Clinical Center , Houston, Texas.|6 VA HSR&D Center for Innovations in Quality, Effectiveness and Safety , Houston, Texas.|7 Baylor College of Medicine , Houston, Texas.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kauth
authors.affiliation: 1 Lesbian, Gay, Bisexual and Transgender Program, Office of Patient Care Services, Veterans Health Administration , Washington, District of Columbia.|8 Boston VA Research Institute, Inc. , Boston, Massachusetts.
authors.forename: Alexis
authors.initials: A
authors.lastname: Matza
mesh_terms: D006801:Humans; D033183:Interdisciplinary Communication; D008603:Mental Health; D011320:Primary Health Care / Q000458:organization & administration; D015397:Program Evaluation; D011613:Psychotherapy / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration; D019114:Remote Consultation / Q000458:organization & administration*; D013997:Time Factors; D063106:Transgender Persons; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*; D008297:Male; D005260:Female
keywords: distance learning; e-health; medical records; telecommunications