ArticleJMIR medical informatics2019
Utilization of the Veterans Affairs' Transgender E-consultation Program by Health Care Providers: Mixed-Methods Study.
Article in JMIR medical informatics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Enabling and hindering aspects of the i²TransHealth e-health intervention for transgender and gender diverse people in Germany: a qualitative process evaluation.BMC health services research · 2026Trial
- Characteristics of transgender health-related provider-to-provider consultations in Brazil's public primary health care system: A cross-sectional study from a Southern Brazilian telehealth service.Archives of endocrinology and metabolism · 2026Article
- Electronic Consultations for Endocrine Conditions: A Scoping Review.Journal of the Endocrine Society · 2024Article
- Patient Characteristics Associated with Receiving Gender-Affirming Hormone Therapy in the Veterans Health Administration.Transgender health · 2024Article
- Evaluating an Electronic Consultation Platform to Support Pediatric Primary Care Providers in Caring for Transgender and Nonbinary Adolescents.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024Article
- Transgender health issues addressed in research on telehealth use: a scoping review.Frontiers in sociology · 2024Article
- General Practitioner Use of e-Consultation to Consult Hospital Specialists: Interview Study to Obtain Physician's Perceptions About Digital Interprofessional Communication.Journal of medical Internet research · 2023Article
- Providing essential gender-affirming telehealth services to transgender youth during COVID-19: A service review.Journal of telemedicine and telecare · 2023Review
- Pediatric Primary Care Providers' Perspectives on Telehealth Platforms to Support Care for Transgender and Gender-Diverse Youths: Exploratory Qualitative Study.JMIR human factors · 2023Article
- A New Virtual Reality: Benefits and Barriers to Providing Pediatric Gender-Affirming Health Care Through Telehealth.Transgender health · 2022Article
- Telemedicine for Gender-Affirming Medical and Surgical Care: A Systematic Review and Call-to-Action.Transgender health · 2022Review
- Providing Gender-Affirmative Care During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic Era: Experiences and Perspectives from Pediatric Endocrinologists in the United States.Transgender health · 2022Article
- Need for Inclusive Consideration of Transgender and Gender Diverse People in E-Health Services: A Systematic Review.Journal of clinical medicine · 2022Review
- Sex Hormone Suppression and Physical Activity: Possible Implications for Transgender Individuals.Transgender health · 2022Article
- Information and communication technology-based health interventions for transgender people: A scoping review.PLOS global public health · 2022Article
- Examining Health Care Mobility of Transgender Veterans Across the Veterans Health Administration.LGBT healthArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2015, the Department of Veterans Affairs (VA) nationally implemented a transgender e-consultation (e-consult) program with expert clinical guidance for providers.
objectiveThis mixed-methods project aimed to describe providers' program experiences, reasons for nonuse of the program, and ways to improve the program use.
methodsFrom January to May 2017, 15 urban and rural VA providers who submitted at least one e-consult in the last year participated in semistructured interviews about their program experiences, which were analyzed using content analysis. From November to December 2017, 53 providers who encountered transgender patients but did not utilize the program participated in a brief online survey on the reasons for nonuse of the program and the facilitators encouraging use.
resultsQualitative analysis showed that providers learned of the program through email; colleagues; the electronic health record (EHR) system; and participation in the VA Lesbian, Gay, Bisexual, and Transgender committees or educational trainings. Providers used the program to establish care plans, hormone therapy recommendations, sexual and reproductive health education, surgical treatment education, patient-provider communication guidance, and second opinions. The facilitators of program use included understandable recommendations, ease of use through the EHR system, and status as the only transgender resource for rural providers. Barriers to use included time constraints, communication-related problems with the e-consult, impractical recommendations for underresourced sites, and misunderstanding of the e-consult purpose. Suggestions for improvement included addition of concise or sectioned responses, expansion of program awareness among providers or patients, designation of a follow-up contact person, and increase in provider education about transgender veterans and related care. Quantitative analysis showed that the common reasons for nonuse of the program were no knowledge of the program (54%), no need of the program (32%), and receipt of help from a colleague outside of e-consult (24%). Common suggestions to improve the program use in quantitative analyses included provision of more information about where to find e-consult in the chart, guidance on talking with patients about the program, and e-mail announcements to improve provider awareness of the program. Post hoc exploratory analyses showed no differences between urban and rural providers.
conclusionsThe VA transgender e-consult program is useful for providers, but there are several barriers to implementing recommendations, some of which are especially challenging for rural providers. Addressing the identified barriers and enhancing the facilitators may improve program use and quality care for transgender veterans.
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