More and more women veterans are being treated at the Veterans Administration. However, sometimes women veterans can receive lower quality healthcare in part due to a VA primary care workforce that has limited experience caring for women especially for gender-specific conditions.
Two studies are underway to study how to remedy the situation. One study involves improving the care for women provided at Community-Based Outpatient Clinics (CBOC.) The other study involves studying how effective it would be to develop a Women’s Health Patient Aligned Care Team (WH-PACT) model to examine outcomes concerning women veterans. For more information, go to www.providerbehavior.research.va.gov/index.asp.
The first study “Controlled Trial of Tele-Support and Education for Women’s Healthcare in CBOCs” (CRE 12-031) started in 2013 is in the start-up phase at the VA’s Greater Los Angeles Healthcare System in their Center for the Study of Healthcare Provider Behavior with Donna Washington, as PI at donna.washington@va.gov.
The reason for this clinical trial is that with the influx of women veterans there may be problems in CBOCs where access to women’s health expertise may not be always be readily available. Since CBOC primary care providers typically have small caseloads of women veterans, it makes it difficult for these providers to maintain their knowledge and skills concerning women’s health.
The goal is to improve womens healthcare in CBOCs with technology-based education and interactive communication intervention that is specially designed for women health providers. The VA has been delivering a standard level of specialized women’s health training but these one-time trainings are not sufficient as knowledge attenuates over times.
The trial includes presenting advanced women health serial patient-based education using in-depth women health cases and studying specific issues. Also, interactive communication will be conducted between CBOC womens health providers and VA Medical Center–based specialists via electronic consultations.
The second trial also initiated in 2013 “Implementation of VA Women’s Health-Patient Aligned Care Teams” (CRE12-026) is being conducted at the VA Greater Los Angeles Healthcare System, Geriatric Research Education and Clinical Center with Elizabeth Yano as PI at elizabeth.yano@va.gov, The trial is studying how to use evidence-based quality improvement methods to develop a Women’s Health’s PACT model by using a cluster randomized trial design that is examining the outcomes and evaluating tools needed to support the PACT model.
Based on the patient-centered medical home concept, PACT aims to improve access, continuity coordination, and comprehensiveness using team-based care that is patient-driven and patient-centered. The question is how should the VA adapt PACT to meet the needs of special populations such as treating women veterans?
The trial will study achievements using patient, provider, and practice surveys, analyzing secondary data, and explore the WH-PACT care on treating chronic diseases, prevention, health status, utilization, and costs.