Utilization of the Veterans Affairs’ Transgender E-consultation Program by Health Care Providers: Mixed-Methods Study (Preprint)

Abstract

communication-related problems with e-consult, impractical recommendations for underresourced sites, and misunderstanding e-consult purpose. Improvement suggestions included adding concise/sectioned responses, expanding provider/patient program awareness, designating a follow-up contact person, and increasing provider education about transgender Veterans and related care. Quantitative analysis found common reasons for not using the program were: not knowing about it, not needing to use it yet, and getting help from a colleague outside of econsult. Common suggestions to improve program use were: 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. Conclusions:The VA transgender e-consult program is useful to providers, but there are several barriers to implementing recommendations, some of which are especially challenging for rural providers. Addressing noted barriers and enhancing the facilitators may improve program use and improve quality care for transgender Veterans.