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Telemed J E Health. 2015 Dec;21(12):1012-8. doi: 10.1089/tmj.2015.0010. Epub 2015 Jul 14.

Teleconsultation and Training of VHA Providers on Transgender Care: Implementation of a Multisite Hub System.

Kauth MR1,2,3,4, Shipherd JC1,5,6,7, Lindsay JA2,3,4, Kirsh S8,9, Knapp H10, Matza L1,5.

Author information

1
1 Lesbian, Gay, Bisexual, and Transgender Program, VHA Patient Care Services , Washington, D.C.
2
2 VA South Central Mental Illness Research, Education, and Clinical Center , Houston, Texas.
3
3 Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center , Houston, Texas.
4
4 Baylor College of Medicine , Houston, Texas.
5
5 VA Boston Healthcare System , Boston, Massachusetts.
6
6 Women's Health Sciences Division, National Center for PTSD , Boston, Massachusetts.
7
7 Boston University School of Medicine , Boston, Massachusetts.
8
8 Office of Specialty Care, VHA Patient Care Services , Washington, D.C.
9
9 Case Western Reserve University , Cleveland, Ohio.
10
10 VA Greater Los Angeles Healthcare System , Los Angeles, California.

Abstract

BACKGROUND:

The Veterans Health Administration (VHA) is piloting a national program providing teleconsultation and training to clinicians to increase knowledge and comfort with treating transgender veterans and to expand clinical capacity. This program is based on Project ECHO and uses specialist expertise to train and educate front-line clinicians. Over time, the front-line clinicians increase knowledge and skills, enabling them to provide care locally and obviate need for patient travel. This program is innovative in its national scope, interdisciplinary team model, and multihub structure. This article describes development of the program and initial results for the first cohort of learners.

MATERIALS AND METHODS:

Five interdisciplinary clinical teams participated in the 14-session, 7-month program. Most teams had some experience treating transgender veterans prior to participation.

RESULTS:

The teams completed at least 12 of 14 sessions. Thirteen of 33 participants completed an evaluation. In general, respondents found the teleconsultation program very helpful and credited the experience with improving their team functioning. Furthermore, respondents reported a significant increase in confidence to treat transgender veterans by the end of the program (59% versus 83%). We explored whether it is possible to recruit VHA clinical teams to participate in lengthy training on a low prevalence but complex condition.

CONCLUSIONS:

Early results support the feasibility and effectiveness of this national VHA teleconsultation and training program for transgender care. Lessons learned from the first group of learners have been applied to two concurrent groups with positive results.

KEYWORDS:

education; military medicine; telehealth; telemedicine; telepsychiatry; transgender medicine

PMID:
26171641
DOI:
10.1089/tmj.2015.0010
[Indexed for MEDLINE]

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