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Semin Reprod Med 2019; 37(01): 032-042
DOI: 10.1055/s-0039-1692398
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Coordinating Care for Reproductive Health Malignancies in the Veterans' Health Administration: Promising Practices, Ongoing Challenges, and Future Research

Kristina M. Cordasco
1   VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California
2   Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California
3   Department of Medicine, Geffen School of Medicine at the University of California Los Angeles (UCLA), Los Angeles, California
,
Jessica L. Moreau
1   VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California
,
Neetu Chawla
1   VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California
4   Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, California
› Author Affiliations
Funding K.M.C. and N.C. were supported in this work by the Department of Veterans Affairs (VA), VA Quality Enhancement Research Initiative (QUERI) Program “Improving Patient-Centered Care Coordination for High-Risk Veterans in PACT” (# QUE 15–276). J.L.M. was supported by VA QUERI Program “The Enhancing Mental and Physical health of Women through Engagement and Retention (EMPOWER)” (QUE 15–272).
Further Information

Publication History

Publication Date:
11 June 2019 (online)

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Abstract

In cancer care, communication and coordination across the cancer continuum is paramount for delivering effective, high-quality, patient-centered care. However, achieving optimally coordinated cancer care is inherently challenging, especially in the case of Veterans Administration (VA) care for women's reproductive health cancers. Given the relatively small number of women Veterans requiring care for reproductive malignancies, VA often must rely on community providers to deliver this care, necessitating coordination across two or more health care systems. Recently, VA has invested heavily in improving care for women Veterans through several initiatives and efforts. This article reviews VA's successes, challenges, and future opportunities in research and innovation in the context of care coordination across the cancer continuum (i.e., prevention and screening, diagnosis and treatment, survivorship care, palliative and supportive care) for women Veterans with reproductive health malignancies. We describe how coordination of VA care for reproductive health malignancies currently reflects a mix of successes that demonstrate use of strong evidenced-based practices and challenges, with solutions yet to be fully developed and implemented. We conclude that there are a multitude of opportunities for future research, interventions, and potential avenues for implementing innovative approaches to coordinate VA reproductive cancer care across the cancer continuum.

Keywords

care coordination - Veterans - women - reproductive health - cancer

Note

This manuscript is an invited submission for a dedicated issue on the reproductive health needs of the Military and Veterans.


Disclaimer

The views expressed in this article are solely those of the authors, and do not necessarily represent the views of the Department of Veterans Affairs or the U.S. government.


Previous Reporting

The reported findings have not been previously published and the manuscript is not being simultaneously submitted elsewhere.


Compliance with Ethical Standards

All authors declare that they have no conflicts of interest.