WASHINGTON, DC—As the number of women being discharged from military service increases, the need for VA to have a firm grasp on treating and preventing breast cancer increases as well. According to officials, VA has comparable treatment options to the private sector and considerably better screening. Their challenge is to get that information to women veterans.

Getting Women to VA for Care

Each year, VA physicians diagnose about 400 new cases of breast cancer among women veterans. Those patients have their choice of all the approved treatment modalities, with most VA facilities having surgeons and oncologists, and half having radiation services. But making the treatment available, and making it available in a way that appeals to women, who frequently have more complex family and social responsibilities than their male counterparts, is another task entirely.

“We definitely have women’s health specialists. And with our increasing programs with the Patient Centered Medical Home, we recognize the unique needs of women veterans. We’re redesigning medical needs to accommodate women,” stated Laurie Zephyrin, MD, director of VA’s Women’s Health Strategic Healthcare Group.

The Patient-Centered Medical Home is an ethos that accentuates a strong personal relationship between patient and physician and coordinated care across the healthcare system. This includes finding ways to make VA more palatable to women. “We want to improve access to care by providing flexibility in when and how women veterans schedule their appointment, so their complicated schedules can be accommodated,” Zephyrin explained. “The goal is that we provide all the care that a woman patient needs in one visit and provide her with a primary care provider trained in gender specific care.”

There are a number of outreach campaigns directed at getting more women veterans into VA healthcare. Those campaigns, including ads and newsletters updated on a monthly basis, are designed to combat the stereotype of VA as a system geared solely toward men.

One initiative VA has planned for the near future is a call center specifically for women veterans. VA hopes the call center will not only give women easy access to answers about VA treatment options, but will send a message that VA is actively seeking them out.

Screening Success

Breast cancer screening rates in 2008 were 87% for VA. This is compared to 69% in the private sector and 50% in Medicaid. Much of VA’s success is attributed to the system’s electronic medical record, which provides a reminder to physicians if a woman veteran is the right age to be screened. “The medical record is extremely helpful in tracking screening,” explained Linda Kinsinger, MD, MPH VA’s director of preventive medicine. “Screening is monitored from the facility level, VISN level, and nationwide.”

VA has had a process in place for 15 years whereby on a monthly basis a sample of patient files is pulled from those seen that month and checked to determine how well the facility has done in providing recommended care, including preventive screenings. “It’s done at every facility, and then rolled up to the VISN level and the national level and then reported quarterly and yearly,” Kinsinger said.

While VA has statistics on how well it is doing in screening for breast cancer, it has no outcome measures for treatment. According to Zephyrin that is one of VA’s priority areas for the future. Another is assuring that women with abnormal mammogram results get prompt and appropriate follow-up care. “Our goal is that they receive the very best care,” she declared.

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