Leading the Nation in Women’s Health: The Important Role of Research

Abstract

Over the past two decades, the Veterans Health Administration (VHA) has supported numerous initiatives to remedy gaps in services available to women veterans. Finding deficits in the VHA’s women’s health care delivery in the early 1990s, reports from the U.S. Government Accounting Office spurred the initial move to upgrade the care provided to women veterans. Unfortunately, much of the country continued to marginalize women’s services in VHA, providing only a “pap” clinic and part-time (and often “collateral duty”) Women Veteran Coordinators to meet all of the needs of women veterans. Nonetheless, there were pockets of true excellence, facilities that engaged in a process of intensive development of comprehensive women’s health centers (Bean-Mayberry et al., 2007Bean-Mayberry B. Yano E.M. Navratil J. Bayliss N. Weisman C.S. Scholle S.H. Federally-funded comprehensive women’s health centers: Leading innovation in women’s health care delivery.Journal of Women’s Health. 2007; 16: 1281-1290Crossref PubMed Scopus (30) Google Scholar; Yano et al., 2006Yano E.M. Goldzweig C. Canelo I. Washington D.L. Diffusion of innovation in women’s health care delivery: The Department of Veterans Affairs’ adoption of women’s health clinics.Women’s Health Issues. 2006; 16: 226-235Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar). In 2008, my office, which oversees delivery of VA health care to women veterans nationally, launched an initiative to take this early work to the next level, transforming VA’s women’s health delivery system into a national leader in women’s health. Our goal is to provide “the best care anywhere” for women veterans (Longman, 2005Longman, P. (2005, January/February). The best care anywhere. Washington Monthly. Available: http://www.washingtonmonthly.com/features/2005/0501.longman.html. Accessed April 18, 2011.Google Scholar). A solid foundation of research is essential to this vision.The U.S. Department of Veterans Affairs has already produced an impressive body of work that has helped to guide changes in strategies for the provision of care for women veterans (Bean-Mayberry et al., 2010Bean-Mayberry B. Batuman F. Huang C. Goldzweig C.L. Washington D.L. Yano E.M. et al.Systematic review of women veterans health research, 2004–2008 (ESP Project #05-226). VA Evidence Synthesis Program, Washington, DC2010Google Scholar, Goldzweig et al., 2006Goldzweig C.L. Balekian T.M. Rolon C. Tano E.M. Shekelle P.G. The state of women veterans’ health research: Results of a systematic literature review.Journal of General Internal Medicine. 2006; 21: S82-S92Crossref PubMed Scopus (144) Google Scholar). However, still more research is needed; this current Special Issue of Women’s Health Issues takes another important step forward in filling remaining gaps, while also identifying new areas of research needing attention.As more and more women are entering and serving in military roles, many of which of which expose them to combat, we are challenged to understand and treat the effects of military service on women’s lives. Examining all of the possible effects of military service includes, of course, not only careful assessment of negative effects and vulnerabilities, but also of positive outcomes based on hard-won opportunities to serve their country, strengths, and resilience, and other factors that may have had less attention overall.Nationally, our population of women veterans is rapidly expanding, from the group of pioneering women who comprised only 3.5% of the military during World War II, to 4% during the Vietnam Era, and to approximately 11% in 1991, during Gulf War I. Today, women comprise 15% of active duty military and 17% of the National Guard and Reserve forces (Women’s Research and Education Institute, 2008Women’s Research and Education InstituteWomen in the military: Where they stand.6th ed. Author, Washington, DC2008Google Scholar). Thus, we need to plan for the many women “in the pipeline” who will be seeking health care from the VA in the next few years and beyond. The characteristics of the women veteran population and subpopulations (e.g., by period of service or era, among racial-ethnic minorities, education, marital status) are changing as well, requiring ongoing research to support our strategic planning and readiness in the face of their long-term preventive, reproductive, chronic care, and long-term care needs.Paralleling this rise in the number of women in the military, the numbers of women using VA health care has nearly doubled in the past decade, and now exceeds 300,000 per year (Frayne et al., 2011Frayne S.M. Phibbs C. Friedman S. Berg E. Ananth L. Iqbal S. et al.SourceBook: Women veterans in the Veterans Health Administration. Veterans Health Administration, Department of Veterans Affairs, Washington, DC2011Google Scholar). While representing impressive growth (and placing substantial demands on the VA system), this group of VA users reflects only 16% of all women veterans alive today, although this level of market penetration compares favorably to the 11% of eligible women veterans (compared with 22% of male veterans) using VHA health services before 2005. Particularly promising is the increasing engagement of newly returning women veterans: 48% of recently deployed Operation Enduring Freedom/Operation Iraqi Freedom women have used VHA services. The VHA must be prepared to meet the needs of this newest generation of veterans, while at the same time ensuring equitable access to high-quality care for women veterans from prior periods of service who may not have recognized their VA eligibility and health care options.To respond to the needs for enhanced services for this rapidly expanding population, we must understand the factors involved in successful provision of high quality care. Through active communication between field-based researchers and our national Women’s Health program/policy office, we have been able to promote collaborations to inform the provision of evidence-based care and to promote the most clinically relevant research. This convergence of research with clinical and policy leaders allows for increased utility of research findings through better understanding of the population and the subpopulations of Women veterans, including differences in women veterans’ needs in rural versus urban areas, by ethnicity and race, among aging women, and reproductive-age women. Research–clinical partnerships allow for developing and evaluating models of provision of health care, exploring factors related to clinical quality, including implementation of behavior change interventions, and identifying and eliminating barriers to needed services. Research also supports the design of educational tools for staff, providers, and veterans, as well as evaluation of the effectiveness of new educational interventions, such as simulation techniques.The VA’s first national Women’s Health Research agenda-setting conference in 2004 highlighted existing strengths and pointed to persistent gaps (Yan et al., 2006Yano E.M. Bastian L.A. Frayne S.M. Howell A.L. Lipson L.R. McGlynn G. et al.Toward a VA women’s health research agenda: Setting evidence-based priorities to improve the health and health care of women veterans.Journal of General Internal Medicine. 2006; 21: S93-S101Crossref PubMed Scopus (70) Google Scholar). Since that time, the VA women’s health research has come into its own, and the future is potentially very bright. However, from my perspective, there are some aspects of our situation that need to be considered if we are to continue to optimally develop and act upon the research results we require moving forward. First, we have an “aging infrastructure” of our research pioneers, and the number of leaders specifically in VA women’s health research is very limited, with senior clinician researchers overcommitted to both research and clinical practice. Fortunately, the VA’s investment in a national Women’s Health Research Consortium has yielded a cadre of over 150 MD and PhD investigators interested in VA women’s health research, many of whom are junior researchers with solid clinical experience seeing women veterans. However, they will continue to wait in the wings if they are not armed with protected time to focus on research, increasing their readiness to step up to leadership roles in this field. There is a parallel and ongoing need for skilled mentors, supported by mentorship training and dedicated funding streams that will support protected time for nurturing the careers of this large group of talented researchers. The expertise of this very limited group is so valuable that we need to find a new way to support their time to mentor others (and provide a succession plan), and, in turn, exponentially expand the VA research portfolio. Providing financial support for mentoring and increased supervision of mid-level and junior researchers is an essential investment with a high likelihood of positive returns in the form of implementation of evidence-based practice (and management) and demonstrable reductions in gender disparities and improved quality of care for our women veterans. Although the results of the VA Health Services Research and Development (HSR&D) Service’s evaluation of their Career Development Award program are pending, I anticipate that funding for a parallel mentoring program would provide “insurance” for the history of investment in VA’s research “human capital,” while likely speeding the production of meaningful research.Indeed, the VA has a distinguished record of building top-notch research workforce capacity. The VA HSR&D’s Research Career Development Award program has supported investigators who have gone on to become leaders in women’s health research and clinical care. The VA Office of Academic Affiliations’ Women’s Health Fellowship program also supports training of women’s health clinicians at seven academic sites nationwide. However, although their clinical training in women’s health care delivery is exemplary, these fellows and other junior researchers may not have critical alignment with mentors with specific women’s health research expertise. Just as an example, a fellow may have interests in cardiology and be paired with a research cardiologist whose focus does not include gender differences. Alignment of interest and mentoring is critical to furthering our women’s health agenda. In addition, strains on VA research funding, as well as on other major funding agencies, have limited opportunities for start-up support for many junior researchers, while also impeding potential impacts of established investigators. Taking advantage of the new VA Women’s Health Research Consortium (which provides education/training and technical consultation, supports collaboration and dissemination, and matches junior investigators with mentors), may allow researchers to improve the quality of their work and maximize success in securing funding in this increasingly competitive environment.As we have moved forward in encouraging the conduct of VA women’s health research, there have been significant challenges. Even in high-priority women’s health topics, we have frequently heard that “there aren’t enough women to include in my study.” Despite increasing numbers of women in the VA, at any one of the 140 VA medical centers, the numbers of women for a study sample may still be limited (Yano et al., 2010Yano E.M. Hayes P. Wright S. Schnurr P.P. Lipson L. Bean-Mayberry B. et al.Integration of women veterans into VA quality improvement research efforts: What researchers need to know.Journal of General Internal Medicine. 2010; 25: 56-61Crossref PubMed Scopus (97) Google Scholar). However, with the VA’s advanced electronic medical record fully implemented in every VA facility nationwide, the VA has opened the door to new greater ease in identifying and including women in research based on their specific characteristics or key variables (e.g., by type of condition, by how care is used). Furthermore, VA HSR&D’s new Women Veterans’ Practice-Based Research Network provides a critical research infrastructure to promote the conduct of multisite studies among women veterans. And although the VA’s data systems provide rich resources for describing women veterans and the care they receive, they also represent a challenge, because they have been difficult to manage and have been increasingly “protected” in ways that put substantial limits on their utility. For example, most VHA data systems historically did not separate out women who were non-veterans (such as VA employees) or were recipients of TRICARE or ChampVA until very recently, potentially skewing the VA’s understanding of their care. This realization, identified by researchers, changed our data-driven understanding of women veterans’ needs, because non-veterans constitute about half of the women in the national VA databases (Frayne et al., 2008Frayne S.M. Yano E.M. Nguyen V.Q. Yu W. Ananth L. et al.Gender disparities in Veterans Health Administration care: Accounting for veteran status changes conclusions.Medical Care. 2008; 46: 549-553Crossref PubMed Scopus (27) Google Scholar). Going forward, efforts to enhance and integrate data sources should take into account the need to ensure that data relevant to women veterans are accessible and accurate.To further the vision of the VHA Women’s Health program office to provide women veterans with the “best care anywhere,” my office has actively partnered with the VA Office of Research and Development, the VA HSR&D Service, and with VA women’s health research leaders directly to address these challenges. Our infusion of resources has included the following.•Early development of the quality improvement and medical education capabilities of the VA HSR&D-funded Women’s Health Research Consortium and Women Veterans’ Practice-Based Research Network; national steering committee membership includes women veterans’ policy leadership from my office (Women Veterans Health Strategic Health Care Group), in addition to senior leaders from the VA Office of Mental Health Services, the VA Office of Quality and Performance, the Institute of Medicine Board on Select Populations (covering military and veteran populations), and the Kaiser Family Foundation, in addition to nationally recognized research experts.•The VA, through my office, has supported the Women’s Health Evaluation Initiative, which has produced a robust database for program evaluation and research, as well as initial sourcebook reports; the first sourcebook provides detailed data about the sociodemographic characteristics and utilization patterns of women veteran VHA patients (Frayne et al., 2011Frayne S.M. Phibbs C. Friedman S. Berg E. Ananth L. Iqbal S. et al.SourceBook: Women veterans in the Veterans Health Administration. Veterans Health Administration, Department of Veterans Affairs, Washington, DC2011Google Scholar). The combined efforts have also allowed for data identification and reconciliation across other data sets and data definitions.•VA Office of Research and Development is supporting collaborations, cooperative studies, quality improvement, and implementation research initiatives, in addition to traditional health services research projects, to which my office frequently provides input.•We direct Women’s Health Program office support for communications, cross-pollination of ideas and projects, ensuring that researchers in the field are aware of my program office’s priorities for quality improvement and program development.•Funded as an operational priority, the National Survey of Women Veterans provided an essential portrait of women veterans’ needs, preferences, use, and experiences with care within and outside of the VA; results will inform policy and generate new research for years to come.•Through the 2010 VA Women’s Health Services Research Agenda Setting Conference, VA HSR&D Service, my office supported the research–clinical partnership building and mentoring aspects of the conference plan; the resulting economies of intellect will generate more collaboration, better studies and an essential infusion of energy in the research process.Ultimately, the goal is to have research inform evidence-based practice and policy for the provision of health care for women veterans and to ensure that alliances between national clinical leadership and national research leadership feed future research of the highest utility. Time is short and the stakes are high: We must be able to be informed about what to do, and measure how well we do it, if we are to provide the highest possible care for the women veterans we serve. Over the past two decades, the Veterans Health Administration (VHA) has supported numerous initiatives to remedy gaps in services available to women veterans. Finding deficits in the VHA’s women’s health care delivery in the early 1990s, reports from the U.S. Government Accounting Office spurred the initial move to upgrade the care provided to women veterans. Unfortunately, much of the country continued to marginalize women’s services in VHA, providing only a “pap” clinic and part-time (and often “collateral duty”) Women Veteran Coordinators to meet all of the needs of women veterans. Nonetheless, there were pockets of true excellence, facilities that engaged in a process of intensive development of comprehensive women’s health centers (Bean-Mayberry et al., 2007Bean-Mayberry B. Yano E.M. Navratil J. Bayliss N. Weisman C.S. Scholle S.H. Federally-funded comprehensive women’s health centers: Leading innovation in women’s health care delivery.Journal of Women’s Health. 2007; 16: 1281-1290Crossref PubMed Scopus (30) Google Scholar; Yano et al., 2006Yano E.M. Goldzweig C. Canelo I. Washington D.L. Diffusion of innovation in women’s health care delivery: The Department of Veterans Affairs’ adoption of women’s health clinics.Women’s Health Issues. 2006; 16: 226-235Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar). In 2008, my office, which oversees delivery of VA health care to women veterans nationally, launched an initiative to take this early work to the next level, transforming VA’s women’s health delivery system into a national leader in women’s health. Our goal is to provide “the best care anywhere” for women veterans (Longman, 2005Longman, P. (2005, January/February). The best care anywhere. Washington Monthly. Available: http://www.washingtonmonthly.com/features/2005/0501.longman.html. Accessed April 18, 2011.Google Scholar). A solid foundation of research is essential to this vision. The U.S. Department of Veterans Affairs has already produced an impressive body of work that has helped to guide changes in strategies for the provision of care for women veterans (Bean-Mayberry et al., 2010Bean-Mayberry B. Batuman F. Huang C. Goldzweig C.L. Washington D.L. Yano E.M. et al.Systematic review of women veterans health research, 2004–2008 (ESP Project #05-226). VA Evidence Synthesis Program, Washington, DC2010Google Scholar, Goldzweig et al., 2006Goldzweig C.L. Balekian T.M. Rolon C. Tano E.M. Shekelle P.G. The state of women veterans’ health research: Results of a systematic literature review.Journal of General Internal Medicine. 2006; 21: S82-S92Crossref PubMed Scopus (144) Google Scholar). However, still more research is needed; this current Special Issue of Women’s Health Issues takes another important step forward in filling remaining gaps, while also identifying new areas of research needing attention. As more and more women are entering and serving in military roles, many of which of which expose them to combat, we are challenged to understand and treat the effects of military service on women’s lives. Examining all of the possible effects of military service includes, of course, not only careful assessment of negative effects and vulnerabilities, but also of positive outcomes based on hard-won opportunities to serve their country, strengths, and resilience, and other factors that may have had less attention overall. Nationally, our population of women veterans is rapidly expanding, from the group of pioneering women who comprised only 3.5% of the military during World War II, to 4% during the Vietnam Era, and to approximately 11% in 1991, during Gulf War I. Today, women comprise 15% of active duty military and 17% of the National Guard and Reserve forces (Women’s Research and Education Institute, 2008Women’s Research and Education InstituteWomen in the military: Where they stand.6th ed. Author, Washington, DC2008Google Scholar). Thus, we need to plan for the many women “in the pipeline” who will be seeking health care from the VA in the next few years and beyond. The characteristics of the women veteran population and subpopulations (e.g., by period of service or era, among racial-ethnic minorities, education, marital status) are changing as well, requiring ongoing research to support our strategic planning and readiness in the face of their long-term preventive, reproductive, chronic care, and long-term care needs. Paralleling this rise in the number of women in the military, the numbers of women using VA health care has nearly doubled in the past decade, and now exceeds 300,000 per year (Frayne et al., 2011Frayne S.M. Phibbs C. Friedman S. Berg E. Ananth L. Iqbal S. et al.SourceBook: Women veterans in the Veterans Health Administration. Veterans Health Administration, Department of Veterans Affairs, Washington, DC2011Google Scholar). While representing impressive growth (and placing substantial demands on the VA system), this group of VA users reflects only 16% of all women veterans alive today, although this level of market penetration compares favorably to the 11% of eligible women veterans (compared with 22% of male veterans) using VHA health services before 2005. Particularly promising is the increasing engagement of newly returning women veterans: 48% of recently deployed Operation Enduring Freedom/Operation Iraqi Freedom women have used VHA services. The VHA must be prepared to meet the needs of this newest generation of veterans, while at the same time ensuring equitable access to high-quality care for women veterans from prior periods of service who may not have recognized their VA eligibility and health care options. To respond to the needs for enhanced services for this rapidly expanding population, we must understand the factors involved in successful provision of high quality care. Through active communication between field-based researchers and our national Women’s Health program/policy office, we have been able to promote collaborations to inform the provision of evidence-based care and to promote the most clinically relevant research. This convergence of research with clinical and policy leaders allows for increased utility of research findings through better understanding of the population and the subpopulations of Women veterans, including differences in women veterans’ needs in rural versus urban areas, by ethnicity and race, among aging women, and reproductive-age women. Research–clinical partnerships allow for developing and evaluating models of provision of health care, exploring factors related to clinical quality, including implementation of behavior change interventions, and identifying and eliminating barriers to needed services. Research also supports the design of educational tools for staff, providers, and veterans, as well as evaluation of the effectiveness of new educational interventions, such as simulation techniques. The VA’s first national Women’s Health Research agenda-setting conference in 2004 highlighted existing strengths and pointed to persistent gaps (Yan et al., 2006Yano E.M. Bastian L.A. Frayne S.M. Howell A.L. Lipson L.R. McGlynn G. et al.Toward a VA women’s health research agenda: Setting evidence-based priorities to improve the health and health care of women veterans.Journal of General Internal Medicine. 2006; 21: S93-S101Crossref PubMed Scopus (70) Google Scholar). Since that time, the VA women’s health research has come into its own, and the future is potentially very bright. However, from my perspective, there are some aspects of our situation that need to be considered if we are to continue to optimally develop and act upon the research results we require moving forward. First, we have an “aging infrastructure” of our research pioneers, and the number of leaders specifically in VA women’s health research is very limited, with senior clinician researchers overcommitted to both research and clinical practice. Fortunately, the VA’s investment in a national Women’s Health Research Consortium has yielded a cadre of over 150 MD and PhD investigators interested in VA women’s health research, many of whom are junior researchers with solid clinical experience seeing women veterans. However, they will continue to wait in the wings if they are not armed with protected time to focus on research, increasing their readiness to step up to leadership roles in this field. There is a parallel and ongoing need for skilled mentors, supported by mentorship training and dedicated funding streams that will support protected time for nurturing the careers of this large group of talented researchers. The expertise of this very limited group is so valuable that we need to find a new way to support their time to mentor others (and provide a succession plan), and, in turn, exponentially expand the VA research portfolio. Providing financial support for mentoring and increased supervision of mid-level and junior researchers is an essential investment with a high likelihood of positive returns in the form of implementation of evidence-based practice (and management) and demonstrable reductions in gender disparities and improved quality of care for our women veterans. Although the results of the VA Health Services Research and Development (HSR&D) Service’s evaluation of their Career Development Award program are pending, I anticipate that funding for a parallel mentoring program would provide “insurance” for the history of investment in VA’s research “human capital,” while likely speeding the production of meaningful research. Indeed, the VA has a distinguished record of building top-notch research workforce capacity. The VA HSR&D’s Research Career Development Award program has supported investigators who have gone on to become leaders in women’s health research and clinical care. The VA Office of Academic Affiliations’ Women’s Health Fellowship program also supports training of women’s health clinicians at seven academic sites nationwide. However, although their clinical training in women’s health care delivery is exemplary, these fellows and other junior researchers may not have critical alignment with mentors with specific women’s health research expertise. Just as an example, a fellow may have interests in cardiology and be paired with a research cardiologist whose focus does not include gender differences. Alignment of interest and mentoring is critical to furthering our women’s health agenda. In addition, strains on VA research funding, as well as on other major funding agencies, have limited opportunities for start-up support for many junior researchers, while also impeding potential impacts of established investigators. Taking advantage of the new VA Women’s Health Research Consortium (which provides education/training and technical consultation, supports collaboration and dissemination, and matches junior investigators with mentors), may allow researchers to improve the quality of their work and maximize success in securing funding in this increasingly competitive environment. As we have moved forward in encouraging the conduct of VA women’s health research, there have been significant challenges. Even in high-priority women’s health topics, we have frequently heard that “there aren’t enough women to include in my study.” Despite increasing numbers of women in the VA, at any one of the 140 VA medical centers, the numbers of women for a study sample may still be limited (Yano et al., 2010Yano E.M. Hayes P. Wright S. Schnurr P.P. Lipson L. Bean-Mayberry B. et al.Integration of women veterans into VA quality improvement research efforts: What researchers need to know.Journal of General Internal Medicine. 2010; 25: 56-61Crossref PubMed Scopus (97) Google Scholar). However, with the VA’s advanced electronic medical record fully implemented in every VA facility nationwide, the VA has opened the door to new greater ease in identifying and including women in research based on their specific characteristics or key variables (e.g., by type of condition, by how care is used). Furthermore, VA HSR&D’s new Women Veterans’ Practice-Based Research Network provides a critical research infrastructure to promote the conduct of multisite studies among women veterans. And although the VA’s data systems provide rich resources for describing women veterans and the care they receive, they also represent a challenge, because they have been difficult to manage and have been increasingly “protected” in ways that put substantial limits on their utility. For example, most VHA data systems historically did not separate out women who were non-veterans (such as VA employees) or were recipients of TRICARE or ChampVA until very recently, potentially skewing the VA’s understanding of their care. This realization, identified by researchers, changed our data-driven understanding of women veterans’ needs, because non-veterans constitute about half of the women in the national VA databases (Frayne et al., 2008Frayne S.M. Yano E.M. Nguyen V.Q. Yu W. Ananth L. et al.Gender disparities in Veterans Health Administration care: Accounting for veteran status changes conclusions.Medical Care. 2008; 46: 549-553Crossref PubMed Scopus (27) Google Scholar). Going forward, efforts to enhance and integrate data sources should take into account the need to ensure that data relevant to women veterans are accessible and accurate. To further the vision of the VHA Women’s Health program office to provide women veterans with the “best care anywhere,” my office has actively partnered with the VA Office of Research and Development, the VA HSR&D Service, and with VA women’s health research leaders directly to address these challenges. Our infusion of resources has included the following.•Early development of the quality improvement and medical education capabilities of the VA HSR&D-funded Women’s Health Research Consortium and Women Veterans’ Practice-Based Research Network; national steering committee membership includes women veterans’ policy leadership from my office (Women Veterans Health Strategic Health Care Group), in addition to senior leaders from the VA Office of Mental Health Services, the VA Office of Quality and Performance, the Institute of Medicine Board on Select Populations (covering military and veteran populations), and the Kaiser Family Foundation, in addition to nationally recognized research experts.•The VA, through my office, has supported the Women’s Health Evaluation Initiative, which has produced a robust database for program evaluation and research, as well as initial sourcebook reports; the first sourcebook provides detailed data about the sociodemographic characteristics and utilization patterns of women veteran VHA patients (Frayne et al., 2011Frayne S.M. Phibbs C. Friedman S. Berg E. Ananth L. Iqbal S. et al.SourceBook: Women veterans in the Veterans Health Administration. Veterans Health Administration, Department of Veterans Affairs, Washington, DC2011Google Scholar). The combined efforts have also allowed for data identification and reconciliation across other data sets and data definitions.•VA Office of Research and Development is supporting collaborations, cooperative studies, quality improvement, and implementation research initiatives, in addition to traditional health services research projects, to which my office frequently provides input.•We direct Women’s Health Program office support for communications, cross-pollination of ideas and projects, ensuring that researchers in the field are aware of my program office’s priorities for quality improvement and program development.•Funded as an operational priority, the National Survey of Women Veterans provided an essential portrait of women veterans’ needs, preferences, use, and experiences with care within and outside of the VA; results will inform policy and generate new research for years to come.•Through the 2010 VA Women’s Health Services Research Agenda Setting Conference, VA HSR&D Service, my office supported the research–clinical partnership building and mentoring aspects of the conference plan; the resulting economies of intellect will generate more collaboration, better studies and an essential infusion of energy in the research process. Ultimately, the goal is to have research inform evidence-based practice and policy for the provision of health care for women veterans and to ensure that alliances between national clinical leadership and national research leadership feed future research of the highest utility. Time is short and the stakes are high: We must be able to be informed about what to do, and measure how well we do it, if we are to provide the highest possible care for the women veterans we serve. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government. Patricia M. Hayes, PhD, is the Chief Consultant, Women Veterans Health Strategic Health Care Group in Patient Care Services for the Department of Veteran Affairs. She has worked throughout the VA to expand initiatives for women veterans.