Radical Redesign of Care: VA Whole Health

With the national pain management crisis, Veteran suicides, rising rates of chronic illness despite high expenditures, and healthcare provider burnout, it is time to radically re-envision and redesign healthcare to create a health, rather than disease, care system. We must expand our understanding of what defines healthcare, developing a Whole Health System (WHS) of care that empowers and equips individuals to discover a path to health and well-being.

The Department of Veterans Affairs (VA) is uniquely positioned to make this a reality for Veterans and our Nation. The WHS has three components: (1) The Pathway to Empowerment, where non-clinical peers partner with Veterans and their family, exploring their mission, aspiration, and purpose and introducing personal health planning; (2) Wellbeing Programs, which include skill building classes in support of self-care goals, health coaches, and proactive, complementary and integrative health (CIH) approaches; and (3) Whole health Clinical Care, where providers are trained in Whole Health, including healing environments and relationships, CIH approaches, and personal health planning. This large-scale transformation requires an interprofessional workforce made up of clinicians and non-clinicians, a well-defined educational and communication strategy, and a cultural shift in the way healthcare is delivered and received.

To truly meet the needs of our Veterans, we must redefine what healthcare means and ensure we address the whole person, their values, and their health and well-being goals, not just their symptoms and/or diseases. Eighteen design sites have been funded since FY16 to pilot components of the WHS. Supported by the Comprehensive Addiction and Recovery Act (CARA) legislation, VA has launched the full WHS in 18 Flagship Facilities in FY18, the first wave in national deployment. Veteran engagement, activation, and satisfaction, utilization of resources, and biometrics will be tracked, as well as the interface with opioid safety and suicide prevention. This presentation will define the interprofessional roles in the Whole Health System of care, describe real-time examples of each component in practice, share testimonials of successes as well as challenges in implementation across facilities in VHA, and highlight early outcomes in facilities undergoing this system transformation.