VA Whole Health: The paradigm shift we’ve been waiting for

“The job of medicine is not only to diagnose and treat disease,” said Tracy Gaudet, the executive director of the Veterans Health Administration, in her foreword to the Passport to Whole Health.

Dr. Gaudet is of course alluding to the traditional “find-it-fix-it” model in which healthcare professionals typically respond (or treat) once a crisis ensues.

This approach works well for issues like strep throat, a broken arm, or a headache. However, it fails to shed light on the full picture, and the remaining needs to break free of the ‘dark room,’ she argues.

To give essence to this metaphor, look at the inadequacy of the traditional healthcare model to treat chronic conditions like diabetes, heart disease, emphysema, etc.  When any of these conditions cross the crisis threshold, you can surely find the problem(s) but can rarely, if ever, fix it entirely.

What is necessary, Gaudet emphasizes, is a proactive, preventative approach that puts the patient in the very center of the healthcare team and inspires the individual to take charge of his or her health, equipped with the necessary tools that reduce the likelihood of crises happening in the first place.

“Ask and ye shall receive,” the proverb goes. In the case of Veterans’ healthcare, we are in the midst of receiving a complete paradigm shift in the way patients are being treated.

The Department of Veterans Affairs (VA) has heard the Institute for Healthcare’s call for a “radical redesign” of healthcare with the Whole Health System, a myriad of programs that demonstrate a conscientious, proactive, and patient-centered approach for those who have risked their lives to care for our nation at large.

The system focuses on self-empowerment, self-healing, and self-care with three core components:

• The Pathway is a partnership with peers where Veterans are encouraged to explore their mission, aspiration, and purpose, and begin their overarching personal health plan which can include family and caregivers.
• Well-being Programs focus on self-care and equip each person with skill building and is synergistic with one’s personal health plan. These programs include complementary and integrative health approaches such as mindfulness, yoga, tai chi, health coaching, and more.
• Whole Health Clinical Care is provided by clinicians who utilize a whole health approach. This is grounded in a healing relationship that incorporates complementary and integrative health approaches based on the veteran’s personal health plan.

Over the past year, the VA has supported the rollout of the Whole Health System at 18 different flagship facilities. These sites are the first wave in the national deployment of the system, and staff members have received intensive education and training, resources and tools, as well as onsite support to ensure the best uptake possible.

More facilities, including the Michael E. DeBakey VA Medical Center here in Houston in partnership with Baylor College of Medicine, will participate in subsequent rollouts. Together, this transformative effort represents a committed partnership between VA clinicians and our nation’s heroes that is critical not only to disease prevention and holistic healthcare, but also the management of complex, chronic conditions.

What matters to the Veteran is given primary importance, and this approach could provide a templated model for other healthcare systems to follow.

-By Edward Odom, M.A., health science specialist, Center for Innovations in Quality, Effectiveness, and Safety (IQuESt) at the Michael E. DeBakey VA Medical Center, Dr. Aanand Dinkar Naik, associate professor, and vice chair of quality improvement and innovations, IQuESt, Michael E. DeBakey VA Medical Center and the Department of Medicine at Baylor College of Medicine, and secondary faculty in the Center for Medical Ethics and Health Policy, and Lea Kiefer, M.P.H, program manager at IQuESt and Baylor