Achieving Whole Health A New Approach for Veterans and the Nation (2023) / Chapter Skim
Currently Skimming:
8 Conclusions and Recommendations
8 Conclusions and Recommendations
Pages 353-370
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 353... ...
The Department of Veterans Affairs (VA) is among the leaders of this movement, initially implementing its Whole Health System (WHS)
|
From page 354... ...
These approaches were built around health systems, people with specific health conditions, and defined regions and communities. The whole health systems that the committee identified had many commonalities, such as being built on a foundation of high-quality primary care and prevention; identifying how people, families, and communities define health and well-being; incorporating crosssectoral approaches and interprofessional teams; and spanning clinical and community settings where people receive care, work, play, learn, grow, and live.
|
From page 355... ...
COMMITTEE GOALS AND RECOMMENDATIONS This report and its recommendations apply both to VA systems of care and, more broadly, to systems of care throughout the United States and internationally. Based on the committee's statement of work and the evidence the committee found, the committee assumed that many in the medical community and outside of it desire to transform conventional medical care to whole health care.
|
From page 356... ...
Health system -- an organization or practice engaged in delivering health care services, including innovative models. Community programs -- programs and services designed to address the needs and wants of a local population.
|
From page 357... ...
• Scaling and spreading whole health care throughout the United States will not be possible without realigning infrastructure, policies, and payment to support, promote, and fund the provi sion of the foundational elements of whole health care. GOAL ONE: COMMIT TO THE SHARED PURPOSE OF HELPING PEOPLE ACHIEVE WHOLE HEALTH Recommendation 1.1: To scale and spread whole health, the Depart ment of Veterans Affairs, the Department of Health and Human Ser vices, other federal agencies addressing health and social services, state and local governments, health systems, social services, community pro grams, and external environment actors (payers, corporations, educa tors, and others)
|
From page 358... ...
. Recommendation 2.2: Health care systems, community programs, social services, and public health organizations committed to helping people achieve whole health should ensure that all sites are ready to
|
From page 359... ...
In the United States, whole health implementations are primarily health system based, although in other countries there are examples that are more community based and even regionally or nationally based. Whether just starting to implement a whole health approach or scaling and spreading an existing approach to new sites, health systems need to take multiple actions to prepare for transforming care, including • Assessing organizational and interprofessional team member readiness.
|
From page 360... ...
Recommendation 3.2: Health care systems should create and strengthen the infrastructure needed to partner with community programs, social care, and public health systems. This recommendation applies to both VA and non-VA systems committed to helping people achieve whole health.
|
From page 361... ...
, complementary and integrative health, health coaching and peer navigation, and individual well-being components of the approach. Future efforts should continue and should advance these activities and more fully develop all foundational elements of whole health care with particular attention to ensuring that the care offered is comprehensive and holistic, addresses upstream factors (e.g., health behaviors, mental health, social needs)
|
From page 362... ...
Recommendation 4.3: Building on its existing health center program, the Health Resources and Services Administration should lead the scale and spread of whole health care in the community. Through its experience in starting up national networks of federally qualified health centers and area health education centers and coordinating more than 3,000 grantees and 90-plus programs designed to provide equitable health care to people who are geographically isolated and economically or medically vulnerable, the Health Resources and Services Administration (HRSA)
|
From page 363... ...
Scaling and spreading effective whole health approaches so that whole health is accessible to all will take fundamental and seismic changes to the structures, processes, and goals of how the nation thinks about and cares for people. Even systems, such as VA, that have implemented a whole health approach are in the early stages of their transformation.
|
From page 364... ...
Federal leadership from organizations such as the Office of the National Coordinator for Health Information Technology can create incentives for informatics vendors to develop and support the systems needed to deliver whole health care, integrate collection and measurement tools into the electronic care delivery workflow, and make data more easily accessible to care systems and academic health services researchers. Public and private payers purchasing health care services should also fund whole health evaluations.
|
From page 365... ...
Delivering whole health care will require VA and Congress to clarify the services that the current MISSION Act legislation and policy covers and to hold regional third-party administrators accountable for establishing the clinical capacity needed to ensure timely, high-quality care. VHA and VBA programs should engage with non-VA health systems and social support programs to promote the routine identification of patients/participants with past military service and create coordinated care systems across VA and community settings to promote whole health.
|
From page 366... ...
This will be a decades-long process and is not a change that the nation can accomplish in the next few years. Moreover, no one organization currently has the authority or responsibility for envisioning and leading the implementation of an effective whole health approach that spans health care, public health, community programs, education, and social services sectors.
|
From page 367... ...
The Center for Whole Health Innovation will need multisector support from other whole health stakeholder agencies and organizations such as CMS, HRSA, Department of Defense, Indian Health Service, Substance Abuse and Mental Health Services Administration, National Institutes of Health, AHRQ, Patient-Centered Outcomes Research Institute, ARPA-H, Social Security Administration, Department of Housing and Urban Development, Department of Education, Department of Agriculture, Department of Labor, Department of Transportation, veterans service organizations, and other representatives of people and communities being served by whole health systems. The recommendation to form the center has many similarities to the recommendation to form the Secretary's Council on Primary Care in the National Academies' Implementing High-Quality Primary Care report.
|
From page 368... ...
Because much of whole health occurs outside of conventional medical care, there is a need to meaningfully invest in developing community programs and social services, especially in historically under-resourced settings with the most unmet need. National poli cies are needed to better allocate payment and resources across the broad spectrum of whole health services such as increased funding to address upstream factors affecting health, allocating more health and social care resources to the people and places in need, training the workforce needed to deliver whole health care, and improved education for all.
|
From page 369... ...
These include how to think about what it means to be healthy, how to deliver health care, who is accountable for delivering health care, and even how to measure success. Throughout the transformation process, the people, families, and communities who receive whole health care should be engaged as equal partners in defining health goals and the preferred strategies to reach them.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.