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Pages 1-16

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From page 1...
... The World Health Organization further expanded the concept to people-centered care, which includes the life course of an individual plus care of the family and community. Going one step further, a whole health approach to care emphasizes that people-centered care should promote well-being as defined by the individuals, families, and communities themselves over the life course.
From page 2...
... People-Centered Tea sed mW ocu m-F ell-B Upstrea eing ic Eq i st ui ol ta le H d b an d an e Ac co si v un en ta b p re h le Com FIGURE S-1  The committee's five foundational elements of whole health.
From page 3...
... They have also demonstrated the positive benefits of a whole health approach, including improved patient experience and patientreported outcomes; increased access to care; reduced emergency room use and hospitalizations; improved clinical quality metrics; improved outcomes for chronic pain, mental health, traumatic brain injury, and healthy aging; reduced maternal and infant mortality; improved health equity; the promotion of team well-being; and some reductions in health care expenditures. These early implementers can help translate the lessons of whole health care to the VA and the broader health care community.
From page 4...
... population. The committee's charge was to consider the foundational elements of an integrated whole health model, but not to identify specific interventions that should be included in whole health models of care or defining specific evidentiary standards for making those decisions.
From page 5...
... Robust evidence demonstrates that each component of comprehensive care (acute and chronic care, mental health care, oral care, vision care, hearing care, complementary and integrative health, spiritual care, social care, health behaviors, and additional upstream factors) improves peoples' well-being.
From page 6...
... and alignment of critical foundational infrastructure (e.g., supportive health informatics; workforce training, education, and wellbeing programs; measurement systems for learning and accountability; and innovative health care financing)
From page 7...
... health care systems can scale and spread whole health, similar reports could be written from the perspective of social services, community programs, public health, or education systems and how they can better integrate and scale and spread whole health themselves. COMMITTEE GOALS AND RECOMMENDATIONS This report and recommendations apply to both VA systems of care and, more broadly, to systems of care throughout the United States and internationally.
From page 8...
... This commitment starts with leadership across public and private sectors, including health care, community programs, social services, and public health organization, payers, educators, and informatics-oriented organizations or vendors, making meaningful actions that include • Securing prioritization and buy-in at all levels of leadership. • Naming the care delivery approach as a "whole health approach." • Making a whole health approach part of the organization's core mission statement.
From page 9...
... Additionally, not all VA sites will have the resources and interprofessional team members to fully implement the WHS, so veterans should be able to access WHS services either on site or through virtual platforms as well as through non-VA health care and community-based systems by taking advantage of community programs through the Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2008 (MISSION Act) (Recommendation 6.1)
From page 10...
... GOAL THREE: INTEGRATE ACROSS SYSTEMS, SERVICES, AND TIME TO SUPPORT WHOLE HEALTH CARE THROUGHOUT THE LIFESPAN Recommendation 3.1: The Department of Veterans Affairs should inte grate the delivery of whole health services between the Veterans Benefits Administration (VBA) and the Veterans Health Administration (VHA)
From page 11...
... Future efforts should more fully develop all five foundational elements of whole health care with particular attention paid to ensuring that the care offered is comprehensive and holistic, to addressing upstream factors and team well-being, and to being accountable to all veterans, with particular attention paid to equity for disabled, socially vulnerable, racial and ethnic minority, women veterans, and others who may have difficulty accessing services due to geography or other factors. Additionally, VA will need to extend its whole health approach to older veterans, women's health, maternal health, family health, LGBTQ+ health, chronic disease management, and healthy aging.
From page 12...
... The National Institutes of Health's dissemination and implementation portfolio and new Advanced Research Projects Agency for Health can also be applied to whole health care. 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
From page 13...
... 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. For the MISSION Act to succeed, it will also have to ensure that there are sufficient networks of community providers and services in areas with unmet veteran needs.
From page 14...
... This is not a change that will be accomplished in the next few years, but rather will be a decades-long process. Moreover, no one organization currently has the authority or responsibility for envisioning and leading implementation of an effective whole health approach that spans health care, public health, community programs, education, and social services sectors.
From page 15...
... Because much of whole health occurs outside of conventional medical care delivery, there is a need to meaningfully invest in devel oping community programs and social services, especially in histori cally under-resourced settings with the most unmet need. National policies are needed to better allocate payment and resources across the broad spectrum of whole health services such as increased
From page 16...
... Scaling and spreading whole health care so that all can have access to needed services is a tall task and will take seismic cultural, structural, and process transformations. These include but are not limited to 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.


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