Radical Redesign of Health Care -Whole Health System

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Office of Patient Centered Care &. Cultural Transformation. . The Healthcare Crisis Facing the U.S.. Healthcare consumes 18% of our GDP . and costs continue to rise, with unsatisfactory results. ID: 729408 Download Presentation

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Radical Redesign of Health Care -Whole Health System




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Presentations text content in Radical Redesign of Health Care -Whole Health System

Slide1

Radical Redesign of Health Care -Whole Health System

Office of Patient Centered Care & Cultural Transformation

Slide2

The Healthcare Crisis Facing the U.S.

Healthcare consumes 18% of our GDP and costs continue to rise, with unsatisfactory resultsChronic conditions consume more than 75% of health care costs, are largely affected by people’s choices and behaviors. The US is now 37th

in life expectancy.

The current health care model doesn’t work

because we do not have a core competency in engaging the person and the family to optimize their health, self-care, and well-being

.

The Opioid Crisis is clear demonstration of the limitations of a “find-it, fix-it” reductionistic paradigm.

Slide3

“The disease-driven approach to care has resulted in spiraling costs as well as a fragmented health system that is reactive and episodic as well as inefficient and impersonal.” The Institute of Medicine Summit on Integrative Medicine and the Health of the Public, Feb 2009

Slide4

But WHAT?

What Does This Radical Redesign Look Like?

Slide5

VHA Healthcare Transformation Shifting the current health care system from

Problem Based Disease Care to Person Centered Health Care

5

Slide6

Whole Health

is an approach to health care that empowers

AND

equips

people to take charge

of their health and well-being,

and live their life to the fullest

.

6

VHA Mission Statement

Honor America’s Veterans by providing exceptional health care that improves their

health

and

well-being

.

Whole Health – What is it?

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Slide8

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THE PATHWAY(Empower)

Partners with Veterans to discover their mission, aspiration, and purpose and begins to create an overarching personal health planPersonal Health Plan

WHOLE HEALTH CLINICAL CARE

(Treat)

Outpatient & Inpatient

Health & Disease Management

within a Whole Health Paradigm

(i.e., Personal Health Planning,

CIH, Health Coaching)

WELL-BEING PROGRAMS

(Equip)

Self-Care/Skill Building and Support

Complementary &

Integrative Health (CIH)

Health Coaching &

Health Partner Support

Community

Community

Healing RelationshipsHealing Environments

Whole Health System - Operationalized

Slide10

Whole Health Pathway

https://www.youtube.com/watch?v=0nkO-3PA29c&feature=youtu.be

Slide11

11Whole Health Partners

Welcome Veterans into the local systemOrient Veterans to Whole Health conceptsCoordinate and connect Veterans

to resources and programs based

on preferences

Facilitate Taking Charge of

My Life and Health (TCMLH)

group programs

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The Whole Health Approach

Slide13

What REALLY matters to you in your life? What do you want your health for?What brings you a sense of joy and happiness?What is your vision of your best possible health?

Personal Health Inventory

Questions

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Personal Health Inventory

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7/18/2018

15

https://www.youtube.com/watch?v=zjYvs9K_4n8&feature=youtu.be

Whole Health Well-Being Programs

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16Well-being Programs

Not Disease focusedProgramming that focuses on wellbeing and CIH approaches to optimize health and wellbeingThe core offerings of a Wellbeing Program equip Veterans with skills to support self-care and wellbeing.Examples:Complementary and Integrative Health (CIH) approaches Wellbeing Classes Health Coaching

Slide17

17CIH Directive 1137 - May 2017

List 1 –

CIH Directive Approaches Approved by USH

List 2 - CIH Directive Approaches “Generally Considered Safe” Approved

by IHCC Advisory Workgroup

Acupuncture

Healing Touch

Meditation

Acupressure

Yoga

Alexander Technique

Tai Chi

Reflexology

Biofeedback

Reiki

Hypnosis

Therapeutic Touch

Guided Imagery

Emotional Freedom Technique

Massage

Animal Assisted Therapy (RT)

*Chiropractic

Aromatherapy*

Additional approaches currently under review

List 1

VA must provide a mechanism to offer these approaches either within the VA facility or in the community if they are recommended by the Veterans health care team.

Slide18

Evidence Maps

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7/18/2018

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Clinical team is one partner in our Veteran’s health care journey

Tie conversation back to MAP

Shared goal setting

SMART goals

Connect Veteran to health coach

Connect Veteran to Education and Well-being resources in support of their goals

Connect Veteran to clinical care teams in support of clinical goals (including CIH)

Whole Health Clinical Care

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Whole Health Clinical Care

https://www.youtube.com/watch?v=wrvHS8oMSWM&feature=youtu.be

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PHP – Integrator of Whole Health System

Professional Care: Conventional and Complementary

Health concerns

 

Prevention/Screening

 

Treatment (e.g., conventional and complementary approaches, medications, and supplements)

 

Referrals

  

Community

Resources 

Support Team

 

Next Steps

Mission, Aspiration, Purpose (MAP):

My mission, aspiration or purpose in life is…

 

My Goals:

 

Strengths (what’s going right already)/Challenges:

My Plan for Skill Building and Support

Mindful Awareness:

Areas of Self-Care:

Working Your Body  

Surroundings

Personal Development

Food and Drink

Recharge

Family, Friends, and Co-Workers

Spirit and Soul

Power of the Mind

Slide22

22 A PHI begins the process of a PHP

Personal Health Inventory (PHI)Personal Health Plan (PHP)

Slide23

This map illustrates patient centered care and whole health innovations at VA health care facilities across the country.

Preparing the Pipeline23

Slide24

Flagship Facilities

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VISN 15

Flagship Facility – St. Louis

Design Sites – Columbia

(2016)

Kansas City

(2018)

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CARA legislation requires

:Expansion of Research & Education on and delivery of CIH to veterans

Pilot program on integration of CIH

and related issues for veterans and family members of veterans.

Min

15 geographically diverse sites

; including at least 2 polytrauma rehab centers

https://vaww.infoshare.va.gov/sites/OPCC/SiteAssets/SitePages/IHCC-home/2017%20CIH%20Plan_CARA%20932.pdf

CARA 2016

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A Whole Health VERA Class in Price Group 4 will be in effect for FY 2018

~6-7k per veteran

In order to qualify for that category, a Veteran needs 10 CIH/WH visits (on 10 different days)

ARC tracking CPT Codes

VERA and Whole Health Updates

Slide27

CIH Directive 1137Signed by USH May 2017: Dictates that CIH approaches are part of the medical benefits package LIST I: evidence of promising or potential benefit

VA must provide a mechanism to offer these approaches either within the VA facility or in the community if they are recommended by the Veterans health care team.LIST II: Generally Considered SafeOptional for inclusion in VA facility, depending on capability (staff/space) at sites

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List 1 –

CIH Directive Approaches Approved by USH

Acupuncture

Meditation

Yoga

Tai Chi

Biofeedback

Hypnosis

Guided Imagery

Massage

Expanding CIH provision and research in the VA are the focus of both Subtitle C in the

Comprehensive Addiction and Recovery Act of

2016

.

CIH is a VA

Office of Research and Development-wide priority

and Health Services Research and Development’s (HSR&D) emphasis is intervention and policy studies focused on effectiveness and implementation of CIH treatment in health service settings.

Slide28

Other National Influences

ECF – Whole Health in Executive Performance Plan1c: Implementing Whole Health (WH)

Executive Order: “Supporting our Veterans During Their Transition from Military to Civilian Life.”

Implementing The Pathway at all facilities, including:

Introduction to Whole Health

Taking Charge of My Life and Health

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7/18/2018

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Slide30

WHOLE HEALTH RESOURCESNATIONAL, ONLINE, LOCAL

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Integrative Health Coordinating Center

The IHCC is charged with developing and implementing CIH strategies in clinical activities, education, and research across the system. Its two major functions are to: identify and remove barriers to providing CIH across the VHA system.serve as a resource for clinical practices and education for both veterans and clinicians.

31

Slide32

Veteran Facing Internet Site

Click

here

to access this site

Google: va.gov/

patientcenteredcare

Slide33

33

Slide34

The OpportunityWe need to fix what is broken, AND, this redesign of health care is

a key differentiator for VA, it serves Veterans in meaningful ways,and can provide a model for the Nation.

Slide35

Now, we can help them be mission ready for their lives, optimizing their health in service of what matters to them.

How Will We Identify Success?When Veterans achieve outcomes they never even imagined.

VETERANS HEALTH ADMINISTRATION


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