2009 — Assessing Implementation of the Whole Health Partnership: A Discussion of Operational Priorities, Practicality and Rigor in Guiding National Adoption
Lead/Presenter: Barbara Bokhour, COIN - Bedford/Boston
All Authors: Bokhour BG (Center for Healthcare Organization and Implementation Research)
Kligler B (Office of Patient Centered Care and Cultural Transformation)
Hyde JK (Center for Healthcare Organization and Implementation Research)
Zeliadt SB (Center of Innovation for Veteran-Centered and Value-Driven Care)
Brief description of panelists:
Barbara Bokhour, PhD (moderator) is principal investigator of the Center for Evaluating Patient Centered Care (EPCC), a QUERI partnered evaluation initiative with the Office of Patient Centered Care and Cultural Transformation (OPCCCT). Benjamin Kligler, MD is Director of the Integrative Health Coordinating Center and Director of Research at OPCCCT. Steven Zeliadt, PhD is a health economist and investigator in the Seattle/Denver COIN. Justeen Hyde, PhD is an anthropologist and qualitative investigator for EPCC
Description of the question or issue that will be discussed:
OPCCCT has developed the Whole Health Partnership (WHP), a personalized, proactive, patient-driven approach to care. The WHP is complex, incorporating personal health planning, health coaching, and complementary integrative health. EPCC researchers are currently evaluating five WHP pilots developing methods for measurement and implementation assessment. OPCCCT is now embarking on an extensive effort to implement WHP in response to the Comprehensive Addictions and Recovery Act (CARA). All 18 VISN directors have committed $90 million annually to implement the WHP in one flagship site per VISN beginning in 2018, reaching full implementation nationally by 2023. This panel will discuss the Whole Health Partnership, plans for implementation, and the design of our partnered evaluation to quantify how its implementation impacts health outcomes for Veterans in the 18 demonstration sites. We will discuss how this approach relates to broader constructs of patient-centered care and the current system of care. We will describe plans to capture utilization of dynamic components of WHP, measuring appropriate outcomes, and use of randomized and naturalistic encouragement designs to assess meaningful effects using tenets of pragmatic trials.
Significance—Description of why the issue is important for Veterans, VA, and the audience:
The WHP has been developed in response to key needs of Veterans and congressional mandates, and is being offered as a critical component of VA's effort to reduce the use of opioids while managing pain effectively for Veterans. Research on how this shift improves the health and well-being of Veterans is critical. This session will provide the basis for researchers to more fully understand the WHP, and explores the complexity of combining implementation activities in a pragmatic trial framework to ensure knowledge is generated to inform the wide scale adoption of a new complex, multi-faceted system for caring for Veterans.