Whole health is physical, behavioral, spiritual, and socioeconomic well-being as defined by individuals, families, and communities. Whole health care is an interprofessional, team-based approach anchored in trusted relationships to promote well-being, prevent disease, and restore health. It aligns with a person’s life mission, aspiration, and purpose. It shifts the focus from a reactive disease-oriented medical care system to one that prioritizes disease prevention, health, and well-being. It changes the health care conversation from “What's wrong with you?” to “What matters to you?”

The Department of Veterans Affairs (VA), the Samueli Foundation, and the Whole Health Institute commissioned the National Academies of Sciences, Engineering, and Medicine to establish a committee to provide guidance on how to fill gaps and create processes to accelerate the transformation to whole health care for veterans, both inside and outside the VA system, and the rest of the U.S. population. The resulting report presents findings and recommendations that provide a roadmap for improving health and well-being for veterans and the nation.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON TRANSFORMING HEALTH CARE TO CREATE WHOLE HEALTH: STRATEGIES TO ASSESS, SCALE, AND SPREAD THE WHOLE PERSON APPROACH TO HEALTH
• Reviewers
• Preface
• Acknowledgments
• Acronyms and Abbreviations
• Definitions
• Summary
  • STUDY CONTEXT AND CHARGE
  • WHAT ARE WHOLE HEALTH AND WHOLE HEALTH CARE?
  • SCALE AND SPREAD OF WHOLE HEALTH APPROACHES
  • COMMITTEE GOALS AND RECOMMENDATIONS
  • GOAL ONE: COMMIT TO THE SHARED PURPOSE OF HELPING PEOPLE ACHIEVE WHOLE HEALTH
  • GOAL TWO: PREPARE FOR A WHOLE HEALTH APPROACH TO CARE
  • GOAL THREE: INTEGRATE ACROSS SYSTEMS, SERVICES, AND TIME TO SUPPORT WHOLE HEALTH CARE THROUGHOUT THE LIFESPAN
  • GOAL FOUR: DELIVER ALL FOUNDATIONAL ELEMENTS OF WHOLE HEALTH CARE ACROSS THE LIFESPAN
  • GOAL FIVE: EVALUATE TO ITERATIVELY REFINE WHOLE HEALTH SYSTEMS AND CREATE GENERALIZABLE KNOWLEDGE
  • GOAL SIX: DESIGN PUBLIC- AND PRIVATE-SECTOR POLICIES AND PAYMENT TO SUPPORT WHOLE HEALTH AS A COMMON GOOD
  • CONCLUSIONS
• 1. Introduction
  • PROJECT ORIGIN AND STATEMENT OF TASK
  • STUDY APPROACH
  • STUDY CONTEXT
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. Defining Whole Health
  • A UNIVERSAL DEFINITION OF WHOLE HEALTH
  • FOUNDATIONAL ELEMENTS OF WHOLE HEALTH
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 3. Evidence Supporting Whole Health's Foundational Elements
  • ELEMENT ONE: PEOPLE-CENTERED CARE
  • ELEMENT TWO: COMPREHENSIVE AND HOLISTIC CARE
  • ELEMENT THREE: UPSTREAM-FOCUSED
  • ELEMENT FOUR: EQUITABLE AND ACCOUNTABLE
  • ELEMENT FIVE: TEAM WELL-BEING
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 4. Whole Health in Practice
  • DEPARTMENT OF VETERANS AFFAIRS WHOLE HEALTH SYSTEM
  • MARY'S CENTER
  • NATIONAL INTREPID CENTER OF EXCELLENCE (NICoE)
  • PROGRAM FOR ALL-INCLUSIVE CARE OF THE ELDERLY (PACE)
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 5. Whole Health Systems' Evidence
  • METHODS
  • DEPARTMENT OF VETERANS AFFAIRS WHOLE HEALTH SYSTEM
  • SOUTHCENTRAL FOUNDATION'S NUKA SYSTEM OF CARE
  • KITSAP MENTAL HEALTH SERVICES
  • ADVANCED CARE FOR THE ELDERLY (ACE) PROGRAMS
  • MARY'S CENTER
  • VERMONT BLUEPRINT FOR HEALTH
  • NATIONAL INTREPID CENTER OF EXCELLENCE
  • NEW ZEALAND'S CANTERBURY HEALTH PATHWAYS
  • AUSTRALIA: SOUTH AUSTRALIA HEALTH IN ALL POLICIES/INTEGRATED CARE ADELAIDE
  • SPAIN'S BASQUE COUNTRY INTEGRATED CHRONIC CARE MODEL
  • GERMANY'S GESUNDES KINZIGTAL MODEL
  • COSTA RICA'S EBAIS COMMUNITY-BASED PRIMARY CARE MODEL
  • FINDINGS AND CONCLUSIONS
  • EVIDENCE SUMMARY TABLES
  • REFERENCES
• 6. Scaling and Spreading Whole Health
  • SYSTEMS CHANGE AND SOCIAL MOVEMENT
  • STRUCTURES AND PROCESSES FOR SCALE AND SPREAD
  • SCALING AND SPREADING WHOLE HEALTH TO ALL ENROLLED VETERANS
  • INTEGRATING SERVICES TO SCALE AND SPREAD WHOLE HEALTH
  • THE ROLE OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION IN SCALING AND SPREADING WHOLE HEALTH
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 7. Infrastructure for Scaling and Spreading Whole Health
  • HEALTH INFORMATICS
  • WORKFORCE
  • MEASUREMENT, LEARNING, AND ACCOUNTABILITY FOR WHOLE HEALTH
  • FINANCING AND PAYMENT FOR WHOLE HEALTH
  • FINDINGS AND CONCLUSIONS
  • REFERENCES
• 8. Conclusions and Recommendations
  • COMMITTEE GOALS AND RECOMMENDATIONS
  • GOAL ONE: COMMIT TO THE SHARED PURPOSE OF HELPING PEOPLE ACHIEVE WHOLE HEALTH
  • GOAL TWO: PREPARE FOR A WHOLE HEALTH APPROACH TO CARE
  • GOAL THREE: INTEGRATE ACROSS SYSTEMS, SERVICES, AND TIME TO SUPPORT WHOLE HEALTH THROUGHOUT THE LIFESPAN
  • GOAL FOUR: DELIVER ALL FOUNDATIONAL ELEMENTS OF WHOLE HEALTH CARE ACROSS THE LIFESPAN
  • GOAL FIVE: EVALUATE TO ITERATIVELY REFINE WHOLE HEALTH SYSTEMS AND CREATE GENERALIZABLE KNOWLEDGE
  • GOAL SIX: DESIGN PUBLIC- AND PRIVATE-SECTOR POLICIES AND PAYMENT TO SUPPORT WHOLE HEALTH AS A COMMON GOOD
  • CONCLUSIONS
• Appendix A. Biographic Sketches
• Appendix B. Disclosure of Unavoidable Conflict of Interest

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2023.Achieving whole health: A new approach for veterans and the nation. Washington, DC: The National Academies Press. https://doi.org/10.17226/26854.

Digital Object Identifier: https://doi.org/10.17226/26854

This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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