I was hired in 2011 by the Veterans Health Administration (VHA) to direct the Office of Patient Centered Care and Cultural Transformation and charged with ensuring that the VA transforms from physician-centered care to personalized, patient-centered care that is based on relationships, built on trust, and committed to positive results over the veteran’s lifetime.
This undertaking represents one of the most massive changes in the philosophy and process for healthcare delivery ever undertaken by an organized healthcare system.
For the nearly nine million patients the VA serves who have committed their lives to the defense of our country, the healthcare system for Veterans should provide them with the opportunity to be “mission ready” for their lives here on the home front. The VA has taken steps to be bold in designing and delivering on this — for our veterans, and for the country.
Barriers to this come in the form of many complex conditions such as chronic pain, sleep disorder, substance abuse, depression, and posttraumatic distress disorder. These are not “find it, fix it” types of problems. These conditions require a new approach driven by the individual needs of the patient.
The VA seeks to partner with veterans and optimize their health in service of what matters to them, to start with them as a person, not their diseases. The top strategic goal for the next five years is to change the way we deliver healthcare, making it personalized, proactive, and patient-driven.
The VA has started this journey by establishing centers of innovation and hundreds of pilot programs across the country that provide new approaches to manage and optimize veterans’ health. These centers now utilize a variety of specialists, such as nutritionists, massage therapists, yoga instructors, acupuncturists, and mindfulness and biofeedback providers. In an effort to understand each veteran’s vision for their own life and identify their own health goals, VA providers partner with patients to create a Personalized Health Plan detailing the support they need from the VA to achieve their goals.
But achieving cultural transformation requires more than additional treatment options and assessment tools, it requires changing how we define and measure success.
Healthcare systems can no longer measure, value and reward episodic application of diagnostics, pharmaceuticals and procedures. These are just transactions, not success.
Instead, the VA is working to develop measures of life-long health. The development of these measures must occur in partnership with veterans. The veteran is the captain of the team and we are some of the invited players. The achievement of veterans’ life-long health and well-being must be what the VA values and rewards. And to get there, we constantly innovate its methods in both conventional and complementary approaches to healthcare.
This requires gathering data — lots and lots of data. The VA tracks veterans across the timespan of their lives, allowing us to discover and demonstrate new models of care, analyze results, and create strategies for their implementation across the VHA. These tested models can then serve as a blueprint for the rest of healthcare industry.
Today’s financial and moral imperatives demand this change in our approach to healthcare. And coupled with the groundswell of unbelievably passionate and talented people across the country, we are more than ever able to deliver on it. With the VA leading the way, the time to act is now.
Tracy Gaudet is director, Office of Patient-Centered Care and Cultural Transformation, Veterans Health Administration.