How whole-person care is shaping the healthcare industry

Keeping IT Brief introduction: From technology and acquisition to citizen services and mission execution, a culture shift is underway with federal government leaders increasingly seeking out solutions that disrupt the way business has traditionally been done. Here we connect with both governments and industry leaders driving this change and delivering the real results in support of their agency mission. This is Keeping IT Brief.  Today, Susan is speaking with Amy Mosher-Garvey, the Performance Impact Director at Leidos.

Susan Sharer: Amy, can you tell us what is whole-person care?

Amy Mosher-Garvey: Sure. Whole-person care is a term that's been around for a while. In healthcare it suggests that health and wellness really is only achievable when we look at the person as a whole being. So it considers social determinants of health alongside of physical and biological factors. It's more than making sure that we're treating illness and it goes way beyond the preventative care too. It recognizes that mental health and financial stability, food security, access to adequate employment, safe housing, meaningful social engagement, even social justice are really all a part of health as we define it. So people who understand the concept of whole person care know that one of the most important numbers in determining a person's health, right up there with any lab test or your blood pressure, is actually your zip code.

Susan Sharer: What does whole-person care look like in healthcare?

Amy Mosher-Garvey: Well, in healthcare, it can look a couple of different ways. I know that when I work with programs who are early in their stages of adoption, that sometimes it's just simply a matter of adding some screening questions that assess things that are maybe not tied directly to your physical health being as we think of it. These screenings might ask people about other related needs and provide resources. Sometimes in more robust programs, you'll see them utilizing a collaborative peer model or a social care program, or other less traditional models of care.

True whole-person care includes working with everything from food scarcity and safe housing, legal issues, financial concerns, access to medications, as a part of the integrated care delivery system. So as you can imagine, this takes a very different approach that includes not just different care delivery perspectives, but also a robust infrastructure of enabling technology to support that integrated operation.

Susan Sharer: Great. Amy, can you say more about the infrastructure that is needed to do this type of care provision successfully?

Amy Mosher-Garvey: You bet. As you can imagine, it really takes a village to address all of the aspects of whole person care. There isn't just a one-stop-shop to address all of these needs. This is where we start to really see the benefit of command and control systems that can help provide situational awareness across multiple supports, multiple providers to engage the patient in their own environment.

Susan Sharer: Amy, tell me a little bit more about command and control.

Amy Mosher-Garvey: Command and control, this terminology actually originally came from our military. Leidos, as you may know, has a long history, more than 50 years actually, of working with the military to solve all kinds of problems, not just in healthcare. And command and control, or sometimes it's referred to as C2, is used to describe a system that is capable of empowering designated personnel in the accomplishment of missions and tasks.

That's exactly what's needed here. You can see all of the enabling technology coming together to serve a disparate group of providers and service delivery individuals who are trying to provide care for an individual person. In whole-person care, we can use enabling technology to get the right information in front of the right people at the right time; sometimes we call this right-sighting, so that the right decisions can be made to solve the problems.

Susan Sharer: That’s great, Amy. Can you provide some examples? How might this be different than an electronic health record?

Amy Mosher-Garvey: Well an electronic health record, or an EHR, is a great source of data. It is a place where you can track and aggregate a number of data points that are derived from transactional interactions with a patient. In whole-person care, we use the data a little bit differently. While some EHRs are better than others at making sense out of just the mountains of data that they contain, they still fall short of showing the overall picture of the individual or the population across multiple sources.

Payer data is another important source.  As payer data tracks individuals across multiple providers, potentially multiple EHRs, multiple different services, but again, it falls short in capturing the full picture. It misses the socioeconomic data. It can miss social relationships, how someone feels about the work they do, or their spirituality. Command and control involves taking data from many of these different disconnected sources and transforming it into actionable insights and positioning it in front of the right people to take action. It includes elements of data curation, aggregation, analytics, and smart data visualization. It can include graphs and heat maps, or demographic data, patient reported data, lots of other things, all those wearables that are so prominent in today's society, remote patient monitoring data. All of that can be used to paint a full picture of the patient and where they're at.

The key then is to get right data into the user specific view that can drive action. It's not good enough to just have mountains of data. We need to make it actionable. We need to make it usable to people who can drive a different outcome. So a physician view, for example, might be different than a patient view or a care coordinator view.

Susan Sharer: And this drives improvement and better outcomes?

Amy Mosher-Garvey: Yes, in a couple of ways. First, it improves the ability to drive improvement at the individual level. Second, it provides situational awareness at the population level. It can help an organization see hotspots of need, identify food deserts, or decide where to deploy specialty care services. Command and control can help visualize need, gaps in care, and even flow through the system. The end result is improved care about availability and access, improved cost control, right sighting of care, and overall improvements and wellbeing of the individual and the community at large.

Susan Sharer: That's great, Amy. Thank you so much for sharing the information about whole person care and the work that you're driving, Amy.

Amy Mosher-Garvey: Thanks for having me.