Patient Perspectives on Implementing a Person-Centered Care System: Experiences From the U.S. Veterans Health Administration's Whole Health System of Care

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Objectives. Replacing the disease-centered, paternalistic approach in healthcare with a person-centered model has become a widely recognized imperative. However, patients' perspectives on and experiences with real-life efforts to implement this approach to care are rarely studied. We examined this issue at a health system with a prominent record of commitment to implementing person-centered care on the system level – the U.S. Veterans Health Administration (VHA). For over a decade, VHA has been transforming itself into a Whole Health (WH) system of care that is person-centered, holistic, and empowering. Methods. We conducted semi-structured qualitative interviews with 19 patients recruited from a single VA medical center and used a combination of qualitative content analysis and thematic analysis to generate themes. Results. We generated three themes. First, patients were largely unaware of WH as a concept or initiative, although some were able to retroactively use the newly introduced concept of WH to reflect on their past care. Second, whereas some patients grasped the meaning of WH easily, others displayed a lack of understanding, conflating WH with other models of care. Finally, when asked about their interest in experiencing WH care, some patients were enthusiastic; others were disinterested or expressed reservations. Conclusions. Patient perspectives from the VHA illustrate that implementing person-centered care requires a paradigm shift not only for clinicians but also for patients, who may be similarly accustomed to a biomedical approach and/or unaware of alternatives. To improve patient engagement in person-centered care, health systems ought to undertake targeted, iterative, multi-pronged education efforts.

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