Shifting the Conversation for Veterans to "What Matters to You?"

MITRE's Joe Villalon has a case of converging identities. He works in our national security division providing warfighting capabilities to Department of Defense—and he serves in the active military reserves using those tools. He's also a long-time client of the VA, another of our government sponsors. A soldier for 32 years and counting, he's been well-accustomed to the services VA offers. That changed last year, when he began using the agency's Whole Health approach to care.

The new system aims to equip veterans to become more engaged around their overall health. Participants develop a personal health plan centered around their individual goals. They can access complementary and integrative health tools and approaches like acupuncture and massage. And they engage in shared decision-making for clinical care, both conventional preventative and medical disease management.

"The services I get now are no longer just a typical doctor appointment where you’re in and out with prescription in hand. Whole Health brings it to an entirely new level—they're looking out for what's really important to me," Villalon says.

He didn't know until recently that across the company, his colleagues in our public-sector division are working to support VA's Whole Health transformation journey. He hopes more people will be able to benefit from their efforts.

The Chief Warrant Officer 4 explains that veterans like him—conditioned to get the mission done without complaint—can find it difficult to voice their needs. And multiple long deployments, including to combat zones, bring diverse health challenges. With his VA medical center 45 minutes away, he appreciates Whole Health's offerings in his community or virtually: yoga, hiking, meditation, and gardening, to name a few.

Moving Beyond the Symptoms

With Whole Health, VA has aimed to shift the conversation with veterans from "What’s the matter with you?" to "What matters to you?" But they needed a way to objectively evaluate the system's effectiveness in the field—i.e., does it meet the needs of veterans across the country living their everyday lives?

The MITRE team developed a data-driven approach to facilitate Whole Health's rollout. This included developing a roadmap and pilot implementation plan that provided VA with a Whole Health Recognition model to assess the effort. The model enables VA's central office and VA medical centers nationwide to engage in bi-directional learning for validation of Whole Health.

Though early in its journey, Whole Health use across VA has noticeably increased. Approximately 1.8 million (29%) of veterans using VA health services accessed Whole Health in 2023, up from 17% in 2022. Even more impressive—since program initiation, opioid use among Whole Health participants decreased 23% (versus 11% decrease among non-participants).

Veterans Health Administration Office of Patient Centered Care and Cultural Transformation Associate Director for Operations Todd Houck says, "This effort between MITRE and VA is empowering VA to deliver proactive, person-centered care to meet veterans' unique needs."

A Connection Comes Full Circle

As Villalon learned his MITRE co-workers have a hand in Whole Health's implementation, they learned of their colleague on the receiving end of their work. The project team is inspired by the connection—as well as the initiative's broader goal.

"Whole Health's biggest potential impact is an overall improvement to the way VA delivers care for veterans and supports its employees," says MITRE's Andrew David, one of the project leads. "It's more than encouraging people to do yoga and come up with what matters to them—it's driving cultural change within the organization."

Achieving that kind of change requires an unbiased, evidence-based validation process. The MITRE team began with a review of existing VA resources for Whole Health. They also engaged key stakeholders to gain insight into their model structures, conducting dozens of interviews across approximately 80 participants and five structured external certification bodies. These included The Joint Commission, the American Nurses Credentialing Center, and the Institute for Healthcare Improvement.

Our experts then conducted qualitative analysis to explore questions such as: What are some of the barriers to Whole Health implementation? What are the facilitators? How could a certification or recognition program help VA structure Whole Health to provide value back to VA medical centers? The answers enabled the team to establish an information baseline about the current state of implementation and develop a plan to validate future-state vision and goals.

Putting Veterans Front and Center

As the Whole Health recognition pilot takes place across a handful of medical centers this year, MITRE continues supporting VA to gather feedback, refine the model, and validate the program and overall process prior to VA's full model implementation in the next few years.

At the end of that process stands veterans empowered to put themselves—not their symptoms—at the center of their care decisions.

Villalon says his early exposure with Whole Health has motivated him to spread the word among his fellow soldiers. "I'm telling them about all these services they’re entitled to and dragging them to the front door of the VA—that's the first step."