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QUERI Whole Health Initiatives

EPCC QUERI’s Evaluation of Whole Health and Veteran Outcomes

Evaluating Patient-Centered Care (EPCC) is a QUERI Partnered Evaluation Initiative (PEI) led by Barbara Bokhour, PhD, co-Director of HSR’s Center for Healthcare Optimization and Implementation Research (CHOIR). Since 2013, EPCC has partnered with the Office of Patient-Centered Care & Cultural Transformation (OPCC&CT) to evaluate the transformation of VA medical care to a Veteran-centered, Whole Health (WH) system of care. The WH approach empowers and equips Veterans to take charge of their health and well-being and live their life to the fullest. EPCC examines the implementation, outcomes, and impact of WH on Veterans, VA care, and employees.

EPCC’s findings have been critical to OPCC&CT’s efforts to spread WH throughout VA’s system of care. For example, in response to the Comprehensive Addiction and Recovery Act (CARA), EPCC conducted a three-year evaluation at 18 flagship sites. EPCC’s findings, which demonstrated the benefit of WH for Veterans, were heavily cited in OPCC&CT’s 2023 report to Congress and garnered VA leadership support for WH expansion. EPCC findings were also cited throughout the 2023 National Academies of Science, Engineering and Medicine Report titled “Achieving Whole Health: A New Approach for Veterans and the Nation.” Additionally, VA Directive 1445: Whole Health System (2023) cites EPCC findings as the basis for the expansion of WH system wide.

EPCC’s work continues in FY2025 with multiple projects, including evaluations of Employee Whole Health, the integration of the three-item Well-Being Inventory into VA care, and OPCC&CT’s strategy of using WH implementation champions to implement WH approaches into primary and mental health care. EPCC works in close partnership with OPCC&CT, providing evidence-based tools for implementation and quality improvement. Findings from EPCC continue to inform VA policy to spread WH transformation system wide.

Complementary and Integrative Health Evaluation Center

Provision of complementary and integrative health (CIH) therapies is a national priority for VA and is part of the Comprehensive Addiction and Recovery Act of 2016 (CARA). QUERI’s CIH Evaluation Center (CIHEC), a Partnered Evaluation Initiative, was established to partner with VA’s Office of Patient Centered Care and Cultural Transformation (OPCC&CT). Over the past eight years, CIHEC has included 23 investigators and staff from six HSR COINs to conduct 21 projects. These projects evaluate the implementation of evidence-based CIH therapies; evaluate the effectiveness of novel CIH therapies as non-pharmacological options for Veteran and/or employee health; or disseminate information and data on VA CIH therapies nationally.

CIHEC’s most important impacts, in partnership with OPCC&CT, include:

• Findings presented to members of Congress and the Congressional Creating Options for Veterans’ Expedited Recovery (COVER) Commission to periodically update Congress on VA’s expansion of and research on CIH therapies.
• Informing VACO and VISN leadership about Veterans’ interest in and use of CIH therapies and the effectiveness of CIH therapies.
• Informing the National Academies of Sciences, Engineering, and Medicine 2023 report on Whole Health, which was presented to the Assistant Secretary for Health and Human Services, Centers for Medicare & Medicaid, and several senators.
• Informing VA clinicians and staff nationally and regionally on the evidence for and how to best implement CIH therapies.

CIHEC continues to examine CIH therapy use and effectiveness using patient-reported outcomes and administrative data, and continues to disseminate information and data on VA CIH therapies, with a new project aimed at developing communication tools to provide guidance for the appropriate use of medical massage in VA.

For more information on CIHEC, please contact Diana Burgess (Diana.Burgess@va.gov).