Patient wellness is a multifaceted experience, involving physical and mental health, social relationships, cognitive function, and more. Whole person care addresses these factors as a whole rather than as separate aspects of a patient’s health.
Comorbidities have a large impact on patient health. For example, people with severe mental illness may be more than twice as likely to have two or more chronic physical health conditions, reducing life expectancy by an average of 10 to 20 years.
Addressing all facets of patient health fills gaps in treatment plans and promotes better patient outcomes. In this article, we will explore the different elements of whole person care, as well as the benefits of this approach that may be useful when growing a medical practice.
What Is Whole Person Care?
Whole person care is a healthcare approach that considers and addresses multiple dimensions of patient well being, and emphasizes collaboration between providers and patients. Instead of looking only at specific symptoms, body systems, and diseases, a whole person approach acknowledges the way different aspects of health are interconnected.
These aspects include a patient’s:
- Physical health
- Mental health
- Cognitive health
- Social health
- Spiritual health, or worldview
Along with individual health experiences, whole person care also considers wellbeing on a communal and systemic level. One meta-analytic review found that strong community social relationships increased the likelihood of patient survival by 50%.
Some of these community-based social aspects of health include:
- Lifestyle
- Relationships
- Belief systems
- Socioeconomic status
- Environmental influences
Because whole person care explores multiple aspects of health, this approach can be implemented across many healthcare contexts, by a diverse set of health care providers and community partners such as:
- General practitioners
- Psychologists
- Health care specialists
- Nurses
- Social workers
- Nutritionists
- Spiritual care providers
Family members are often included in the health care team, particularly when a patient is unable to advocate for themselves. Above all, patient-centered care is essential to a whole person approach. This care model centers patient preferences and values, and gives them the final say in their personalized treatment plan.
Whole Person Care Program - Los Angeles
From 2017 to 2021, the Whole Person Care-Los Angeles (WPC-LA) pilot program was implemented in Los Angeles, with the goal of improving health outcomes for the most vulnerable and systemically marginalized members of the community.
This included patients who were:
- Experiencing homelessness
- Involved in the justice system
- Pregnant
- Living with mental illness, substance use disorders, and/or complex health conditions
WPC-LA’s programs were implemented by the Los Angeles County Department of Health Services (LAC-DHS) and funded by the Medicaid Waiver 1115. The initiatives improved health services by expanding care services, strengthening collaboration, building better infrastructure, and improving data sharing between health care organizations.
In total, 150,619 participants were served by WPC-LA, with the help of 187 partner organizations and 200+ community health workers. While this pilot program ended in December 2021, a new state-wide program called CalAIM is building upon the results of the pilot as of January 2022.
This implementation of the whole person care model was incredibly successful in addressing health equity through physical health, behavioral health, justice, and social services systems.
According to the 2022 Impact Report, the programs run by WPC-LA resulted in the following outcomes:
- 7 to 24% reduction in emergency room visits.
- 8 to 21% increase in primary care utilization.
- 4 to 30% reduction in hospitalizations.
- 34% of participants experiencing homelessness were connected to beds within 12 months, and 53% retained their housing for an additional 12 months.
- 2,589 beds added for interim housing, recuperative housing, and enriched residential care programs.
The success of this program has been foundational in our understanding of whole person care, and demonstrates the power of improving healthcare systems and social services.
Characteristics of Whole Person Care
Whole person care addresses multiple aspects of patient wellbeing, including:
1. Physical health
Rather than considering individual organs or body systems, whole person care takes patients’ full wellness experience into consideration. For example, if a patient was dealing with both stress and chronic stomach aches, a whole person approach would explore the ways these ailments are connected.
Along with this, rather than focusing on one treatment course, the whole person model invites various approaches from different providers.
For example, a patient’s physical health might be addressed through multiple treatment strategies in combination, such as:
- Surgery
- Pain medicine
- Pain management education
- Acupuncture
- Special dietary guidelines
Working with a collaborative team of providers addresses multiple aspects of a patient’s physical health. Along with this, strong communication between providers can reduce the number of medical appointments for patients, which may increase their life satisfaction.
2. Mental and behavioral health
Psychological health plays a major role in patients’ overall wellbeing. For example, many patients with depression also report chronic joint pain, limb pain, back pain, and gastrointestinal problems. Whole person care addresses the ways in which mental health impacts patient decision-making, behavior, and adherence to treatment.
This care model also includes exploration of patients’ relationships with others. One scoping review of PubMed and PsychInfo databases found that 83% of studies reported that social connections were beneficial in treating depression.
In order to assess all aspects of a patient’s mental health, a care team might consist of:
- Psychiatrists
- Therapists
- Meditation and mindfulness coaches
- Social workers
- Stress management groups
If left untreated, chronic stress can be detrimental to patients’ brain health, immune system, and more. Empathetically addressing patients’ life stressors can make a difference in patients’ long-term health. Using cognitive and mental health assessments can help providers track the progress in patients’ treatment journeys.
3. Cognitive health
In the United States, almost 10% of adults over 65 have dementia, and an additional 22% have mild cognitive impairment. The whole person care model considers the way in which cognitive challenges impact a patient’s overall wellbeing.
For example, many dementia patients struggle with medication adherence. If, for instance, a patient reported that medication was not improving their symptoms, whole person care might explore how consistently the medication was taken in addition to alternative reasons or solutions.
The holistic nature of whole person care doesn’t separate cognition from other aspects of health. Including cognitive function tests in regular physicals is a simple way to take note of how a patient’s cognitive function might be impacting their overall health.
Creyos helps providers monitor cognitive health and improve patient outcomes with tools such as:
- Scientifically-validated tasks to measure cognitive function
- Patient questionnaires that can be completed at home or in the clinic
- Data-driven performance reports that can be shared among the health team, improving multidisciplinary collaboration
4. Social health
The CDC defines social determinants of health (SDOH) as “the nonmedical factors that influence health outcomes,” which include:
- Food security
- Housing quality and security
- Early childhood development
- Economic status
- Education level
- Job security and work conditions
- Access to affordable health care
- Social discrimination
- Intergenerational trauma
- Systemic marginalization
Studies suggest that these factors contribute to 30 to 55% of health outcomes. A whole person outlook recognizes that, with these determinants in mind, there can be no one-size-fits-all approach to treatment. Acknowledging the social aspects of patient wellness can help providers identify those that may benefit most from preventative care strategies tailored to individual patient circumstances.
For example, gender plays a role in social determinants of health; while women are more likely to experience dementia, they also provide 70% of care hours for dementia patients. Caregiver burnout can lead to cognitive and mental health challenges for caregivers themselves. Whole person care can look like acknowledging the gendered element of this strain to provide women caregivers with adequate resources for their own wellbeing.
5. Spiritual health
Studies have shown that up to 83% of patients want their providers to be aware of their religious beliefs. For the most part, this stemmed from the desire to have doctors understand how their beliefs impact their behaviors and decision-making.
Patient-centered care prioritizes open communication between providers and their patients, and allows patients to guide decision-making. Open conversations about faith can guide health teams towards treatment options that are most appropriate for individual patients.
Patients’ existential and spiritual experiences can be supported by collaborating with other professionals, such as:
- Hospital chaplains
- Faith leaders
- Death doulas
For example, 73% of patients who desired conversations around spiritual wellness wanted them in the context of death and life-threatening illness. A whole person approach recognizes that patient care does not stop when diseases are chronic or terminal. Addressing a patient’s spiritual health ensures they are treated with dignity through the end of their lives.
Health Outcomes Associated With Whole Person Care
Research shows that whole person care leads to better health outcomes for patients. In a review of whole care models in primary care, one study found that 24.7% of patients described the initiative as the “best care ever,” with an additional 37.6% describing it as “excellent.”
Along with the positive emotional experience, this review found several additional positive health outcomes, including:
- Reduced stress levels (reported by 77.7% of patients in one study)
- Increased physical activity (reported by 50.5% of patients)
- Improved nutrition (reported by 65.2% of patients)
- Lower costs (of up to 24% lower costs in all categories except drugs), reducing financial strain on patients
95% of patients reported that they felt they had input into their treatment plan, which highlights the value of patient autonomy in a whole person approach.
Because whole person care includes a variety of providers in the health team, continuity of care is essential to patient wellness. One study revealed that patients care more about the emotional aspects of feeling safe, secure, and confident in their providers—instead of defining continuity as “seamlessness.”
Rather than demanding perfection, patients prioritized feeling as though they were being listened to and could trust that their information was being communicated between team members.
Importantly, 35% of patients report that their patient experience impacts their future healthcare decisions. Leading with person-centered communication makes a difference in patient outcomes over time.
Workflow and Operational Benefits of Whole Person Care
Along with positive health outcomes for patients, the whole person care model also has a positive impact on providers. Individual patient-provider relationships are an important part of whole person care, but the systematic aspect holds equal value.
One major part of WPC-LA’s success came down to organization across the health care professionals and community partners that were involved. Over 200 community health workers facilitated connections between the different services involved, allowing providers to focus on giving the best possible care.
One study found that physicians who felt they were meeting patients’ social needs were less likely to experience burnout. With 28% of healthcare professionals citing burnout as their reason for quitting, the whole person care model can be a step in managing the root causes of burnout and retaining healthcare staff.
Along with improving morale, the whole person care philosophy has several operational benefits, such as:
- Simplifying internal referrals by having an established network of providers
- Clarifying roles among the health team to prevent repeat conversations
- Streamlining assessments and reports with comprehensive tools
- Building more connections among providers in the long-term
Tools like Creyos Health can play a large role in centralizing different elements of care, such as:
- Including cognitive and mental health assessments in one place
- Automatically uploading session notes into patient records with EHR integration
- Easy-to-understand assessments in multiple languages that acknowledge patients come from a variety of cultural and socioeconomic backgrounds
- Automation of tedious assessment processes, leaving more time for clinicians to learn about each patient’s unique needs
- Creating user-friendly reports that facilitate connections with patients, arm them with data to help make decisions about their own healthcare, and that can easily be shared with other providers
- Integrating virtual primary care with traditional in-person processes
With improved continuity of care among practitioners, patient needs can be consistently addressed from a holistic viewpoint. This protects patients from repeating themselves and becoming disheartened by the medical system, and prevents information from getting lost between providers.
Improving the State of Public Health With Whole Person Care
Following the COVID-19 pandemic, the health care system has gone through complicated transformations for patients and providers alike. In 2024, the whole person approach has the capacity to improve patient-provider relationships and help the healthcare system become more sustainable for healthcare professionals.
This post was edited by Mike Battista, Director of Science and Research at Creyos (formerly Cambridge Brain Sciences).