THE IMPORTANCE OF THE WHOLE PERSON HEALTH SCORE ASSESSMENT

BIJAN SASANINIA PROGRAM COORDINATOR FOR WPHS, RIVERSIDE UNIVERSITY HEALTH SYSTEM

In 2022, I was tasked with being the Program Coordinator for the Whole Person Health Score (WPHS) project at Riverside University Health System (RUHS). The California Department of Health Care Services had initiated a multi-year program that requires health systems to improve health outcomes and quality of life of residents and offer a broad service delivery system. In response to the new state requirements, my department was uniquely created to support the implementation and expansion of the WPHS throughout Riverside County. The goal was to teach our health system to think about overall health in a new way and create a pathway for our care teams to address complexities for our vulnera- ble patient populations.

The Whole Person Health Score is an innovative holistic health measurement tool that was developed at RUHS over six years ago and is based on a 28-question assessment that measures six different areas of health.

The goal of the tool is to capture the elements in a person’s life that make the biggest impact in regards to life-expectancy and well-being. The assessment produces a color-coded letter score in each area of health that both the provider and patients can easily understand. The Whole Person Health Score is designed to track change over time and supports strategic care coordination by simplifying and prioritizing areas of greatest need for the patient. Ultimately, the WPHS is designed to empower patients to make improvements towards their health.

This project requires a lot of attention to detail to be effective. For example, in this role, it was necessary to develop processes and workflows that enabled care coordination throughout different departments. I’ve also developed and managed workgroups for more than 15 different WPHS projects and have also helped to establish program goals and priorities, coordinated with our research team, and developed informational materials to educate care teams on how to best utilize the WPHS tool in order to have a holistic approach to care.

The work to create the Whole Person Health Score was really led and inspired by patients. In fact, patients helped with determining the wording, the placement, and significance of questions used in the assessment. The unusual and ultimate six-letter display of the Whole Person Health Score was based on feedback from patients, who stated that letters were easier to understand than numbers.

When I first joined the WPHS workgroup in 2017, I was a volunteer health coach that had helped pilot the assessment among patients. My role as a health coach was to provide supplemental health education and motivational support to assist patients to self-manage their chronic medical conditions. In piloting the assessment, we would ask them what they thought each question meant, if the questions were important to understanding their health, and if the color-coded score accurately described their perception of their overall health.

The most compelling experience was when we were asking patients about whether we should include a question about “The Purpose of Life.” This question incited a deeper dialogue with patients, and I was humbled by how compelling patients were in telling their story, discussing significant events that led to how they acquired their chronic conditions, where they were at with their health, and what motivated them to move forward. I feel that going through the WPHS with patients provides a therapeutic interaction that gave patients a moment to reflect on what really matters in life.

There were times where I would find some patients that were in significant distress. However, finding the appropriate resources was initially challeng- ing and not always straightforward. At that time, I started to capture patient stories and the barriers that were presented (with the patient’s permission), and I would present them as patient case studies to leadership to bring awareness of the complexity of needs identified with the WPHS and how their unmet needs impacted their self-management of care. The stories challenged the workgroup to think through feasible solutions to assist the patient and possible pathways where we could improve care delivery. My work to advocate for patients led me to being asked to join the RUHS Team as a full-time staff member. My work now focuses on exploring how WPHS impacts our patients, advocating for use of the WPHS within RUHS, training care teams on the WPHS, and helping care teams realize the value and benefit of learning of the whole person approach to care in their scope of work.

What I am excited about is that Riverside County has initiated an Integrated Service Delivery program to improve accessibility of county-wide services. As part of this effort, Riverside County Departments (starting with those related to Health and Human Services) will collaborate to utilize tools like the WPHS to engage with county residents, identify health disparities, and inform strategic planning on how to allocate health and social resource and interventions for our population and improve service delivery overall. This initiative gives me hope that the patient stories I presented to the RUHS leadership years ago has had a positive impact and that countless people dedicated to the wellbeing of our community are working together to find robust and effective solutions for complex health and social problems, especially for those residents who may be in times of critical need.

In the future, I am looking forward to increasing numbers of care teams at RUHS that will find value in adopting the WPHS as a meaningful metric that can help the better engage and collaborate with their patients and promote conversations on how everyone has the potential to achieve a long and healthy life. I look forward to seeing how the Whole Person Health Score can help to further transform the way in which our health system delivers care to all of our residents, including those in greatest need. I envision a future where people throughout Riverside County and beyond can be informed on what actions can be taken to improve their position in life and strive towards a path of self-improvement.