Expanding whole health access for rural veterans with pain: Virtual hub-and-spoke models

VA's Clinical Resource Hubs (CRH) are well-positioned to fill pain care gaps experienced by rural-dwelling patients through regional hub-and-spoke models. We examined how CRHs integrated Whole Health approaches to expand access to this care for chronic pain.

Qualitative interviews conducted with employees in 4 CRHs were rapidly analyzed to examine how CRHs organized and delivered Whole Health care.

CRHs delivered Whole Health care in interdisciplinary pain, stand-alone Whole Health, and primary care clinics. All offered varied Whole Health services (Whole Health coaching, complementary and integrative health therapies, and Whole Health groups), and incorporated key elements of person-centered communication to ensure care aligned with what mattered most to patients. Considerations unique to CRH delivery included multiple referral pathways, orienting patients to this short-term centralized care model, obtaining medical clearance, ensuring care continuity upon discharge, and telehealth adaptations. Participants perceived multiple benefits of Whole Health in CRHs for the healthcare system and patients.

Whole Health care can be successfully integrated into innovative centralized health system models like CRHs, enhancing accessibility. Replicating these models requires establishment of clear entry and discharge processes, and attention to virtual care delivery.