My Care Guide for VeteransiOS app for person-centered care planning
We are committed to supporting and improving the personal health journeys of Veterans. Providing seamless care for Veterans is especially challenging because it often includes many healthcare providers, both within and outside of the VA healthcare system. Our My Care Guide mobile app was developed to support Veterans with a person-centered care plan that adopts a broader, long-term view for wellness that is guided by a Veteran’s personal team of doctors, therapists, family caregivers, and supportive friends. The Iraq and Afghanistan Veterans of America (IAVA), a non partisan advocacy organization with over 400,000 members worldwide, published a statement about VA Secretary Shulkin’s 2017 “State of VA” address regarding the need to improve healthcare for our women veterans:
It was disappointing to see so little focus on women veterans today. Not only absent in the Secretary’s remarks, but largely overlooked in his plan, were the disparity in services and cultural issues women face at the VA. Women are the fastest growing segment of the veterans population, and more than 345,000 women have deployed since 9/11. Women veterans must begin to be a stated priority of this Administration.
Person-Centered Care – Veteran Journeys
These personas are fictional characters distilled from user research that represent the needs of larger groups of veterans. The descriptions (but not the specific sample data) were created by VHA Human Factors Engineering and intended to aid in the development of usable and useful healthcare systems at the VA.
- Meghan’s Journey – Post-9/11 Era Female
- Byron’s Journey – Post-9/11 Era Male
- Dan’s Journey – Vietnam Era Veteran
- Philip’s Journey – WWII & Korean Era Veteran
For each of these veteran journeys, we are creating sample data using the HL7 FHIR®© standard and using those data to develop, test, and demonstrate the capabilities of My Care Guide to support person-centered care. The sample data are a work-in-progress that evolve with our work on defining and aligning with best practices for standards-based care planning. The app screen images included below will be updated as the best practice and sample data continue to evolve.
Person-centered care for women, with initial focus on maternity care, is the first clinical application for My Care Guide app pilot testing. Meghan’s Journey fits directly within the post-9/11 veteran mission of IAVA and their call for action to support women veterans.
Meghan is 33 years old and a post-9/11 Veteran who served in Afghanistan and is recovering from a Traumatic Brain Injury (TBI) and PTSD. Meghan recently became pregnant with her third child and is coordinating care plans between her primary care provider at VA and a community provider outside of VA for her maternity care. Meghan has concerns about possible negative effects of her PTSD anti-anxiety medication on her new baby.
Meghan’s Life Story — Meghan joined the Navy after graduating high school in the summer following 9/11. She deployed to Afghanistan as an individual augmentee with the Combined Forces Command Afghanistan. It was there that she narrowly avoided being killed when the truck in front of hers in a convoy was struck by an RPG. However, her best friend was not as lucky and died in the attack. Meghan advanced to the rank of Yeoman First Class before leaving the service; she and her first husband divorced near the end of her second enlistment.
After a couple of years, she married a Navy Senior Chief who is stationed at Oceana Naval Air Station. They live in Virginia Beach, Virginia where she works as a legal secretary. Still haunted by seeing her best friend killed, she sees a Mental Health Counselor at the Virginia Beach Outpatient Clinic. Her new husband look forward to having a child together.
Dan is 69 years old and a Vietnam Veteran who continues to struggle with the effects of PTSD and Diabetes (resulting from Agent Orange exposure). He is being treated for hypertension, and also smokes an occasional cigarette, a habit that he has not been able to break, despite several attempts.
Dan’s Life Story — Dan was drafted into the Army in 1965. Following training he was deployed to Vietnam, where he served for 14 months, advancing to the rank of Sergeant. He initially engaged with the VA when he put his name on the Agent Orange Registry but was subsequently awarded a disability rating of 40% for service connected knee, shoulder and elbow issues. Since then, he has come to realize that the events that led to his divorce 10 years ago could stem from unresolved issues resulting from the PTSD he suffered since the war.
Byron is 36 years old and deployed to Iraq three times as a member of the Marine Corps. He earned the Purple Heart for a leg injury received in an IED attack. His PTSD and anxiety led him to develop a problem with alcohol. His wife and VA care team are concerned about Byron’s risk for suicide.
Byron’s Life Story — Byron was commissioned in the Marine Corps in 1999 after college. He had just been assigned to duty on an Aircraft Carrier in its Marine Corps Detachment when 9/11 happened. He transferred to an Assault Amphibian Battalion at the end of 2002 and was part of the first wave in Operation Iraqi Freedom. During the push to Baghdad his leg was wounded in an IED attack. For his injury he received the Purple Heart. He deployed to Iraq twice more over the next few years. The strain of deployments was taking its toll on his marriage, so he decided to get out at the end of his last deployment.
Captain Campbell’s Purple Heart and his leg injury along with service-connected PTSD and anxiety qualified him for VA health services. AmVets assisted him in the filing of his disability claims. His PTSD and anxiety led him to develop a problem with alcohol. His wife convinced him to enroll in a substance abuse program at the Atlanta VAMC.
Philip is 90 years old and lives with his daughter, Joyce, who is his primary family caregiver. He has numerous health issues and is nearing the end of his life. He lives to share his experiences and memories with those close to him. Joyce uses the My Care Guide app to help manage her father’s care planning and treatment with emphasis on his personal goals.
Philip’s Life Story — Philip joined the Army Air Corps in 1943 when he turned 18. He was assigned to the glider pilot training and flew a WACO CG-4A for mission Chicago with the 101st Airborne during the Normandy Invasion. He landed his glider 2 miles west of Sainte-Marie-du- Mont, which was successful but it was a hard landing and he later discovered he had two compression fractures in his neck as a result. Despite his injuries he helped man the anti-tank gun his glider carried. His neck injury kept him from being redeployed to the Pacific theater and he spent the remainder of the war at Fort Campbell.
After leaving the Army Air Corps in 1946 he returned home and married his high school sweetheart. He opened up a small hardware store that he operated until he retired in 1995. The couple had one daughter, Joyce, who has provided care for him since his wife died in 2007. Divorced with 2 grown children, Joyce works from home as a billing clerk. This allows her the flexibility and resources to care for her father, who lives with her in her home.