Uncovering what matters
Whole person health has come a long way. When we first developed the Personal Health Inventory (PHI), this tool was revolutionary. Asking patients about what mattered in their lives? Considering what brought them joy?
Those things were rarely considered part of the primary care appointment. Today, it’s more common to ask about what we sometimes call personal and social determinants of health. But the PHI goes beyond lifestyle habits and ZIP codes.
What truly matters to your patient? Now – and in the future?
The PHI can help both of you understand more about their mental, emotional, physical, and spiritual health and how all those aspects interact.
Now available electronically
We have two versions of the PHI: one for primary care and one for oncology. This tool was adapted from and aligned with the U.S. Department of Veterans Affairs Whole Health model. To improve access to the PHI for you and your patients, we now have an e-version of the PHI. This digital format streamlines the process and allows it to be sent securely. This fosters increased continuity of care and reduces administrative burdens.
Using it in the office visit
Patients can complete the PHI on their own, or you or your staff can use it in the office. Patients are prompted to self-assess their wellbeing across various domains on a scale of 1 to 5. Using simple questions and a respectful, conversational tone, it encourages patients to reflect on their daily experiences, identify strengths and concerns, and figure out what they might like to improve. Simply by sitting with a patient and talking about the PHI’s questions, we can uncover sources of mental, physical, or emotional pain and work with them to develop a truly personalized care plan.
PHI use scenarios
Imagine a scenario where a patient presents with persistent fatigue and difficulty concentrating. You review his completed PHI and notice a low score in the “Sleep” domain, indicating potential sleep disturbance. However, you also observe a low score in the “Social Support” domain, which may suggest feelings of isolation or lack of emotional support. This insight allows you to explore the interconnectedness among sleep quality, emotional wellbeing, and social connections and start making changes as part of a holistic treatment plan.
Imagine another patient who is struggling with chronic pain. Her PHI shows low scores in the “Moving” and “Stress Management” domains. Together, you can discuss what she enjoys doing to move her body – perhaps gardening or taking walks with a friend – and what she might try to manage stress, such as a guided meditation or even walking meditation. Addressing these areas can help you develop a plan that can lead to better health while recognizing your patient’s individuality and what matters to her.
Uncovering what matters
If you struggle talking with your patients about what matters to them, consider exploring the training and resources from Ariadne Labs, a joint center for health systems innovation at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. Their Serious Conversations guide has a step-by step process for finding out what matters to a patient – regardless of the patient’s condition.
Primary care and oncology PHI
The primary-care specific PHI can be particularly valuable in primary care settings, where we have the opportunity to build long-term relationships with our patients and help them create whole health over time, even avoiding long-term disease or disability. By using the PHI in routine assessments, we can identify potential concerns early on. This helps us initiate timely interventions or referrals to appropriate resources, fostering preventive care and promoting better health outcomes.
The oncology-specific PHI can also be used to guide cancer treatment decisions. In any setting, it can start meaningful discussions with patients and may be especially helpful in high-stakes situations and end-of-life care. You may want to ask a patient to bring the completed PHI to their appointment, perhaps highlighting areas they would like to focus on or concerns they want to address. This structured approach helps you talk about what matters most during the time available to both of you.
If you haven’t used the PHI yet, we encourage you to explore the new electronic versions and to consider implementing this tool in your practice.