Open Access Open Access  Restricted Access Subscription or Fee Access

Person-centered Medicine in the United States VA Health System: A Literature Review

Yulin Chu, Juan Mezzich


Person Centered Medicine (PCM) has been described across healthcare fields nationally and internationally over the past decades. There have been, however, no attempts to appraise systematically the relevant literature from the US VA health care system, important because it is the largest integrated in the country with over 200 hospitals and health facilities. The present study was aimed at conducting such literature review using “person-centered medicine”, “patient-centered medicine”, “individualized care”, and “people-centered care” as key words, and engaging PubMed and MeSH electronic data bases from 1997 to 2011, inclusively. The review yielded 31 articles emerging from across the United States, particularly from the East Coast. They covered a wide range of clinical settings, with a greater presence in primary care, rehabilitation and mental health. The numbers of published papers strikingly increased over the 15 years covered. All key features of PCM were identified across the articles, with a predominance of people-centered development of services, ethical commitment, relationship focus, individualization of care, and person-centered education and research. These findings are seen to be in line with recent trends in the health field and enunciated aspirations within the VA health system. The large size and features of the VA health system may offer special opportunities to conceptualize, pilot, implement and evaluate PCM developments in a manner that may enhance this health system and stimulate health care model innovation across the country and beyond its borders.


Person-centered medicine (PCM), patient–centered care, U.S. Veterans Affairs Healthcare

Full Text:



Miles, Andrew and Mezzich, Juan E., (2011). Advancing the global communication of scholarship and research for personalized healthcare: the International Journal of Person Centered Medicine. International Journal of Person Centered Medicine 1 ;( 1) 1-5.

Mezzich J E, Snaedal J, Van Weel C, Health I. (2010). Person-centered Medicine: A Conceptual Exploration. International Journal Of Integrated Care, Supplement.

Mezzich J E, Kirisci L, Salloum I. (2011). INPCM-WHO Project on Developing Measures to Assess Progress Towards people-centered Care. Technical Report. International College of Person Centered Medicine, New York.

Mezzich J E, Snaedal J, Van Weel C, Health I. (2010). Toward Person-Centered Medicine: From Disease to Patient to Person. Mount Sinai Journal of Medicine 77: 304-306.

Stewart M. (2005). Can a healthcare system be transformed? Lessons from the past decade at the Veterans Health Administration. Healthc Pap 5(4):56-9.

Kupersmith J, Francis J, Kerr E, Krein S, Pogach L, Kolodner RM, Perlin JB. (2007). Advancing evidence-based care for diabetes: lessons from the Veterans Health Administration. Health Affairs (Millwood) 26(2):w156-68.

Post EP, Metzger M, Dumas P, Lehmann L. (2010). Integrating mental health into primary care within the Veterans Health Administration. Families, Systems & Health 28(2):83-90.

McKay JR, McClellan AT, Alterman AI, Cacciola JS, Rutherford MJ, O'Brien CP. (1998). Predictors of participation in aftercare sessions and self-help groups following completion of intensive outpatient treatment for substance abuse. Journal of Studies on Alcohol and Drugs 59(2):152-62.

Stevens DP, Kizer KW, Elwood TW, Warden GL. (1998). VA aligns health professions education with healthcare priorities. Journal Allied Health 27(3):123-7.

Cowper DC, Hynes DM, Kubal JD, Murphy PA. (1999). Using administrative databases for outcomes research: select examples from VA Health Services Research and Development. Journal Medical System 23(3):249-59.

Feussner JR. (1999). Priorities for Patient-Centered Research. Medical Care 37(9):843-5.

Lynn MM, Achtmeyer C, Chavez C, Zicafoose B, Therien J. (1999). The evolving role of advanced practice nursing within the new Veteran's Health Administration. Health Care Manage Review 24(4):80-93.

Kominski G, Andersen R, Bastani R, Gould R, Hackman C, Huang D, Jarvik L, Maxwell A, Moye J, Olsen E, Rohrbaugh R, Rosansky J, Taylor S, Van Stone W. (2001). UPBEAT: the impact of a psychogeriatric intervention in VA medical centers. Unified Psychogeriatric Biopsychosocial Evaluation and Treatment. Medical Care 39(5):500-12.

Stalhandske E, Bagian JP, Gosbee J. (2002). Department of Veterans Affairs patient safety program. American Journal of Infection Control 30(5):296-302.

Miller CL, Druss BG, Rohrbaugh RM. (2003). Using qualitative methods to distill the active ingredients of a multifaceted intervention. Psychiatric Services 54(4):568-71.

Kazis LE, Miller DR, Skinner KM, Lee A, Ren XS, Clark JA, Rogers WH, Spiro A 3rd, Selim A, Linzer M, Payne SM, Mansell D, Fincke RG. (2004). Patient-reported measures of health: The Veterans Health Study. Journal of Ambulatory Care Management 27(1):70-83.

Perlin JB, Kolodner RM, Roswell RH. (2004). The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care. The American Journal of Managed Care 10(11 Pt 2):828-36.

Weiner J, Aguirre A, Ravenell K, Kovath K, McDevit L, Murphy J, Asch DA, Shea JA. (2004). Designing an illustrated patient satisfaction instrument for low-literacy populations. American Journal of Managed Care 10(11 Pt 2):853-60.

Fooks C, Decter M. (2005). The transformation experience of the Veterans Health Administration and its relevance to Canada. Healthc Pap 5(4):60-4.

Perlin JB, Kolodner RM, Roswell RH. (2005). The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care. Healthc. Pap 5(4):10-24.

Ramirez B, Nazaretian M. (2005). Quality, value, accountability and information as transforming strategies for patient-centered care: a commentary from an international perspective. Healthc Pap 5(4):52-5.

Doebbeling BN, Chou AF, Tierney WM. (2006). Priorities and strategies for the implementation of integrated informatics and communications technology to improve evidence-based practice. Journal of General Internal Medicine 21 Supplement, 2:S50-7.

Janzen SK, Mugler AS. (2008). Nursing leadership collaboration for rehabilitation of polytrauma patients. Rehabilitation Nursing 33(6):242-6.

Dobscha SK, Corson K, Perrin NA, Hanson GC, Leibowitz RQ, Doak MN, Dickinson KC, Sullivan MD, Gerrity MS. (2009). Collaborative care for chronic pain in primary care: a cluster randomized trial. Journal of the American Medical Association 25; 301(12):1242-52.

Jia H, Chuang HC, Wu SS, Wang X, Chumbler NR. (2009). Long-term effect of home telehealth services on preventable hospitalization use. Journal of Rehabilitation Research and Development 46(5):557-66.

Atkins D, Kupersmith J. (2010). Implementation research: a critical component of realizing the benefits of comparative effectiveness research. American Journal of Medicine 123(12 Supplement, 1):e38-45.

Dobalian A, Claver M, Fickel JJ. (2010). Hurricanes Katrina and Rita and the Department of Veterans Affairs: a conceptual model for understanding the evacuation of nursing homes. Gerontology 56(6):581-8.

Sigford BJ. (2010). Paradigm shift for VA amputation care. Journal of Rehabilitation Research and Development 47(4): xv-xix.

Tew J, Klaus J, Oslin DW. (2010). The Behavioral Health Laboratory: building a stronger foundation for the patient-centered medical home. Families, Systems & Health 28(2):130-45. Review.

Wallin MT. (2010). Integrated multiple sclerosis care: new approaches and paradigm shifts. Journal of Rehabilitation Research and Development 47(5): ix-xiv.

Clark ME, Hooten WM, Sanders SH. (2011). Interdisciplinary pain rehabilitation: current challenges and future opportunities. Pain Medicine 12(1):152-3.

Dunbar B, Sink P, Alsobrook D, Bailey B, Lonczak T, Starnes R. (2011). Ethical perspectives of sustaining residents' autonomy: a cultural transformation best practice. Nursing Administration Quarterly 35(2):126-33.

Eisen SV, Bottonari KA, Glickman ME, Spiro A 3rd, Schultz MR, Herz L, Rosenheck R, Rofman ES. (2011). The incremental value of self-reported mental health measures in predicting functional outcomes of veterans. Journal of Behavioral Health Services & Research 38(2):170-90.

Finnell DS, Lee J. (2011). Psychometric properties of the decisional balance for patient choice in substance abuse treatment. Issues in Mental Health Nursing 32(4):243-9.

Rose KD, Ross JS, Horwitz LI. (2011). Advanced access scheduling outcomes: a systematic review. Archives of Internal Medicine 171(13):1150-9.

Mezzich JE (2011). Building person-centered medicine through dialogue and partnerships. ci 1: 10-13.

Barber ME (2012): Recovery as the new medical model for psychiatry. Psychiatric Services 63, 3: 277-279.

Mezzich JE, Miles A, Snaedal J, van weel C, BotbolM, Salloum IM, Van Lerberghe W (2012): The Fourth Geneva Conference on Person-centered Medicine: articulating Person-centered Medicine and People-centered Public Health. International Journal of Person Centered Medicine 2: 1-5.

Institute of Medicine (2001). Crossing the quality chasm: a new health system for the new century. Washington, DC: National Academies Press.

Petzel RA (2012). What does the future look like for VA health care? US Medicine 4: 3-5.



  • There are currently no refbacks.