10 Jun The Whole Child Approach to Pediatric Care
Children in America face an unprecedented rise in chronic childhood illness, from allergies to autism. The current healthcare system is set up to treat acute diseases, but lacks the capacity for complex cases. In contrast, the whole child approach uses collaborative care, including physical, behavioral, development, and environmental health. Integrated care focuses on the whole child and the importance of the practitioner-patient relationship. This holistic approach emphasizes collaboration between families and multiple healthcare practitioners. In the whole child approach, pediatricians have open discussions with families about mental health, nutrition, immunizations, and parenting practices. This integrated care model offers versatile solutions to the challenges facing children today.
Core Principles of the Whole Child Approach
Moving the pediatric healthcare system toward the whole child approach will require a paradigm shift. This starts with primary care pediatricians establishing trusted relationships with families so they can work together to advance children’s health outcomes. Then, the primary practice collaborates with different specialists, including behavioral health specialists, to meet the child’s individual needs. Members of the child’s care team should share certain understandings about their overall principals. For example, the whole child approach values:
- Human Dignity— children have intrinsic value that needs to be nurtured in healthy families and communities
- Societal Benefit— improving children’s health is essential to a functioning society
- Holistic Medicine— healthcare systems must consider all aspects of wellness—body, mind, and spirit
The Benefits of Treating the Whole Child
Whole child care treats all aspects of the individual—body, mind, and spirit. It is a comprehensive way to achieve positive outcomes. This holistic approach focuses on the child, not only their symptoms. Children are complex, and treating the whole individual can address the underlying causes rather than temporarily reducing symptoms. The whole child approach provides improved quality of care and better access to services. For example, integrating behavioral health into pediatric practice has long-term benefits into adulthood.
When families have better access to mental health services, they are less likely to slip through the cracks. In the whole child approach, providers look at the big picture with regard to the child’s well-being. Communicating as a team leads to improved overall health outcomes. In the long term, comprehensive treatment is more effective and cost efficient. It produces impactful quality of life changes with long-lasting outcomes.
Whole Family Care
Raising a child with special health care needs requires time and energy to care for the child, putting added stressors on the entire family. Parents have to coordinate an assortment of services—school, primary care, behavioral healthcare, and medical care. The time and money spent supporting their child can lead to problems with parent health, employment, finances, and relationships. Whole child care means supporting the family as well as the patient.
Family involvement in decision making is critical to integrated care. Family-centered treatment brings the caregivers to the table and supports their efforts to manage their child’s health. Care plans take the family’s goals, priorities, and capacities into account. Comprehensive family-centered care includes access to education, coaching, peer support, and care coordination.
Integrating Behavioral Healthcare
The mind and body affect each other in unseen ways. Poor mental health affects a child’s ability to make healthy choices and fight chronic disease. Likewise, children with chronic illness are more likely to have behavioral and mental health challenges. Integrating behavioral healthcare and primary pediatrics recognizes the complex interactions between physical and mental health, and requires specialized assessments and collaboration between providers.
Integrating behavioral healthcare services into the pediatric primary care setting promotes better health outcomes for children and families. When primary and behavioral practitioners bring their skills together, they support the physical, mental, and social-emotional health of the child. It also makes it easier to detect early onset of behavioral health issues and family risk factors. With care coordination, specialized support services are in place to prevent patients from falling through the cracks.
Pediatric Care Coordination
Children with chronic conditions need behavioral, social, and educational support as well as medical care. Care coordination is not the same thing as case management. It includes increasing convenience of care by facilitating communication between many different service providers. Care coordination includes:
- Referral assistance and tracking
- Test tracking and follow-up
- Goal setting
- Care planning
- Communication among providers
These valuable activities contribute to the overall care of the child.
Using EHRs to Support the Whole Child
The use of technology helps to facilitate and streamline care coordination. Powerful EHRs are key to care coordination. These robust systems track diagnoses, treatments, immunizations, development, referrals, and follow-ups. They can also be used for treatment planning, goal setting, and communication between providers.
EHRs are especially beneficial for integrating behavioral healthcare into primary pediatrics. Different providers working within the same system can access patient reports and dashboards instantly, making it easier to get a big picture view of the child’s health. Plus, EHRs streamline billing, particularly for those enrolled in Medicaid or CHIP.
The child and family benefits when pediatricians collaborate on the whole child approach with behavioral health clinicians, therapists, and other professionals. Taking the time to discuss mental health, nutrition, parenting, and child development helps families thrive and mitigates future health problems.