Wednesday, February 25, 2009

Report From the Summit on Integrative Medicine

The first day of the Summit at the Institute of Medicine was action packed with an all star lineup of thought leaders in the field of medicine. Harvey Fineberg, President of the IOM provided opening remarks followed by Ralph Snyderman, Chancellor Emeritus of Duke University and chair of the Summit Planning Committee. Dr. Snyderman provided the following framework comparing conventional care and integrative care:

Conventional Care:
  • Reactive
  • Sporadic
  • Disease Oriented
  • Find It/Fix It
  • Physician Directed
  • Dogmatic

Integrative Care:

  • Proactive Life Care
  • Continuity of Care
  • Health/Prevention
  • Individual Empowerment
  • Enlightened

An interesting discussion involved whether to call this form of care Integrative Medicine or Integrative Health. There seemed to be more support for Integrative Health by the more than 600 attendees. More to come on the Summit in the days ahead.

Friday, February 20, 2009

Electronic Health Records and Integrative Health

We are hearing that one of the ways to “save” our healthcare system is to have a massive move toward electronic health records (EHR), sometimes referred to as electronic medical records (EMR). The consistent use of up-to-date information by health care providers is supposed to enable providers avoid medical errors (which are costly) and improve the overall quality of care. The theory is that high quality care is cost effective care. Obviously, just because a provider has access to a more complete and comprehensive EHR does not automatically mean that your care will improve. Health care providers have got to review the record and consider its contents in the context of a patient’s presenting problem. Most providers these days barely have time to review their own record let alone a collection of diverse practitioners who may have provided services to a patient in a variety of settings.

An EHR in an integrative health setting is an essential part of providing truly integrative care. In a typical integrative health center, practitioners will take the time to review a patient’s record and use its contents to influence clinical interventions. At the Marino Center, we use an advanced version of the GE Centricity system that is used by ALL practitioners, including primary care physicians and nurse practitioners, specialist MDs, acupuncturists, chiropractors, physical therapists, massage therapists, nutritionists, allergy and IV nurses, and mental health providers. This comprehensive record is essential to supporting the integrative health model. In this manner, integrative health can be a leading example of the value of a “patient centric” health record.

Wednesday, February 11, 2009

Summit on Integrative Medicine and the Health of the Public

Later this month, several of my Marino Center colleagues and I will attend the Institute of Medicine Summit On Integrative Medicine and the Health of the Public in Washing ton DC. This conference has reached capacity enrollment of over 600 with a waiting list of several hundred more. Several papers have been commissioned for this conference and may be accessed at
http://www.iom.edu/CMS/28312/52555/62252/62351/62353.aspx. These papers provide a comprehensive overview and analysis of Integrative Medicine.

A key issue raised in several of these papers is the need for a standardized definition of integrative medicine. An appropriate baseline is form the Consortium of Academic Health Centers for Integrative Medicine which states “Integrative Medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing”.

I will report back on the Summit’s proceedings in early March.

Friday, February 6, 2009

Perceived Benefits of Complementary and Alternative Medicine

Dr. Anne McCaffrey, the Director of Research and Education at the Marino Center for Integrative Health, was part of a research team that conducted a study of the perceived benefits of Complementary and Alternative Medicine. The purpose of the study was to examine the benefits associated with CAM treatments from the patient’s perspective using a whole systems research approach as a guiding framework. The study involved focus groups of six to eight patients each, all of whom have experienced CAM therapies. The results of the study will be published in Open Complementary and Alternative Medicine Journal.

In general, participants described physical health benefits including relief and improved function, and positive psychological benefits such as improved coping and resilience. Social health benefits that arose from the positive aspects of the patient-practitioner relationship were also reported, including support and advocacy. In addition, participants identified empowerment, increased hope and spiritual growth as results of receiving CAM treatments.