A new LinkedIn group has been created to develop a community of learners around the opportunities and challenges for integrative health and medicine in the post-Affordable Care Act payment and delivery system. The group is called the Project for Integrative Health and the Triple Aim (PIHTA). The title references the “triple aim” values being promoted by many in the new era: better patient experience, enhanced population health and lower p
A new LinkedIn group has been created to develop a community of learners around the opportunities and challenges for integrative health and medicine in the post-Affordable Care Act payment and delivery system. The group is called the Project for Integrative Health and the Triple Aim (PIHTA). The title references the “triple aim” values being promoted by many in the new era: better patient experience, enhanced population health and lower per-capita costs. The group manager is Jennifer Olejownik, PhD, who holds a grant-funded position in managing the same-titled initiative at the Center for Optimal Integration: Creating Health. The LinkedIn group’s purpose is described as “to stimulate dialogue among all stakeholders interested in this intersection [of IHM and the Triple Aim values] such as Federally Qualified Health Centers (FQHCs), Patient Centered Medical Homes (PCMHs), health systems-based integrative centers, Accountable Care Organizations (ACOs), Worksite Health Clinics, Leadership programs, and individual educators and practitioners in the integrative health and medicine who are interested.”
Comment: I am involved with Olejownik in sharing information, answering questions and fomenting dialogue on this site – including a post on the Trek decision, below. Link-up and contribute! Let’s learn about best practices in these emerging opportunities.
Trek Bicycles announces integrative employee health center
In a June 25, 2014 release, Trek Bicycles announced plans to open a new health center for its employees that includes an array of integrative services. The primary care provider at the clinic, which presents itself as a holistic and integrative model, is Katie Knipfer, PA-C, a physician assistant “with years of primary care and family medicine experience also completed the prestigious University of Arizona’s Integrative Medicine Fellowship.” The site will offer fee-for-service visits with a choice of an acupuncturist, massage therapist and a chiropractor.
Comment: Another great example of integrative employer-owed clinics is on the endeavor at Cisco. (See National Business Coalition on Health: chiropractor presents on the addition of DCs, LAcs and PTs to medical home) If you have examples, please contact email@example.com.
Does measurement of “patient experience” in the Triple Aim parallel the limited meaning of “prevention” in health system outcomes?
Comment: Integrative health and medicine clinicians have for years bemoaned the neutered definition of “prevention” as merely forms of early diagnosis and immunizations, perhaps coupled with some late night public service announcements on wearing seat belts. What of a clinical practice that directly engages, first and foremost, treating disease by restoring health, as the naturopathic version of integrative doctors have handily put it? This limited framing of a critically important concept came to mind while working with Olejownik on the PIHTA project reported above. One PIHTA goal and tool is to populate a resource base with the best evidence for the value of integrative health and medicine in meeting the first arm of the “triple aim” – “enhance patient experience.” Drill into the measures, however, and what you get is a concern about wait times, on the phone and in the office, courtesy, cleanliness and respect. All are remedial for a system that has lost its way.
But what of the “patient experience” captured by Dan Cherkin and colleagues in “unexpected positive outcomes of CAM treatments” or the finding of other researchers that add qualitative to quantitative outcomes and find such outcomes as reduced sleeplessness, fewer allergies, higher energy, better self-efficacy, and more, as part of the routine “patient experience” of whole person care. (See Secret Sauce and Positive Side Effects in Whole Person Care.) Those with clinical practices principally located in dispensing drugs on a rapid schedule have forgotten to imagine the kinds of “patient experience” that might flow from other approaches to care giving. This positive patient experience is limited to wait times and telephone friendliness before the arrival of the prescription. Clinicians, take back the light! A good pressure point on the current move toward the values-base of the triple aim may be to boldly assert that the framing of patient experience outcomes be more broad. We are seeking to do that through PIHTA. Help wanted!