Researcher Christine Goertz, DC, PhD (pictured left) has had a uniquely influential career that began inside the chiropractic profession as a national health services research leader. She subsequently became the first licensed integrative health practitioner to be employed by the National Institutes of Health. She’s led the Optimal Healing Environments strategy at Samueli Institute and in 2011 was appointed as, again, the only integrative health practitioner, to the Board of Governors of the powerful, Affordable Care Act initiated Patient Center Outcomes Research Institute. Now Goertz has turned her attention to what will become a multi-disciplinary drive to create optimal back pain care, the not-for-profit Spine Institute for Quality™ (Spine IQ™).
All practitioners who offer back pain care – the most significant condition treated in the nation’s delivery organization-based integrative centers – who are interested in gathering “functional outcomes using a reliable outcomes measure” are invited to participate. Participants in Spine IQ will ultimately be able to “demonstrate the value of their practice to themselves, to patients, payers and other stakeholders by benchmarking on more than 20 performance measures.”
The organization – for which Goertz and her colleagues have already raised $750,000 – was founded out of an evidence-based realization that for back pain “current medical practices are often ineffective or carry unacceptable levels of risk.” She and her co-founders – a group which includes a Blue Cross Blue Shield quality executive – believe that “the time is right for a new approach to spine care.” The focus is on “leveraging the primary spine practitioner (PSP) model, quality benchmarking, PSP education, and spine care research through the use of clinical data registries.”
The organization’s strategy is to invite individual spine care practitioners to participate in a data registry. The founding group is chiropractic-centric. It includes the likes of Academy of Integrative Health and Medicine treasurer Bill Meeker, DC, MPH and former co-chair of the American Medical Association’s (AMA) Health Care Professionals Advisory Committee Review Board (HCPAC) Anthony Hamm DC. The plan is to become a multidisciplinary organization that grows an evidence-committed network of spine care professionals. The goal: “Unite with other primary spine practitioners who are using the power of data to change spine care delivery.”
I interviewed Goertz shortly after she returned from a presentation at a conference in Florida where the Spine IQ concept was, she reported, well-received: “There is increasing recognition that data will be the great leveler.” Her audience affirmed Spine IQ’s founding belief that, in this era of the Triple Aim and value-based care, those who can show that they are willing to capture their outcomes, and can show that they are positive, will eventually be serving a greater portion of the patient base.
To best position the initiative with Medicare and other payers, Goertz and the team chose to partner with a mainstream data registry vendor, CE City, the motto of which is: Technology to Power the Healthcare Quality Enterprise. Goertz, who serves as Spine IQ’s CEO, shares that the vendor has “about a third of the Qualified Clinical Data Registries (QCDR) Medicare business – we wanted a firm that has a strong investment in staying at the top of the field.”
The organization is not open for registration yet. Doors will open for a limited group this year then be thrown open more widely in 2017. Participation for different provider types is presently open to anyone who uses evaluation and management (E & M) codes, chiropractic manipulative therapy (CMT) codes, massage, or acupuncture codes. Goertz says that the organization can decide to expand that cluster prior to any new calendar year. Participation is anticipated to be approximately $500 per year per practitioner.
Comment: The cross-walk from “alternative medicine” to an integrative therapeutic order in regular medicine that features more conservative approaches and less invasive means will be paved with data. Goertz and her colleagues are playing the long game of brick-by-brick construction – one practitioner at a time – of a new order here. This will not be for everyone. Yet this initiative is undeniably a grand act led by a powerful team of change agents. Yes, said Goertz, “it’s a big dream – a big plan.”