http://accahc.orghttp://optimalintegration.org

ACCAHC Mission

Advance patient care through fostering mutual

understanding and respect among the healthcare

professions.

An organization and a project built to

Practice Collaboration in Order to Create Optimal Access & Integration

Context: Policy & Health System Change• Policy: Specific inclusion in federal

healthcare overhaul legislationWorkforce inclusionDelivery (medical homes, community health)Payment (non-discrimination)Research (comparative effectiveness)Health promotion & prevention

• Policy: “Real world” focus at NCCAMNew strategic plan focuses on health, outcomes, disciplines & integration

• Health systems 25% with some form of CAMMajor initiatives: VA, Allina, Beth Israel NY, Swedish, Duke plus

• Employers/payers/public healthCost, over-treatment, painPrimary care potential

Patient choice

ACCAHC Core Disciplines5 with federally-recognized accrediting agencies, plus …

CAM Disciplines: Expansion, Maturation, Recognition

Updated from ACCAHC’s Clinicians’ & Educators’ Desk Reference on the Licensed Complementary & Alternative Healthcare Professions (2009)

Profession Accrediting Agency

Established

US Department of EducationRecognition

RecognizedSchools or Programs

Nat’lExam

Created

StateRegulation

 

TotalLicensed

Practitioners

Acupuncture and Oriental medicine

1982 1990 54 1982 44 25,000

Chiropractic 1971 1974 16 1963 50 70,000

Massage therapy

1982 2002 85 1994 43 250,000

Direct-entry (homebirth) Midwifery

1991 2001 12 1994 26 1200

Naturopathic medicine

1978 1987 7 1986 15 4500

Power through CollaborationBuilding the ACCAHC Platform

• 4 Councils of Colleges/Schools• 5 Accrediting Agencies• 3 Certification and Testing Organizations• 4 Traditional World Medicines/Emerging

Professions organizations• Council of Advisors with leading MD/RNs

in health systems, academic medicine

16 Member Organizations

ACCAHC: By the Numbers

• 16 national organizations• 350,000 licensed practitioners– 100,000 DC, LAc, ND only

• 183 accredited schools/programs • 20,000 students (DC/LAc/ND only)• Yoga teachers/therapists• 7 MD/RN advisers

DC-LAc-ND alone are 95% of the certified or licensed integrative practice workforce

Integrative Care Workforce: Comparison• Fellows, American Board of Integrative

and Holistic Medicine• Fellows, Arizona Center for Integrative

Medicine• Board Certified Holistic Nurses

________________________

• Integrative MD/RN with specialty standards

• Licensed DC/ND/LAc

1500

500

900______

2,900

100,000

Context: CAM Disciplines Stepping Up

• Integration themes for ACC-RAC and AAAOM in 2011

New integration themed DC-led journal (Topics)• Integration in institutional missions

Northwestern, Bastyr, NUHS, NYCC, SCUHS• Initial accreditation activity exploration

Integration, co-management, referral• Partnerships with academic health centers• Major initiatives with VA, DoD

DC, LAc, other modalities

Membership commitment and participation In ACCAHC

ACCAHC: Some External Accomplishments2005-Present

• Network with MD/nurse academics– Collegiality, contacts, barrier removal, discipline

respect in IM definition• Publish ACCAHC CEDR-disciplines book

– Disciplines versus therapies focus• Place CAM disciplines on 2 IOM panels

– Health focus, CAM participation, collaboration • Move CAM disciplines into national

interprofessional education (IPE) dialogue– Getting CAM disciplines to the table

• Help shape NCCAM Strategic Plan– Increased focus on CAM disciplines; more $$ to

CAM schools for EBM, research participation

ACCAHC: Establishing Strategic Priorities2006-Present

• 2006 – Decide to form organization• 2007 – Bylaws, dues, RWG formed• 2007 – RWG formed, via Standard Process

2008 – Incorporate, form EWG/CWG • 2009 – Planning retreat; focus on integration• 2009 – RWG, NIH R-25 evidence in education• 2009 – Begin Competencies• 2010 – Finish Competencies; begin ACT• 2010 – RWG led, influence NCCAM plan• 2010 – Endorse Center for Optimal Integration

2011 Forward – COI Web Portal+ as encompassing vehicle for ACCAHC

mission

Identified Self-Care for the CAM Disciplinesto Foster System Inclusion

•Competencies •Evidence

(as language of integration and as practice improvement )

• Forge optimal care that respects patient choice

• Activate & support educators, students, researchers, clinicians & administrators

• Influence other stakeholders• Create access

Become accepted parts of care teams

COI: Methods• Aggregate useful information– Templates, tools, models, how-to,

curricular components• Organize activity– Newsletters, communities of interest– Educate on key policy issues

• Online course(s)– Competencies, possible certification

• Stimulate leadership

Major Content Area #1:

Competencies for Optimal Practice in Integrated Environments

Competencies Overview

•11 month process (Sept. 2009-August 2010)•50 professionals from 8 disciplines•All ACCAHC Working Groups plus Board of Directors•5 major competency areas•28 competency elements

“I wish all providers had these competencies .”

Administrator, Department ofIntegrative Medicine, Beth Israel Hospital (NYC)

Major Content Area #1:

Competencies: Adopt a Competency Task (ACT) Project

ACT Overview•Begun September 2010•ACCAHC educator leaders “adopt” an element as volunteer faculty •Goal: Develop 1-2 hour course module for each competency element•Phase 1: Course objectives, reading list, syllabus/outline•Phase 2: Complete/post (power-point, voice-over powerpoint, other)

Quality content indevelopment on 18 of 28

Major Content Area #1:

Competencies: Envisioned Next Steps*

•Contract professional team•Develop online course•Bring in conventional partners•Seeks formal endorsements•Explore potential certification•Seek CE recognition•Add interactive components•Develop teams for onsite CE•Continuous quality improvement

* Requires significant COI funding

Major Content Area #2:

Evidence: The Language of IntegrationKey Audiences

•Door opener•Medical directors•In-service presentations•Grand rounds•One-on-one referrals

Key Attitudes/Skills•Research literacy•Comfort with science•Non-defensive •Articulate about strengths and weaknesses

Evidence-Based Healthcare and Evidence Informed Practice:Key ACCAHC Competency Domain

Major Content Area #2:

Evidence Opportunity: Partnership for Dissemination of Exceptional Learning from NIH-Funded Programs

Overview of “R-25s” ProgramsFunded by NIH to:

•Expand role of evidence in education in CAM schools•Foster research literacy•Stimulate research interests•5 DC schools, 2 ND schools with NIH funded programs

– All are represented in ACCAHC•Requirement to disseminate

185 ACCAHC-affiliated, accredited programs have never had educational

support in this areas.

Major Content Area #2:Partnership for Dissemination: Sample Content Areas

• Defining evidence-related competencies– Clarity on what EBM is*

• Strategies to engage institutional leaders in culture change– Faculty– Board/Trustees

• Share best practices/proven strategies• Role of librarians• Engage dialogue on challenges of evidence

& research in whole practice fields

Major Content Area #2:Partnership for Dissemination: Envisioned Additional Steps

• Continue to urge NCCAM to increase funding for evidence

• Develop and support networks of CAM science educators– Web-based communities

• Deliver programs at key conferences

• Convene meetings on evidence challenges/strategies in CAM fields

• Publish white paper(s) to help policy makers on whole practice and discipline evidence

COI: Additional Envisioned ProgramsTraining Leadership in Optimal Integration

•Use experts in leadership•Use experts on team care•Train individuals •Train local teams

Top interest of ACCAHC Board

Create Communities in Optimal Integration

•Accrediting agency issues•Delivery issues•Payment issues•Policy issues

Convening/white papers

• ACCAHC strategy is an organizer’s– Make plans based on resources available

• Basic requirements: $105,000 over 3 years ($315,000)– Fundamental level of 2 key projects– Some staffing, web, consulting, writing,

organizing, content development• Resources for excellence: Numerous

major project opportunities

Societal value of optimal integration is tremendous. What we achieve will rest on what we can bring to

the work.

An organization and a project built to practice collaboration in order to create optimal access and integration.

Thank-you!