Author Archives: Samueli Institute

Innovation In Chronic Pain Care At University of Bridgeport

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The breakthrough change James Lehman, DC, MBA, FACO is implementing at the University of Bridgeport Health Sciences division has the potential to improve patient care, boost patient and provider satisfaction while cutting the cost of provider pain care by 33%.

His big idea is to implement a new guideline for the use of chiropractic specialists as gatekeepers for the diagnosis and treatment of back pain. Continue reading “Innovation In Chronic Pain Care At University of Bridgeport” »

3 Opportunities for Integrative Medicine

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headshot of Dr. Jonas

Wayne B. Jonas, MD, President and CEO, Samueli Institute

In his interview with the Natural Medicine Journal, an electronic peer-reviewed journal and open access website dedicated to the field of integrative medicine, Wayne B. Jonas, MD, describes three opportunities for the field of health and wellness and how Samueli Institute and others are working to make progress in these areas.

1. Establish an evidence base

Providers and patients are constantly faced with claims about therapeutic and healing practices. Trying to sort out what works and what does not is often done in a haphazard and unreliable manner—or the information is not available at all.

The evidence gap poses a challenge to health professionals, educators, funders and patients seeking to establish whether a health claim is supported by valid clinical evidence. Over the last decade Samueli Institute researchers have tackled the evidence gap for these and other topics:

  • Breast Cancer: A review uncovered specific interventions (i.e., pharmacological, behavioral, psychological, complementary and alternative medicine, multi-modal) aimed at mitigating the fatigue-sleep disturbance-depression symptom cluster in breast cancer patients and survivors.
  • Resilience in the Military: Samueli Institute rigorously assessed the quantity, quality, effectiveness, and safety concerns on multi-modal, biopsychosocial training programs used for the self-management of emotional stress.
  • Supplements: Samueli Institute’s reviews have uncovered how supplements can improve performance and sustain health for omega 3’s, melatonin for sleep, and others.

As more non-traditional health care treatments are accepted, this research becomes even more important to inform providers, guide policy and empower patients.

2.  Incorporate healing practices into large systems

hands_forblogMerely having the evidence is not enough. Most patients undergoing surgery still cannot access post-surgical acupuncture more than a decade after it was deemed effective. Ensuring that large hospital systems are successfully able to integrate these evidence-based practices into standard care is needed to move the field forward.

Complementary and integrative practices like acupuncture, massage, manipulative therapies, and education on diet, nutrition, and other self-care approaches are not very integrated, with conventional medicine or themselves. They are not part of normal medical training, are usually delivered in silos of practice, often aren’t found in the same place, are not part of a patient centered medical home, are not incorporated into national guidelines and are not paid for by insurance. Therefore, integrative practices tend to operate in isolation.

The need to improve quality of care is fueling Samueli Institute’s work in the Chronic Pain Breakthrough Collaborative. Health care systems and clinics receive consultative support in process improvement to integrate care which results in better outcomes for both patients and providers.

3. Show impact on the bottom line

Dr. Jonas discusses the need to demonstrate how complementary and integrative practices are cost effective within large health care systems.

Progress can only be achieved by knowing the return on investment of wellness behaviors and programs, and the success rates of traditional health interventions like medications and surgeries and how they compare with alternative treatments.

When Valley Hospital in Ridgewood, New Jersey decided to train their nursing staff in using holistic integrative care – for themselves and with their patients, a look at the operating margin of 9.64%, nine times the average for New Jersey confirmed that the decision to incorporate integrative, holistic care was clearly on target.

More success stories like this will provide a powerful financial driver for wellness.

Listen to the full interview to hear the biggest advances and future predictions for the field of Integrative Medicine.

Combatting Chronic Pain with Acupuncture

BFA Acupuncture 2015

Opioid use has reached epidemic proportions in military and civilian populations and in 2014 the Centers for Disease Control and Prevention (CDC) designated opioid overdose prevention one of the top five public health challenges[i].

Most notably, 80% of heroin users report that their opioid use began with prescription pain relievers.[ii], [iii]

Chronic Pain in the Military

Continue reading “Combatting Chronic Pain with Acupuncture” »

Podcast – An Interview with Dr. George Isham

Podcast Banner George Isham

George Isham, MD, Chief Health Officer of HealthPartners, a nonprofit health provider that covers more than 1.5 million lives in Minnesota and Wisconsin, joins Samueli Institute President and CEO Wayne Jonas, MD, this week for a podcast interview on the future of healthcare.

Clinical Care Accounts for Only 20% of Health

In a 20 minute interview, Isham and Jonas discuss the groundbreaking work of Dr. David Kindig, who argued that clinical care is responsible for as little as 20 percent of overall health. The vast majority of factors influencing health, he said, come from social determinants, such as socioeconomic factors, the environment, and the health behaviors of individuals.

It is through this lens of the importance of what happens outside the doctor’s office that Jonas and Isham consider the future of care and wrestle with real world questions of promoting health within a system that reimburses prescriptions, procedures and clinical treatments.

“If you change the way that people are paid such that you reward the outcomes, then doctors are free to figure out based upon good science what works and what they should begin to do,” explained Isham.

“This will increase satisfaction not just in patients, but in clinicians as well. People are highly motivated when you have a mission that is larger than self. That’s why doctors went to medical school and why nurses trained to be nurses.

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