CHRF News File

Townsend Letter for Doctors and Patients, August-Sept, 2004

The CHRF News Files, a product of the Collaboration for Healthcare Renewal Foundation (CHRF), reports on collaborative initiatives and business developments of relevance to the emerging integrative medicine industry. Your receipt of the News Files is made possible through a grant from the Center for Integrative Health, Medicine and Research (CIHMR).

CHRF is a multi-stakeholder, not-for-profit organization funded through industry participation and philanthropic contributions, dedicated to seeding and networking collaborative efforts to foster optimally integrated healthcare. For more information, go to www.thecollaboration.org. If you have News File ideas, please contact Elaine Zablocki at ZablockiE@thecollaboration.org.

[c]2004 Collaboration for Healthcare Renewal Foundation (www.thecollaboration.org)

1. Hennepin Clinic Wins JCAHO Accreditation Again

The Alternative Medicine Division at Hennepin Faculty Associates (HFA) in Minneapolis, MN, was the first integrative clinic in the country to be accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Recently it won accreditation for the third time. Independent clinics, of course, don't need to deal with JCAHO, but accreditation is an option for any ambulatory clinic that's part of a hospital system. "It's a gold star in the marketplace if you're JCAHO-accredited," says Patricia Culliton, MA, LAc, director of the Alternative Medicine Division. "It really means you're 'top of the line.'"

Winning JCAHO accreditation is a stressful process. At the HFA Alternative Medicine Division, visiting JCAHO staffers spent three days going through patient charts and employee files, and reviewing all key processes. They checked everything. Any employee might be stopped in the hallway and asked, "What's your fire and evacuation plan?" Preparing for JCAHO accreditation means training employees to be sure they meet standards on a host of measures. For example, the JCAHO requirement is that any patient who complains about pain should be asked about their pain on every visit. "About 80% of the people who come here experience pain," Culliton says. "We developed a pain questionnaire and trained our staff to ask about pain in an open-ended way, every time the patient is seen."

JCAHO also emphasizes good chart documentation. For integrative clinics, this can be a special challenge, since some CAM providers are used to relatively informal charts. "Training CAM providers to document in charts to the level of academic medicine is an ongoing process," Culliton says. "Everyone who joins us has required training, some more than others."

The HFA Alternative Medicine Division has been dealing with JCAHO accreditation for six years and has developed a substantial body of expertise, Culliton says. They now offer consulting services to other hospital-based integrative clinics on how to prepare for JCAHO accreditation. For more information: Pat.Culliton@hfa-mn.org

2. Integrative Medicine Wellness Center at University of Michigan

The Integrative Medicine Wellness Center (I M Well Center) in Ann Arbor, part of Michigan Integrative Medicine and University of Michigan Health Services, opened its doors in May 2003. It is located within an existing family practice clinic, which substantially lowers overhead, says medical director Monica Myklebust, MD. The clinic revamped the space to create a healing environment with a water feature in the lobby, wooden cabinets, and comfortable chairs, and they offer patients fabric gowns rather than paper. For start-up funds, a substantial grant from a private donor was matched by the medical school. This will offer support to the clinic throughout its first two years, and Myklebust expects other aspects of the clinic, such as a retail service for herbs and supplements, will eventually be in place to bring in additional income.

The I M Well Center has developed an unusual model. At present, it does not offer primary care. Instead, patients come in for a 90-minute consultation with an integrative physician, to tell their story and review all their current conventional and alternative therapies. They then return in 2 to 4 weeks for a 30- to 60-minute visit, to discuss a comprehensive, integrative plan for their care. Ongoing follow-up visits are recommended. The fee for the initial visit is $300 and for the second, $100-$200. Services are offered on a cash-only basis. Most commonly, people who seek out this service are dealing with chronic physical or mental health challenges or with life-threatening diseases, or are people who want to optimize their health.

Myklebust spends 40% of her time doing clinical work at the I M Well Center, and the other 60% handling administrative responsibilities and bringing integrative ideas into the entire health system. "Historically, we've seen that large medical institutions tend to develop silos, and specialty centers function quite separately from other aspects of the institution," Myklebust says. "Our goal is to offer integrative care throughout the system." For example, energy healing, massage, acupuncture, and music could be offered to patients, their families, and staff. Massage is already offered in certain programs, but Myklebust envisions a coordinated effort to offer services like these to all those who could benefit from them. For more information: http://www.med.umich.edu/imp/imwell