Integrative health centers can build the business case for complementary and alternative medicine by sharing stories of successes and failures.
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| Sita Ananth | Barbara Findlay, R.N. |
Mary Grayson’s recent editorial in Hospitals & Health Networks (August 2008) on the business case for hospitals to “go green” struck a chord. With any innovation, venture, project, program or investment, demonstrating the business case is crucial to its success.
Over the past decade of working in this field, we have met hundreds of leaders in complementary and alternative medicine (CAM), as well as CAM champions, physicians, nurses and CEOs who support CAM programs, all of whom feel passionately about their work and believe strongly that integrative health care can transform how patient care is delivered in this country. Their ardor has guided them to advance this work in their organizations, as demonstrated by the most recent Health Forum survey of CAM in hospitals. These individuals are the “early adopters.” They are doing it because they believe it’s the right thing to do or because it’s important to respond to the needs of their communities and patients.
But here’s the dilemma. How do you convince these mission-driven pioneers of CAM and integrative medicine to evaluate their efforts so they can inform the next wave? While they may not feel compelled to build a business case, their help is needed to generate solid, credible evidence about what works—and what doesn’t—from both the clinical and economic perspectives. As Jon Christianson and his co-authors state in their book Reinventing the Patient Experience, for early adopters, a compelling vision articulated by a trusted leader is sufficient to motivate organizational change. However, later organizational adopters typically will demand supporting evidence from the early adopters before they will implement innovation. A true Catch-22.
Living Laboratories
Developing and building a strong evidence base for integrative medicine is not an easy task, as we at the Samueli Institute have found. For example, we have been working with several hospitals around the country to gather and analyze data from their integrative medicine programs. These “living laboratories” offer us an opportunity to correlate data—patient satisfaction, safety, cost, employee satisfaction—to their patient health outcomes. But first, we need to gather data on outcomes, and less than half of all hospitals are collecting such data.
Once we have the outcomes data, how do we correlate it? It is a lot harder than one can imagine. First, when data are gathered in various departments throughout the organization, the data are often delivered in varying formats. There may be turf issues as to who “owns” the data. Then, there’s the question of data quality: Is it consistent and complete? Was the data collection process rigorous? Do hospitals have the internal expertise to conduct this research? Finally, who will pay to conduct this evaluation?
While these questions beg answers we don’t always have, we would still like to call on the integrative health care community to:
Developing and building a strong evidence-base for integrative medicine is a worthy goal. Milt Hammerly, M.D., vice president of integrative medicine and medical affairs at Catholic Health Initiatives, cautions us that unless we can demonstrate value—both tangible and intangible—for any program, it will be viewed as a “cost” and will be the first to be eliminated. Let’s prevent that from happening.
Sita Ananth, M.H.A., is director of knowledge services, Optimal Healing Environments, for the Samueli Institute, a nonprofit medical research organization in Alexandria, Va. She is also a regular contributor to H&HN OnLine. Barbara Findlay, R.N., B.S.N., is a consultant with the Optimal Healing Environments Program at the Samueli Institute and a co-author of the book Reinventing the Patient Experience: Strategies for Hospital Leaders.
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