Charles Elder1, Nadine Ijaz2, John Weeks3, Jennifer Rioux4, Cheryl Ritenbaugh5. 1. 1 Kaiser Permanente Center for Health Research, Portland, OR. 2. 2 Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada. 3. 3 johnweeks-integrator.com, Editor-in-Chief, JACM, Seattle, WA. 4. 4 Integral Ayurveda and Yoga Therapy, Carrboro, NC. 5. 5 Family and Community Medicine, University of Arizona, Tucson, AZ.
Abstract
CONTEXT: Value-based health care has emerged as a manifestation of the conventional medicine community's awareness of the overlapping needs to both better incorporate patient centeredness into practice and research paradigms and further develop a systemic approach to cost reduction. BACKGROUND: The origins of the whole systems research (WSR) movement date to the late 1990s, when the U.S. Congress legislated appropriation of funds to stimulate the U.S. National Institutes of Health to evaluate popular traditional, complementary, and integrative medicine (TCIM) practices. Questions immediately arose over how well these forms of practice could be measured through standard randomized controlled trials, and the WSR community began to articulate and adapt innovative methodologies for evaluating TCIM interventions. DISCUSSION: This column explores the potential impact of WSR methods and exemplars on the clinical practice and research communities seeking to successfully implement and measure the complexities of value-based health care. Four potentially cross-talking themes are specifically discussed: complex behaviorally focused interventions, patient-centered outcomes, team-based care, and resilience and well-being. CONCLUSION: The time is ripe for clinicians and investigators to capitalize on methodologies, exemplars, and learnings from the WSR literature toward improving care, developing more robust research strategies, and furthering the dialogue between the TCIM and conventional medicine communities.
CONTEXT: Value-based health care has emerged as a manifestation of the conventional medicine community's awareness of the overlapping needs to both better incorporate patient centeredness into practice and research paradigms and further develop a systemic approach to cost reduction. BACKGROUND: The origins of the whole systems research (WSR) movement date to the late 1990s, when the U.S. Congress legislated appropriation of funds to stimulate the U.S. National Institutes of Health to evaluate popular traditional, complementary, and integrative medicine (TCIM) practices. Questions immediately arose over how well these forms of practice could be measured through standard randomized controlled trials, and the WSR community began to articulate and adapt innovative methodologies for evaluating TCIM interventions. DISCUSSION: This column explores the potential impact of WSR methods and exemplars on the clinical practice and research communities seeking to successfully implement and measure the complexities of value-based health care. Four potentially cross-talking themes are specifically discussed: complex behaviorally focused interventions, patient-centered outcomes, team-based care, and resilience and well-being. CONCLUSION: The time is ripe for clinicians and investigators to capitalize on methodologies, exemplars, and learnings from the WSR literature toward improving care, developing more robust research strategies, and furthering the dialogue between the TCIM and conventional medicine communities.
Entities:
Keywords:
integrative medicine; value-based health care; whole systems research