1. http://accahc.org http://optimalintegration.org

2. ACCAHC Mission Advance patient care through fostering mutual understanding and respect among the healthcare professions.

3. An organization and a project built to Practice Collaboration in Order to Create Optimal Access & Integration

4. Context: Policy & Health System Change Policy: Specific inclusion in federal healthcare overhaul legislation Workforce inclusion Delivery (medical homes, community health) Payment (non-discrimination) Research (comparative effectiveness) Health promotion & prevention Policy: Real world focus at NCCAM New strategic plan focuses on health, outcomes, disciplines & integration Health systems 25% with some form of CAM Major initiatives: VA, Allina, Beth Israel NY, Swedish, Duke plus Employers/payers/public health Cost, over-treatment, pain Primary care potential Patient choice

5. ACCAHC Core Disciplines 5 with federally-recognized accrediting agencies, plus … ACCAHC Chiropractic Medicine Naturopathic Medicine Direct-entry Midwifery Traditional World Medicines & Emerging Massage Therapy Acupuncture and Oriental Medicine

6. CAM Disciplines: Expansion, Maturation, Recognition Updated from ACCAHCs Clinicians & Educators Desk Reference on the Licensed Complementary & Alternative Healthcare Professions (2009) ProfessionAccrediting Agency Established US Department of Education Recognition Recognized Schools or Programs Natl Exam Created State Regulation Total Licensed Practitioners Acupuncture and Oriental medicine 198219905419824425,000 Chiropractic 197119741619635070,000 Massage therapy 1982200285199443250,000 Direct-entry (homebirth) Midwifery 19912001121994261200 Naturopathic medicine 197819877 198615 4500

7. Power through Collaboration Building 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

8. 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

9. 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

10. 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

11. ACCAHC: Some External Accomplishments 2005-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

12. ACCAHC: Establishing Strategic Priorities 2006-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

13. Identified Self-Care for the CAM Disciplines to Foster System Inclusion Competencies Evidence (as language of integration and as practice improvement )

14. 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

15. 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

16. 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 of Integrative Medicine, Beth Israel Hospital (NYC)

17. 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 in development on 18 of 28

18. 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

19. Major Content Area #2: Evidence: The Language of Integration Key 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

20. Major Content Area #2: Evidence Opportunity: Partnership for Dissemination of Exceptional Learning from NIH-Funded Programs Overview of R-25s Programs Funded 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.

21. 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

22. 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

23. COI: Additional Envisioned Programs Training 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

24. ACCAHC strategy is an organizers – 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.

25. An organization and a project built to practice collaboration in order to create optimal access and integration. Thank-you!