Monday, June 24, 2019

June Community Survey and Opportunity to Submit Qs

keywords: research, community survey, conferences, electronic health record (EHR), hospital-based practice
Earlier in June, I sent out a community survey to learn about our community's hospital-based electronic health record use experience.

Goal: understand which EHR systems the community is using and any feedback about how that is working well or what the challenges are.
How will this info be used?
If there is a good response rate, the de-identified data will be used in a blogpost summary. If there are common concerns or issues reported, that will be added to our outline of issues to address in the future "Issues in Hospital Practice" community webinar/interview series. For more about this special Project series, see the post on the webinar series project.

This week I will be attending the 2019 Society of Acupuncture Research (SAR) conference in Vermont. This is an in-person conference. Several colleagues told me they are unable to attend, so I offered to submit their questions to the panels in the hospital-based practice pre-conference (Thursday) sessions. If you work in hospital-based practice as an acupuncturist or as a manager or department head of a program that includes acupuncturists as clinicians, you may send me your questions and I will submit them to the panels this week. However, for timing, you must get your queries in to me by Wednesday, 6/26/2019.  Since I am traveling, the best way for me to have all the queries together is to use the survey form. So, I just added the SAR query option as the last section to the June community survey.

Learn more about the topics, presentations, and panels to inform the queries you want to send me on the related subjects at this conference link.  😄

More about the Pre-Conference Agenda
“Research is formalized curiosity. It is poking and prying with a purpose. ” -Zora Neale Hurston
quoted from conference agenda page:

Pre-Conference Special Interest Group 2 – Acupuncture in a Health Care System: Research Opportunities and Obstacles  This workshop is for acupuncturists who work in a health system or hospital setting in order to provide a space for collaboration, networking and strategic initiative. Each two-hour segment consists of two sessions, as follows.
  • The Risks and Rewards of Using the Electronic Health Record (EHR) for Research
    • Jeff Dusek, PhD, Director of Research, Connor Integrative Health Network, University Hospitals, Cleveland, OH
    • One of the major transformations in healthcare has been the growth and reliance on the electronic health record (EHR) in healthcare.  The EHR is truly ubiquitous in 21st century hospitals. 
    • The goal of this talk will be to provide some helpful hints and education to assist researchers who are considering requesting data from the EHR treasure trove.  The talk will review both risks and rewards of using data from the EHR for research and provide some potential ways to be an active participant in the EHR build at their own institutions.
  • Developing an EHR Template across Systems for Clinical Care and Research
    • Helen Ye, MS, LAc., UCSF Osher Center for Integrative Medicine
    • As increasing numbers of acupuncturists work in institutional settings, electronic health records (EHR) are a fundamental aspect of documenting patient care; however multiple EHR systems are used across settings and institutions, and EHR training in acupuncture educational institutions is minimal. 
    • Documentation practices need consistency for patient care purposes, research, and to accurately reflect the work, skills and training of acupuncture and Chinese medicine providers in Western medicine environments.
    • In addition, the tremendous potential for “data mining” through EHR systems is severely constrained without common templates that allow for consistent data gathering of patient care.  
    • The University of California at San Francisco’s (UCSF) Osher Center’s Chinese medicine team has worked to develop consistent documentation practices with templates and shortcuts for frequently used content and tools within EPIC, one of the country’s largest and commonly used EHR systems in large institutions, to be published in the Journal of Alternative and Complementary Medicine. 
    • If researchers and practitioners are able to develop a consensus template(s) across institutions, data gathering for multiple research projects can be leveraged to a much larger degree; patient outcomes and best practices can be better monitored and identified, providing further support for the profession, as well as education and training programs and policy decisions.
    • This session will allow the opportunity to explore these possibilities through the presentation of UCSF’s work on their EHR, and a panel discussion to provide input on moving this fundamental shift in paradigm for all acupuncture practitioners and researchers in institutions across regions. 
  • Response Panel time
Afternoon sessions
  • Integration of Acupuncture into Health Systems: Where are the tipping points?
    • Arya Nielsen, PhD, LAc., Icahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health
    • Integration of acupuncture into health systems is not a uniform process.  At each institution, choices are made as to which inpatient or outpatient units will offer the service, which patients are eligible, and who makes the decision to refer.  These decisions are the inflection points determining how quickly integration proceeds, and several factors can tip them in one direction or another.  The acupuncture evidence base is one key factor; others include perceived benefits of acupuncture (by patients or care providers), cost data, and the potential for acupuncture to help with specific challenges already identified — from the need to provide smoking cessation services to the current opioid epidemic, or the paucity of treatment options for conditions such as pain, threatened miscarriage and irritable bowel syndrome. 
    • This session, intended for acupuncturists working in health care systems as well as researchers, will explore these three factors in practical terms.  
  • Panel discussion with Arya Nielsen and Claudia Citkovitz 
    • the panel will discuss areas of systems-based practice where acupuncture’s clinical impact appears to be strong despite lack of research to date, and areas where acupuncture may be useful in addressing patient care problems previously identified by the institution.
  • Integration of Acupuncture at the Veteran’s Administration
    • Juli Olson, Doctor of Chiropractic, Masters of Acupuncture and OM, Diplomate in Acupuncture (NCCAOM), Licensed Acupuncturist
    • Justin Heesakker, Doctor of Acupuncture and OM, Diplomate in Oriental Medicine (NCCAOM), Licensed Acupuncturist
    • The purpose of this talk is to share what is happening in the Veteran’s Administration, regarding the integration of acupuncture in the largest healthcare system in the United States.
    • We will talk about challenges and opportunities of rolling out acupuncture on such a large scale across a large area. This is a very exciting time where a large group of veterans now have access to acupuncture care that previously would have had to pay out of pocket, and new possibilities are opening for large-scale acupuncture research.
    • In 2017, a list of approved evidence-based Complementary Integrative Health (CIH) methods of care were added to the Veteran’s Benefits Package. Included are acupuncture, biofeedback, clinical hypnosis, guided imagery, massage, meditation, tai chi/qi gong and yoga. In 2018, the Veteran’s Administration created a Qualification Standard for Licensed Acupuncturists so they may be hired as full time federal employees. Developing policies and offering best practices allows for greater acceptance of the profession and quick integration.
    • The growth of acupuncture is expected to continue at a quick pace. In order to meet the immediate demand for acupuncture services, the VA has widely trained non-acupuncture providers in Battlefield Acupuncture (BFA). Policies have been developed to improve access, including allowing multiple disciplines to train and provide BFA, eliminating written consent for auricular acupuncture and utilizing note templates in the EHR to collect research data specific to BFA.
    • In preparation for the decision to add acupuncture to the Veteran’s Benefit Package, the VA underwent a systematic review of the literature culminating in the Acupuncture Evidence Maps published by the VA’s own Health Services Research and Development branch in 2014.  In collaboration with the Department of Defense acupuncture has been included in several VA/DoD Clinical Practice Guidelines (CPG). 
    • As acupuncture becomes more widely available, the ability to measure both subjective and biometric outcomes, conducting clinical research on a large scale will be possible through the electronic health and designed notes. Additionally, capturing utilization & cost data provides an opportunity to examine cost effectiveness for acupuncture, CIH and the Whole Health model.  The Whole Health framework is a patient-centered care model that emphasizes a patient’s own goals for their health with resources and skill building to help them achieve those goals.

Looking forward to hearing from you all in the survey! Stay tuned to the newsletter for post-conference notes.  :) 

You can buy me a coffee while I am traveling this month and while I am at the conference, whether a shot of espresso, a cup of cocoa,
or a carafe of coffee while I meet with other hospital-based colleagues at the conference.