Crowdfunding Campaign for 2017 Hospital Handbook Projects

Happy Spring!
Our very first crowdfunding campaign is launching this week.
Goal:  to get the 2017 Hospital Handbook Projects off the ground!

Trillium blooming in local hospital healing garden.
photo credit:  Megan Kingsley Gale

Check out the campaign page on Indiegogo for more information and how to contribute.
You can contribute any time on the website.

For a full list of the 2017 projects and descriptions, check out the crowdfunding campaign page.

Some of the projects include the webinar series, some resource publications, and jump-

starting the hospital practice acupuncturist data project.

To build this community resource, contribute via the website or the campaign page today!
Thank you.
Megan

related blogposts:
Related blogposts:

Our 2017 Campaign has Launched! 

Campaign for the 2017 Projects  

Creating Resources to Grow and Connect the Integrative Medicine Hospital Practice community
What is the Project?
Support Acupuncturists and their Hospital Administrators (Sponsors)
Check out our new Facebook Page
Featured Perk:  Kids and Parents Learning Package
Featured Perk:  Nutrition, the whole foods and integrative medicine approachese

Featured Perk:  Friend of Integrative Medicine
Reflective Readings to Inspire Your Day

Featured Perk:  Are you in the Present Moment?  learning about mindfulness

Love Chocolate?  

FDA Pain Guideline Recommends Acupuncture

Do you want to follow our work?  Just contribute to our fundraiser, subscribe to this blog, and join the contact list on the website.

Highlights of Meridians Winter 2017 issue

The Winter 2017 issue Meridians:  Journal of Acupuncture and Oriental Medicine, (Meridians:  JAOM 2017 4(1)) arrived this month and I had the opportunity to read several of the articles.  Here are my notes on those I enjoyed reading most.

How to access Meridians:

If you are an NCCAOM Diplomate, the electronic edition is a free benefit, just go to the Diplomate Benefits page.  

Not an NCCAOM Diplomate?  You can buy a copy of the issue you want through the Meridians website.

Meridians  is also indexed on CINAHL and EBSCO.

Research Literacy

Jennifer Stone has a succinct, 1 page article about how to prepare a scientific paper for poster presentation, p. 18.

The review of Richard Hammerschlag's lectures [p.27] was interesting and I am looking forward to looking at the presentation conference slide link [referenced on p.28].  Dr. Hammerschlag's advice, as reported here, on double-blinded acupuncture studies, was, basically, don't do it. See the article for the explanation.

The sham vs. verum acupuncture problem.   NIH has not marked any type of study with sham acupuncture as a control as "low priority".  To learn more about why, there are a couple good explanations in this issue.  One from Dr. Hammerschlag on p. 27 and another in a full article by Ryan Davenport, "Acupuncture and RCTs:  A Critique of Sham and Verum Methodologies", p. 29-31, 44.  

30% equals clinical efficacy revised 7.3.2017

I hear this phrase quoted often in my volunteer work with systems change. I see it is quoted on p. 28,  “The classic self-assessment tool for pain evaluation has to do with measurement of pain reduction. A 30% reduction was considered successful.”
Where does this 30% number come from?  
It is a standard that originated with a well-cited article from The New England Journal of Medicine published in 1988 by Laupacis et al, "An assessment of clinically useful measures of the consequences of treatment".  30% or more change in patient-reported scores (using a validated measurement tool) is considered clinically meaningful change.
That is often interpreted as any clinical outcome that is less than 30% is not considered meaningful (as a metric--I am sure 29% improvement meant much to a patient).  And 30% or more improvement in function is considered meaningful.  So far I see this quoted in RCTs (randomized controlled trials), clinical effectiveness trials, and literature reviews.  Literature reviews that can show a minimum of 30% change (usually an improvement in symptoms or function) is useful when providing evidence of clinical effectiveness when making a change in policy whether it is facility-level, state-level, or national level policy. 

Tai Chi, a modality to improve health, balance

And, apparently, Tai Chi decreases fear of falling in the elderly.  The article starts on p. 28.

Tai Chi is a great modality to teach patients.  Are you able to offer it (class or one-on-one practice) at least weekly to patients?  Maybe your clinic or facility has a wellness center that offers ongoing classes where people can practice? Tai chi can be specific for a condition or general for wellness.

similar blogposts

on research literacy:

A good Resource webpage 
Research journals, literacy, levels to consider when publishing or perusing 

Meridians: The Journal of Acupuncture and Oriental Medicine

keywords:  research literacy, research journal, resource

Meridians: The Journal of Acupuncture and Oriental Medicine is a peer-reviewed scientific journal in the field of East Asian Medicine.  This journal is Medline-compliant and in the following databases:
CINAHL--a nursing profession database
EBSCO--international scholarly database

In 2016 Meridians became the official journal of the National Certification Commission on Acupuncture and Oriental Medicine (NCCAOM).  As such, the electronic version of the journal is offered as a free member benefit to NCCAOM Diplomates.

To view or buy current or past issues of Meridians, go to their website.
For social media updates, check out their Facebook page.

Research Literacy
Meridians has a great Resource page for Scientific Writing and Research Literacy page compiled by editor Jen Stone.
Go check out the resources available or linked to this resource page:

• 5 Short "How to" Articles on Scientific Writing
• How to Write a Pilot Study
• How to Write a Good Case Report
• CARE Case Reports:  Resources
• How to Write a Good Abstract
• CONSORT Transparent Reporting of Trials
• NIH Protocol Design Templates
• International Committee of Journal Editors
• Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICT-A)

• Poster Presentation Resources
• Federal Funding Resources
• CAM Scientific Databases
• Research Societies

Acupuncture, a covered Worker's Compensation Benefit

keywords:  worker's compensation act, state laws, legislation

Originally published in the De-Stress Vets blog, 2016.06.27

Acupuncture is one of the therapeutic procedures an East Asian Medicine practitioner (also known as Licensed Acupuncturist) uses when facilitating recovery from injury.  Acupuncture is one of several rehabilitation modalities that speed recovery from injury and help someone return to work more quickly (than not using it).  That is why it is now a commonplace procedure that is covered in worker's compensation laws.

Check your state for its requirements and laws on worker's compensation.  Here is a list of states that cover acupuncture for common workplace injuries under their worker's comp laws or acts (updated March 2016):

States where acupuncture is covered under worker’s comp benefit (29 + D.C.)

Alaska	Florida	Massachusetts	New Jersey	Pennsylvania
Arizona	Hawaii	Michigan	New Mexico	Rhode Island
California	Illinois	Minnesota	New York	Virginia
Colorado	Indiana	Missouri	Ohio	Washington DC
Connecticut	Kansas	Nebraska	Oklahoma	West Virginia
Delaware	Maryland	Nevada	Oregon	Wisconsin

As of March 2016, 29 states and D.C. cover acupuncture services for worker's comp claims

A literature survey of state law was done in March 2016.  This survey noted that the above (in chart) states and D.C. cover acupuncture for at least one condition under that state's worker's comp benefit.

Note:  state law varies.  Worker's comp laws can change each legislative session, so check in with your local office for the latest update.

Related posts:  The Affordable Care Act (ACA) and Acupuncture

the Vet Choice Program

correction October 2018
For most recent information on acupuncture coverage by workers' comp, contact the AAC Info Network, which does training for Acupuncturists and their admin and billing staff on coding and billing in the field.  https://www.aacinfonetwork.com/

National Practitioner Databank

keywords:  credentialing and privileging process, hospital employment, new hire, hospital practice, malpractice insurance, adverse events

The National Practitioner Databank (NPDB) and the credentialing process

What is the NPDB?
The National Practitioner Databank tracks info on health care providers including malpractice insurance and reported adverse events.  It is standard practice in the process of hiring and credentialing a health care practitioner at a hospital to query the NPDB.  Just as background checks are standard practice.

How does it relate to or affect you?
Every health care provider who works in a medical center has an entry as a practitioner in the NPDB.
You can learn more about it and see an infographic at the NPDB website.  If you want to see what your entry looks like or if you have an adverse report, you can do a self-query.

There used to be two data banks which credentialers would have to check for a health care practitioner, the NPDB and the HIPDB.  As of May 2013, the HIPDB has been rolled into the NPDB to streamline the databank and query process.

related:  HIPDB

Meridians: JAOM published journal article, more references and resources

Landing page for paper accepted for publication in Meridians journal.

My Meridians article reference:

Gale M, Hospital Practice:  Recognition of Acupuncturist as a Licensed Independent Practitioner (LIP).  Meridians:  JAOM, 2016 3(4) (accepted for publication)

What is this? 

This is an endnote reference landing page for an article I wrote published in the Medline-compliant peer reviewed scientific journal, Meridians:  The Journal of Acupuncture and Oriental Medicine

For how to contact the author of the blog (myself), please see the contact email within the biography of the article or contact me.

This blog serves one aspect of the Hospital Handbook Project.  For the mission and goals of this project, please see our About page: “What is the Hospital Handbook Project?”.  The blogposts are intended as basic descriptions of topics and issues related to Hospital Practice for an East Asian Medicine Practitioner (also known as an Acupuncturist).  Many topics are still conversations in progress and deeper discussions are, due to length and complexity, not covered in depth by the blog.  Hence, the blog is only one aspect of The Project.   If you are interested in joining the conversation or donating to this work, please contact the author/editor.

Short review of what LIP is, how it relates to Acupuncturists (East Asian Medicine Practitioners), how it is defined by The Joint Commission (TJC), how it relates to hire and credential process, and medical staff appointment:

Acupuncturists are LIPs and how that affects how to hire and credential them

endnote #2:  Referenced OPPE, FPPE, TJC, and peer record review

More about focused and ongoing professional practice evaluation (FPPE, OPPE) and peer record review. 

Joint Commission references 

Peer Record Review    

endnote #3:  hospital practice credentialing and privileging process

In 2015-2016 I was part of the NCCAOM Hospital-based Task Force.  We created a document that was published on the NCCAOM website in July 2016.  This document, Credentialing of Acupuncturists for Hospital-Based Practice:  A Resource Guide for NCCAOM Diplomates, is available to NCCAOM Diplomates for free and to all others for a low price.  To find this document, go to the NCCAOM website (www.nccaom.org), and look under “Diplomate Benefits” page. If you are an NCCAOM Diplomate, just log in for free access to the document.  If you are not, you can still access the document for a small fee by contacting NCCAOM or following the links on the website.

  

Explaining the Semantics of credentialing and privileging for the Acupuncturist as LIP, advice from Megan and Fuji.  

If you are interested in more information on this topic, please donate and join the email list to support this work. 

Endnote 6--the Excel file

The BLS occupational Code Comparison Chart of L.Ac.s to other LIP professions is available through the Hospital Handbook project.  Please contact the Hospital Handbook project author/editor. 

endnote #23:  Discussions on the following topics:

Hospital sponsor, supervision and the hospital sponsor

Dual-licensees and the hospital sponsor

Supervision of an acupuncturist

All of these continue to be conversations-in-progress.  If the info you are looking for is not here in the blogpost, please understand the posts are usually brief notes on the topic.  If you would like to join the conversation or support this work, please donate and join the email list. 

Endnote 24

The hospital sponsor is more than your average administrator.  The hospital sponsor is an innovator and a synergist.  The sponsor advocates for you, your field of practice, and navigates the hospital system world to create space for integrative medicine.  As a hospital-practice Acupuncturist, do what you can to support your hospital sponsor.

Hospital sponsor  

Supervision 

BLS Occupational Code update

Updates since Jan. 2018
On Jan. 1st, 2018, the Standard Occupational Code (SOC) for Acupuncturists began official use.
In February 2018, the VA announcing an update to their Staffing Handbook to include Acupuncturists.  The Handbook classifies the profession as LIPs, please see blogpost and its references for details.

The Acupuncturist Occupational Code FAQs

keywords:  credentialing, hospital employment, national standards

Q:  Do Acupuncturists have a federal occupational code?  What is it?
Yes.  29-1291-Acupuncturist

Q:  When is the BLS occupational code finalized?  Is it useful for hospitals before it is finalized?

2018 and Yes.

The Acupuncturist Occupational Code, as tracked by the U.S. Bureau of Labor and Statistics (BLS) is not finalized until 2018.  The electronic print edition of the BLS's Standard Occupational Classification (SOC) handbook is scheduled to be published in summer 2017.

What is great about BLS and O*Net is that you can look online (O*NET) and see the final, detailed draft of the code.  I have heard from various hospital credentialing experts from as early as 2012 that this info, even while not “finalized” is useful info for them.  It writes their credentialing packet for them, in essence.  

While we wait this last year for the code to be finalized, it is good to know how useful just the final published draft of the occupational code is to credentialing experts and those who write position descriptions (job descriptions).

I have written more about the Acupuncturist occupational code and how it relates to hospital practice in the fall issue of Meridians, "Hospital Practice:  Recognition of Acupuncturist as a Licensed Independent Practitioner (LIP)".

Gale M, Hospital Practice:  Recognition of Acupuncturist as a Licensed Independent Practitioner (LIP).  Meridians:  JAOM, 2016 3(4):  11-16, 41.

NCCAOM has lead the way in the creation of the occupational code.  See their website for the latest update.

related blogposts:  
My Meridians article reference page

Updates since Jan. 2018
The official BLS Standard Occupational Code (SOC) for Acupuncturists, Jan. 1st, 2018
The VA Occupational Staffing Code for Acupuncturists announced, Feb 2018