Integrative medicine delivery models
Secondary Topic: Faculty development/leadership
Tertiary Topic: Health Services Research/Cost Effectiveness
Building the infrastructure for CIH in VA: Lessons Learned from the VA Integrative Health Coordinating Center
Alison M. Whitehead, MPH; Kavitha Reddy, MD; Belinda Collingbourne, MBA; Sara Grimsgaard, MHMS; Juli Olson, DC, LAc; Benjamin Kligler, MD, MPH, , Washington, DC, United States
Late Breaker: No
Implementation of complementary and integrative health (CIH) across the Veterans Health Administration (VA) had been inconsistent and limited before Fiscal Year (FY) 2000. Given evidence of benefit, commitment to innovation, and desire to help patients with chronic pain and mental health conditions, as well as improve wellbeing, VA is embarking on a major healthcare transformation. The Integrative Health Coordinating Center (IHCC) in VA's Office of Patient Centered Care and Cultural Transformation was established in 2014 to identify and address barriers to implementing CIH across VA, and to serve as a resource for clinical best practices and education for Veterans, staff, and leadership. An FY15 internal survey showed 93% of VA facilities offered at least one CIH approach. The most widely offered approaches were acupuncture, meditation, yoga and tai chi which are known to help with complex issues Veterans face such as pain management and mental health conditions, as well as optimization of wellbeing. IHCC is building the infrastructure to support streamlined implementation of CIH across VA to include policy, tracking/billing mechanisms, new professions, clinical guidelines, access to CIH approaches through telehealth, and strategic partnerships. Guiding implementation are evidence maps, which provide a visual overview of the distribution of evidence for each approach, systematic reviews and further research on outcomes. Supported by the Comprehensive Recovery and Addiction Act (CARA) legislation, VA has launched the Whole Health System (WHS) in 18 Flagship Facilities in FY18, the first wave in national deployment of more comprehensive CIH services. The WHS model will serve as a delivery system for bringing effective, evidence-based CIH approaches and self-care strategies into the care plan of every Veteran. This session will discuss steps IHCC has taken to build the infrastructure for comprehensive implementation of CIH across VA, describe barriers encountered, and share best practices and lessons learned.
The VA is unique in that it covers all aspects outlined in this year’s conference: research, education, clinical practice, and policy. The VA is the largest integrated healthcare system in the US. Policy that is implemented in VA often impacts other organizations. Lessons learned from the work VA has done in the area of CIH could help inform other hospitals and academic institutions.