The Integrative Health Policy Consortium (IHPC) Education Committee (which I co-chair) recently crafted a definition of "Integrative Health" to be adopted by major integrative health organizations, the U.S. healthcare system, and advocacy groups. The definition is as follows: Integrative health is a collaborative, comprehensive, person-centered approach to health creation and disease care including social determinants, and embraces all evidence-informed disciplines, both conventional and complementary, in order to achieve optimal well-being.
Before we go any further, please allow me to take a step back and paint a quick picture for background and historical context. Back in 2005, leaders in the field of Complementary and Alternative Medicine (CAM) met with conventional healthcare professionals and academics at the "National Educational Dialogue to Advance Integrated Health Care: Creating Common Ground" at Georgetown University in Washington, D.C. They recognized that we needed a national organization to advocate and write specific legislation for the practice of CAM in the United States, and the Integrated Healthcare Policy Consortium was born (now known as the Integrative Health Policy Consortium, or IHPC).
Defining Integration
The leadership of IHPC found that most people who spoke about "Integrated Medicine" were referring to the integration between insurance companies' databases and hospital electronic health records, and had nothing to do with the involvement of CAM professionals. "Integrative Medicine" in practice at that time meant that an oncologist may work with a physical therapist and social worker, and possibly a psychologist on an "integrative team" supporting cancer patients. The National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM) changed their name to the National Center for Complementary and Integrative Health (NCCIH) in 2015, reflecting the change in government awareness around Integrative Health.
Now let's fast forward to today: Claudia Witt et al., wrote a paper in 2016 defining Integrative Health in roughly 90 words as "A state of well being in body, mind, and spirit that reflects aspects of the individual, community, and population. It is affected by: (1) individual biological factors and behaviors, social values, and public policy, (2) the physical, social, and economic environments, and (3) an integrative healthcare system that involves the active participation of the individual and healthcare team in applying a broad spectrum of preventive and therapeutic approaches. Integrative health encourages individuals, social groups, and communities to develop ways of living that promote meaning, resilience and wellbeing across the life course."
The authors' definition captures the intent of integrative health in terms of social determinants of health, having the patient involved with their healthcare decisions, and identifying the value of meaning, resilience and well-being. All important attributes, but legislators (and the American public alike) have a short attention span and we were looking to cut that word count in half, aiming for 40 words or less.
Whole Health Model of Care
Notice we begin with collaboration. We believe that an integrative health system in the U.S. needs to be collaborative and non-hierarchical. All team members have an equal voice, with a focus on being patient-centered, so that the team has the patients' best interest in mind and offers them a number of choices for their treatment plan. (Patient satisfaction and health outcomes improve when they play an active role in their care.)
The term "comprehensive" reflects the "Whole Health" model of care currently being applied by the Veteran's Administration's Center for Patient Centered Care and Cultural Transformation.
They use homeopathy, meditation, yoga therapy, tai qi and qigong, Traditional Chinese Medicine, guided imagery, and hypnosis in addition to conventional care for the treatment of their veterans. The VA has shifted the medical paradigm from "What's the matter with you?" to "What matters to you?" and measure functionality and life satisfaction metrics. Medical literature is rife with the term "evidence-based" and we purposely chose "evidence-informed" to allow for less stringent case studies and clinicians' personal experience to guide patient treatment options. Just an FYI - less than 20 percent of hospital procedures have solid scientific support.
The Education committee developed a white paper along with the definition to provide clarity on the proper intent of each term in the definition for the public and legislators. It will be offered for use in bills and regulatory language as well as public information campaigns. In 2017, IHPC coordinated the development of the Integrative Health and Wellness Congressional Caucus to educate legislators on all things integrative. We presented on non-pharmacological options to opioids and integrative pain management, and will be addressing the cost effectiveness of integrative management of chronic disease such as diabetes and heart disease.
The definition has been ratified through IHPC, the Academic Collaborative for Integrative Health (ACIH), and the Academy of Integrative Health & Medicine (AIHM). Our goal is to have this become the standard definition in the U.S. and perhaps internationally.
Members of the IHPC Education Committee
- Bill Reddy, Co-Chair, IHPC
- Len Wisneski, Co-Chair, IHPC
- Coquina Deger, Bastyr University
- David Jacobs, Academic Collaborative of Integrative Health
- Brad Jacobs, Academy of Integrative Health & Medicine
- Blake Langley, Bastyr University (student)
- Susan Luria, Connor Integrative Medicine Network, University Hospitals
- Roger Mignosa, Integrative Osteopathic Physician
- Beth Renne, Integrative Nurse Practitioner
- Taylor Walsh, Integrative Health Strategies
- Suzan Walter, American Holistic Health Association
- Joann Yanez, Academic Collaborative of Integrative Health
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