The second group that illustrates a great model of integrated care is one that I've very recently become involved with. It is called TRIARQ and is headquartered in New York. TRIARQ was started by a number of physicians and physical therapists who recognized that they were both working with the same patients, but in many instances not benefiting from a thorough and comprehensive understanding of the treatment approaches they were each using. As the TRIARQ Web site states:

"TRIARQ is a community of Physicians, Patients, Physical Therapists, and other healthcare professionals working together to create new standards in clinical and service excellence through continuing education, research, and cross-discipline collaboration.

"Healthcare for patients with musculoskeletal injuries is fragmented among physicians, physical therapists, occupational therapists, and patients. Historically there has been limited communication or coordination of care amongst these groups. We are seeing fundamental changes in the philosophy of patient care including stress on continuity, quality, scientific based treatment and performance of healthcare professionals. The success of treatment, measured by patient satisfaction, needs to improve."

TRIARQ has recently opened up its membership to massage therapists, and actively encourage the participation of massage professionals in this interprofessional dialogue.

After speaking at a recent symposium with members of TRIARQ in New York, I was once again thoroughly impressed by the degree of respect and mutual collaboration among all the individuals representing their own unique perspectives. It is this type of integrated health care that will provide patients the most effective opportunities to enhance their health and well-being.

TRIARQ Philosophy

The TRIARQ research philosophy is simple. It states:

"In order to advance the science of rehabilitation and the standards in musculoskeletal healthcare a collaborative approach to clinical research is necessary. As part of the TRIARQ community we foresee unprecedented opportunities for cross discipline research in at least 4 primary categories:

1. Clinical Trials for best practices and rehabilitation.
2. Practice management / patient service issues.
3. Impact of health care insurance and policies on quality of care.
4. Evaluation of emerging and existing technologies in Rehabilitation.

The TRIARQ model espouses the triumph of collaboration, quality and continuity of musculoskeletal healthcare. Our approach is to effect change in three (TRI) key areas (ARQs):

Collaboration: We provide the platform for seamless integration and coordination of care amongst physicians, therapists and patients.

Education: We develop and provide 'evidence based' educational material for therapists and their assistants.

Practice Management: In the constantly changing and complex landscape of managing a practice and your patients - we provide the tools and support to ensure that key success factors are addressed."

I would encourage all chiropractors to seek out not only these organizations, but any opportunities to enhance your own understanding and awareness of what people in other health care fields do so you can best understand how to integrate those practices with your own. Visit the TRIARQ Web site (www.triarq.com) to see what you can learn or how your can contribute to its integration philosophy. To learn more about the ACCAHC and its partner organizations, visit www.accahc.org.

We are at a place in our health care system where we must get out of our individual silos and find ways to deliver optimal integrated care. The more we learn about each other, the better we will be in our own approaches to treating patients. One of the stated values of the ACCAHC sums it up best when it quotes the Institute of Medicine statement that "the goal of integrating care should be the provision of comprehensive care that is safe and effective care, that is collaborative and interdisciplinary, and care that respects and joins effective interventions from all sources."

---

Whitney Lowe is a licensed massage therapist who writes on orthopedic essentials for one of DC’s sister publications, Massage Today. He has been in practice for more than 20 years, and is a recognized authority on pain and injury treatment with massage. He is also the author of several books.