The Academic Consortium for Complementary and Alternative Health Care (ACCAHC), created in 2004 as a project of the Integrated Healthcare Policy Consortium and featuring representation from educational, accrediting, testing and certification organizations in chiropractic, acupuncture, massage therapy and naturopathic medicine, among others, has released Competencies for Optimal Practice in Integrated Environments. Developed as the result of extensive collaboration involving academic leaders from eight different disciplines, Competencies details the competencies and related knowledge vital for integrated practice, grouped into five distinct fields as follows:
Health Care Policy: Describe policy issues, structures, emerging clinical and economic models, and other factors that may impact clinical and financial decisions; discuss how cost, compensation models and incentive structures influence care decisions; summarize recent history of integrated care, including varieties of integrated care models; describe best practices, opportunities and challenges.
Institutional Health Care Culture and Practice: Explain inpatient and outpatient health system accreditation standards and protocols; describe authority structures and decision processes; explain credentialing and privileging mechanisms; identify and discuss liability issues; contrast provider payment models; describe the clinical services and processes of care for other disciplines in a facility; identify and apply common medical terminology; appraise a medical record; select appropriate medical codes; define relevant short-hand and abbreviations; evaluate standard charting and documentation in both paper and electronic medical record formats.
Inter-Professional Education (IPE): Describe the various health care systems in common practice including both conventional and the licensed complementary and alternative health care fields, as well as the emerging fields and traditional world medicines; discuss the emphasis each places on disease prevention, wellness and the therapeutic strategies engaged for health creation.
Communication and Inter-Professional Relationships: Discuss concepts of one's own discipline in terms appropriate for administrators and practitioners in other disciplines; role-play strategies useful for building appropriate consultation, referral and co-management relationships; identify decision processes in complex institutions; demonstrate public speaking and presentation skills to represent your discipline and practice to larger groups; produce written and presentation materials suitable for both consumer and professional audiences; identify leadership strategies useful in fostering institutional change; and integrate the knowledge, skills and values described in the practitioner-to-practitioner section of Health Professions Education and Relationship-Centered Care (Pew Health Commission, 1994, page 36).
Evidence-Based Health Care and Evidence-Informed Practice: Discuss basic research principles and methodologies within the context of both clinical and mechanistic research; evaluate research; explain the role of scientific evidence in health care in the context of practitioner experience and patient preferences and apply evidence-informed decision making; describe and discuss the research base within one's own discipline; relate contemporary issues in integrative practice research, including those relative to measuring whole practices, whole systems and health outcomes; identify and appraise the positive and negative interactions and contraindications for one's own modalities and agents; and identify standard research methods and tools appropriate for assessing one's field in a clinical setting.
"The era of integration is here," said Mike Wiles, DC, MEd, vice president /provost of Northwestern Health Sciences University and co-chair of the consortium's Education Working Group. "Yet the educational standards and clinical models of the licensed integrative health care disciplines are generally not emphasizing integrative models of care. These competencies focus us all on the current and future needs of providers." Dr. Wiles and other members of the Education Working Group joined multidisciplinary professionals from the ACCAHC's Clinical Care Working Group, Council of Advisors, Board of Directors and member organizations in developing the competencies. Overall, more than 50 individuals had input into the process, which began in September 2009.
As of press time, the ACCAHC is "aggregating and creating content" to develop a Web portal to be utilized as a resource for health care practitioners, organizations and educators to move toward the competencies. The portal, named The Center for Optimal Integration, will be accessible online at www.optimalintegration.org.
Current chiropractic ACCAHC members include the Association of Chiropractic Colleges, National Board of Chiropractic Examiners and Council on Chiropractic Education. To learn more about the consortium, its mission and members, visit www.accahc.org.
