On the Revolution Health Site Integrator Readers Stimulate Dialogue on Rating Hospital "Integration"

Summary:  America Online founder Steve Case's Revolution Health web platform officially opened last week in a move which mainstream media is viewing as a battle of the titans - Revolution versus Web MD. From the Integrator perspective, the site opening is more local and personal. The local is that integrated health care is overseen by Integrator advisor and Revolution's senior medical director for care, Bradly Jacobs, MD, MPH. The personal is that Jacobs invited me to be an "expert blogger" - not reporting like here, but everything from the hip - for the Revolution site's "Healthy Living" zone. We've cooked up a dialogue, born from comments to the Integrator stories on Cancer Treatment Centers of America and "integration light," of rating hospitals for their level of integration. Jacobs lays down his ideas for "integrative medicine light" and "integrative medicine medium" and "integrative medicine robust." I give him a little response. What do you think are the markers for a quality integrative medicine program?

From one perspective, the opening of the Revolution Health web portal to the public -- all services free the first year! - may be viewed as Borg versus Borg. In which Steve Case, the founder of American Online and of Revolution! takes on internet health leader Web MD.

Case announced last spring that he plans to put up to $750-million of his own money, and who knows how much of that of others, into his efforts to revolutionize healthcare. (See related Integrator article.) Web MD, meantime and after a decade, is still looking to turn its first profit.

Now from another perspective, the Revolution site provides an unusual opportunity for integrated care. Case's avowed consumer-focus has disposed him to an openness to the interest in natural, complementary and integrative health practices. Case put his money where his mouth is when he hired

, an Integrator-advisor and founding clinical director of the UCSF Osher Center to serve as Revolution's senior medical director for care. Revolution is putting an unimaginable amount of money into making the site extremely well-trafficked. Want revolution? Why not use it to stir up some trouble ... err, useful dialogue?

Last November, Jacobs gave me an opportunity to be an "expert blogger" on the "Healthy Living" portion of the Revolution site. I thought: Nice potential for creating some traffic back and forth to the Integrator. May learn to talk better to consumers. (Shorter sentences John, always shorter sentences.) A chance to reach a different audience with some of our challenges. Also, as pure blog, can easily grow based on the reporting on this site. I said yes.

Bradly Jacobs, MD, MPH

What follows below is a sequence which describes how some of this cross fertilization can work:

• an Integrator article (Will "Integration Light" by Competing Hospitals Kill Cancer Treatment Cewnters of America's Plans for an Inpatient Facility?") produced
  
• astute comments from Integrator readers (Your Comments : WA State's Denial of CTCA a "Travesty" and a "Showcase" on Variances in Integration Models) which led to
• a Revolution posting by yours truly based on these commentators (Is the term "integrative medicine" meaningless?)
  
• followed by a couple comments from Jacobs then his thoughtful posting on his Revolution blog, below ("The spectrum of integrative medicine.")
  
  

"In the most recent posting in John Weeks blog Healthy Living, he appropriately asks us to consider whether "...the so-called "integrative medicine" movement wouldn't be assisted if hospitals had to abide by some standards before they can make the claim to the public of being "integrative" or of integrating "complementary and alternative medicine."  " He adds, "The suggestion was made that "integrative" is no more meaningful that "organic" - before organic standards were put in place. "

"I asked John to consider what criteria he would use in creating these 'standards' and will offer my own for consideration herein......

"Integrative Medicine Light:  Complementary and Alternative Medicine (CAM) health professionals providing patient care in a outpatient clinic or hospital without communication amongst themselves nor with the treating conventional health professionals.  These services are usually massage, relaxation, +/- movement therapy (yoga, tai chi), +/- whole medical systems such as Traditional Chinese Medicine, or Naturopathy.

"Integrative Medicine Medium: CAM and conventional providers share the same office space and may even share patients but there is no communication between providers about the care of specific patients.  This is the most popular form of "Integrative Medicine".

"Integrative Medicine Robust:  Multiple providers from different disciplines meet on a regular basis to discuss the care of specific patients. Providers might include e.g. Chinese Medicine providers (acupuncturists), Naturopaths, Massage therapists, Osteopaths/Chiropractors, Medical Doctors (from multiple specialties), Pharmacists, Social Workers, Physical Therapists, Yoga therapists, Meditation instructors, Tai Chi instructors, etc.)"