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The Journey of HealthJourneys: Downloading Guided Imagery into the Business of US Health Care PDF Print E-mail
Written by John Weeks   

The Journey of HealthJourneys: Downloading Guided Imagery into the Business of US Health Care

Summary: The most significant penetration of complementary and alternative health care into mainstream US medicine is not integrative medical doctors, or holistic nurses, or massage therapists or any other complementary, integrative or holistic practitioner type. Rather, that position is held by digitized CDs and now web-available downloads of guided imagery tapes. The leader in the field is been HealthJourneys, founded by Belleruth Naparstek, LISW, BCD. Here is a portrait of the growth of that business since 1989, when a little audio cassette was introduced into a Kaiser Permanente hospital.
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guided imagery, health plans, hospitals, practices, CDs, mind-body What happened in 1989 in Northeast Ohio involving little audio cassettes that marked a significant new direction for mind-body practices in US health care?


A recent e-newsletter of HealthJourneys, founded by Belleruth Naparstek, LISW, BCD, recounts the answer to that question. According to the firm, Kaiser Permanente began in that year to distribute “quaint cassettes” of guided imagery content in order to assist the healing processes of certain of their members. The cassettes were supplied by Naparstek.

HealthJourneys shared this bit of history as part of an announcement that shows how much buy-in has leap-frogged at the giant, staff-model HMO:

“Kaiser Permanente is now offering free guided imagery downloads to all its members nationwide … Members go to their doc’s web page or a pod cast page, and access any of seven digitized guided imagery recordings: Healthful Sleep, Ease Pain, Pregnancy & Childbirth, Successful Surgery, Mastering Menopause, Weight Loss, and Relieve Stress.”
guided imagery, CDs, downloads
Belleruth Naparstek - demand keeps growing
The journey of HealthJourneys is a remarkable tale of a quiet advance of mind-body medicine in health system payment and delivery. But have these inexpensive self-care tools gained appropriate respect and utilization in the community practices of integrative MDs, naturopathic physicians, holistic nurses, acupuncturists, chiropractors and others?


Built on researched quality of life and cost outcomes


The journey for HealthJourneys has advanced by quantum leaps based on evidence – first of clinical value, and later of cost savings.
After the Ohio beginnings, nurse anesthetist Brad Larsen, RN  led a guided imagery pilot with surgery patients at Kaiser’s Santa Rosa Hospital. Larsen's work got the attention of Kaiser physicians like behavioral medicine leader David Sobel, MD  and complementary medicine at Kaiser leader Harley Goldberg, DO.

Major lift off began when Deborah Schwab, MSN, a Blue Shield of California employee began a study which not only looked at patient satisfaction and quality of life outcomes. Schwab’s work, which began to be presented in industry-related publications nearly a decade ago, looked at the impact of guided imagery CD use by surgery patient. Schwab studied big dollar issues including the potential impact on length of hospital stays. In a study published in last fall in (Summer 2007, Volume 22, Number 1; 8-14), reported a reduction of 14% in mean total charges among surgical patients, or $2003 per procedure. 

   
A study published last fall
in Advances reported a
reduction of 14% in mean
total charges among
surgical patients, or $2003
per procedure.


 
The products are now being used with returning soldiers with PTSD. Said Naparstek: “We've got some exciting upcoming research results from a pilot with the Durham (North Carolina) VA which Duke researchers have run. Naparstek says they are “especially pumped about this” work with what she bluntly refers to as “the crappiest 'mental' condition known to humankind.” She appears to delight in the value coming from not a team of highly-paid experts but rather an “inexpensive, portable, accessible intervention for soldiers.”

Marketing into the four-corners of the healthcare system

Naparstek and her HealthJourneys operation early on showed a strong marketing instinct. They backed the soft medicine with smart economic strategies. A website  and a quality e-newsletter has now joined a well-produced catalogue of “Resources for Mind, Body & Spirit.”  The recent 48 page HealthJourneys portfolio includes products from numerous other integrative health leaders including Andrew Weil, MD and John Kabat-Zinn, PhD.

     
Some Corporations Using
Health Journeys
Guided-Imagery Products

   

Health Plans

United Healthcare
Blue Shield of California
Oxford Healthplans
(now part of United)

Biothech/Pharma

 Boche
Amgen
Ortho Biotech
Glaxo

Hospitals

120 VA hospitals
Mayo Clinic
Kaiser Permanente


Titles target a few score of health conditions - pain, infertility, surgical procedures, cancer, cardiology, MS, stroke - to healthy living topics such as sleep, stress, meditation, weight loss, and peak performance. Skimming through, one is struck by a panacea-like nature of this meditative, calming medicine in our modern world. There is truly something for everybody – from $16.95 up. The top 3 sellers, according to Rich Coleman, the firm's vice president for strategic marketing, are: Healthful Sleep, Relaxation & Wellness and Relieve Stress. All are by Naparstek.

The reach of HealthJourneys products is not just across conditions, but also across stakeholders. Kaiser, as noted, is not the only health plan which is offering CDs. HealthJourneys also has agreements with numerous other major players in payment, delivery, pharmaceuticals and hospitals and health systems. Some 120 Veteran’s Administration facilities make these products available to their customers. Mayo Clinic has recently begun making them widely available.

HealthJourneys, a privately-held business, declined to give information on total revenues or total numbers of clients of different types.

Incorporation into individual integrative practices


I asked Coleman about the extent to which individual integrative practitioners – MDs, naturopathic physicians, acupuncturists, nurses, chiropractors and even massage and Yoga therapists -- actively promote the use of these CDs, tapes or uploads in their practices.


Coleman says that “many are selling individual CDs to their patients.” But hard data were not offered. More often, Coleman suggests, institutions purchase the products for use within facilities. He shares that individual practitioner customers “represent a steadily growing group.”


The idea for this story grew of learning that Naparstek’s CDs are highly regarded by holistic nurse managers as part of the chronic pain pilot for Medicaid beneficiaries managed by Alternative Medicine Integration Group. But even here the use is typically initiated by the nurse manager, rather than the acupuncture physician or massage therapists practitioners who are credentialed into the pilot.


Kaiser, mindbody, uploads, health journeys
Piloting then, uploads for all patients now
Coleman said be believes that many other practitioners use the CDs in their practices but are more likely to give the patient the catalog, rather than directly selling the products. Limiting factors may be inventory management or shelf space. Said Coleman: "The most frequent comment we hear is that they have a lack of display space.” But many of the community-based integrative practitioners sell supplements. Couldn’t these be handled similarly?  Said Coleman: “We don’t ask, so we don’t know how many of our customers sell vitamins.”


While the data are sketchy, Coleman offers that “massage therapists, spas, wellness practitioners and social workers seem most likely to re-sell our CDs.”


Comment:  CDs and tapes are an attractive complementary health care offering for a large corporation.
The outlay is nominal. One needn't worry about paying for any benefits plans, retirement programs or even significant shelf space if one brings these into practice. Yet the user can boast of integrating evidence-based complementary and alternative medicine. These little discs or dig-downloads are an interesting competitor to the individual practitioner who may do some guided imagery or stress reduction in his or her practice. It's hard to compete, on a cost basis. Yet the shown power of these agents, particularly if the recommending practitioners lends their credit by promoting them as useful home care, is clearly significant. I wonder to what extent schools and training programs for any type of integrative, holistic or natural health practitioners are teaching their students to routinely integrate these inexpensive tools into clinical practice. Any feedback, educators?

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