The Journey of HealthJourneys: Downloading Guided Imagery into the Business of US Health Care
Written by John Weeks
Saturday, 31 May 2008
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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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:
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 atKaiser’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 Californiaemployee 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-newsletterhas 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 byAlternative 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.
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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for inclusion in a future Your Comments Forum.
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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?
