Evidence for CAM healthcare options: Nurturing community-campus partnerships for musculoskeletal health

The aim of the Evidence for Complementary and Alternative Medicine (CAM) Healthcare Options (ECHO): Nurturing Community-Campus Partnerships for Musculoskeletal Health project was to understand the process through which a community health center and a chiropractic college might offer collaborative and patient-centered health services for people with muscle, bone and joint pain. Our two health-focused organizations, Palmer College of Chiropractic (PCC) and Community Health Care (CHC), embarked upon a year-long endeavor to assess the feasibility of integrating primary medical care, chiropractic and adjunctive services to allow people with musculoskeletal conditions access to low-or-no cost integrated medical and chiropractic services in a “one-stop” location. At the onset of this project, our institutions had never before collaborated on patient care initiatives and the CHC had not previously offered comprehensive pain management services which included CAM modalities. Our multidisciplinary spine care team used an action research cycle of planning, implementation, observation, and critical reflection to develop a preliminary model of musculoskeletal pain management, which included inter-institutional agreements, patient identification, referral mechanisms, and standardized pain and functional outcome assessments. Mixed methods approaches including observation, fieldnotes, patient and staff questionnaires, and interviews documented the action research process. In this presentation, we describe collaborations and challenges in the implementation process, present demographic and clinical characteristics of CHC patients who utilized chiropractic services, and report patient and staff evaluations of the benefits, areas for improvement, and possibilities for long-term sustainability and expansion of this program.