269497 Integrative Chiropractic Services in VA: A Pilot Study (VICCS)

Monday, October 29, 2012 : 5:00 PM - 5:15 PM

Raheleh Khorsan, MA , Military Medical Research and Integrative Medicine, Samueli Institute, Corona del Mar, CA
Angela Cohen, MPH, CHES , Research, Department of Veterans Affairs, North Hills, CA
Monica Smith, DC, PhD , NUHS Adjunct Faculty -- Off-site, National University Health Sciences -- Off-site Adjunct, San Rafael, CA
Anthony Lisi, DC , VHA Chiropractic Service, Office of Rehabilitation Services, Dept of Veterans Affairs, West Haven, CT
Brian Mittman, PhD , VA Center for Implementation Practice and Research Support, Dept of Veterans Affairs, North Hills, CA
Ian Coulter, PhD , RAND/Samueli Chair for Integrative Medicine, RAND Corporation, Santa Monica, CA
Joan A.G. Walter, JD, PA , The Samueli Institute, Alexandria, VA
Despite its increasing prominence and acceptance, the chiropractic profession has functioned outside of mainstream medicine for most of its history. Chiropractic training, research and clinical services have not commonly been incorporated within hospital settings. Nevertheless, chiropractic care, which is the largest CAM service, is increasingly viewed as mainstream and increasingly integrated into traditional healthcare, and thus sits at the confluence of mainstream medicine and CAM. The US Department of Veterans Affairs (VA) introduced chiropractic services into its healthcare delivery system in 2004. Before this directive, chiropractic was available only as an off-site (fee-for-service) clinical service. In 2001, the Department of Veterans Affairs Health Care Programs Enhancement Act required the VA to provide chiropractic services at a minimum of one facility in each of its regions (i.e., Veterans Integrated Service Networks (VISNs)). To comply with this law, VA-Directive-2004-035 was issued in July 2004, establishing the provision of on-site chiropractic services within the VA healthcare system. By directive, all patients seen in VA chiropractic clinics are referred by medical providers. Thus, the delivery of chiropractic services within VA is likely to be substantially different from that seen in private practice settings. This session discusses the emphasis on integrated care implemented in the VA (i.e. integrative chiropractic services) for veterans returning from ongoing operations in Afghanistan and Iraq (i.e., VA's Post-Deployment Integrated-Care Initiative) as well as a national palliative care program (Comprehensive End-of-Life Care Initiative), and is modifying current care delivery arrangements as part of an ongoing primary care-mental health care integration initiative.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Program planning
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Like any emerging field integrative health care faces the problem of how to define and operationalize itself. The objective of this session is to discuss the definition and operationalization of integrative chiropractic services for veterans returning from ongoing operations in Afghanistan and Iraq (i.e. facilitate inter-professional communication and coordinate care, improving health outcomes, benefit to health care delivery, reducing costs, etc.).

Keywords: Alternative Medicine/Therapies, Chiropractic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: She’s a Research Associate of the Military-Medical Research Program & Integrative-Medicine Research Program at the Samueli Institute. She’s also a doctoral student at the University of California Irvine, Department of Planning, Policy, and Design, concentration in health promotion. A demographer and researcher, she prepares, organizes, and conducts research in variety of areas such as the evaluation of healing applications within healthcare. She analyzes qualitative and statistical. She has co/authored reports, presentations, and peer-reviewed articles.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.