Balens 2017 CPD Event

Transcription

1 Balens 2017 CPD Event Building Healthcare Networks in your Local Community Robert Verkerk PhD Founder & Executive Director, Alliance for Natural Health International

2 Building healthcare networks in your local community - Hawthorn Health Initiative Rob Verkerk BSc MSc DIC PhD FACN Alliance for Natural Health International *

3 Who s the flat earther? CAM practitioner? Skeptic?

4 Status of evidence Conclusive? evidence therapy does not work (cause and effect not demonstrated) Conclusive evidence therapy works (cause and effect demonstrated)

5 Crisis = time of opportunity & change

6 Change ahoy Negative Positive

7 Three Horizons International Futures Forum

8 BAU is it working?

9 Individual Community

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12 The challenge EVIDENCE! But what do we want to inform: Evidence-based Medicine? Evidence based practice (EBP)? Practice based evidence (PBE)? Effective healthcare? Effective for specific health problems? Improved outcomes compared with standard treatment?

13 The EBM hierarchy

14 Six biases against patient and carers in EBM

15 RCT vs TRW RCT Single/double-blind Randomised + control Mean effects Eliminates P-T and social relationships Eliminates Hawthorne effect Outliers ignored Biases (Greenhalgh et al, 2015) = MEASUREMENT OF EFFICACY OF THERAPEUTIC INTERVENTION TRW Self-selected population No control population P-T effect Hawthorne Effect Self-care incl diet/lifestyle, physical activity, restoration Includes concomitant treatments Patient experience DIFFICULT TO MEASURE = SYSTEM OF HEALTHCARE

16 What are we most interested in? Patient experience Adapted from slide presented by Edzard Ernst at CAMexpo 2007

17 Specific therapeutic effect vs total effect?

18 What determines outcomes? Time with practitioner Time without practitioner

19 Average vs best practitioner effect

20 Health status: multi-factorial How much influence does a CAM intervention have, compared with choices made as part of our self-care routines?

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22 HHI: Getting started 1 2

23 HAWTHORN HEALTH INITIATIVE Forum Event 2017

24 HAWTHORN HEALTH INITIATIVE Forum Event 2017 New Website ~ Community & Membership, Research & Resources, News & Views

25 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Research ~ Pilot Questionnaire for Therapists Not everything that can be counted counts, and not everything that counts can be counted.. - Albert Einstein Pilot Questionnaire was sent to approximately 300 CPD Attendees Reponses received from 48. Questionnaire will be revised and sent to Balens Client Base.

26 HAWTHORN HEALTH INITIATIVE Forum Event 2017 What are your main areas of practise? (please tick main areas apply up to a maximum of 5) 14 Massage & Aromatherapy (All forms) 2 Craniosacral Therapy 14 Other therapist / Practitioner 2 Hopi Ear Candles 11 Healing (all forms), Meditation & Mindfulness 2 Kinesiology 11 Manipulative Therapy inc. Osteopathy & Chiropractic 2 Shiatsu 9 Reiki 2 Talking Therapies 7 Acupuncture & Dry Needling 2 Teaching & Supervision 7 Nutrition Therapy 2 Traditional Chinese Medicine 7 Reflexology 2 Yoga & Pilates 6 Neuro Linguistic Programming 1 Bowen Technique 5 Herbal / Flower Medicine 1 Emotional Freedom Technique 4 Acupressure 1 Foot Health Practice 3 Homeopathy 1 EMDR / Iridology 3 Hypnotherapy 1 Music & Sound Therapies 2 Conventional Medicine and Dental 1 Sports Therapy, Personal Training & Fitness

27 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Why did you decide to become a healthcare practitioner Natural healthcare Interest in health & Dissatisfaction with Aligns with your A desire to make a

28 HAWTHORN HEALTH INITIATIVE Forum Event 2017 How many hours a week on average do you normally practise? Over 50

29 HAWTHORN HEALTH INITIATIVE Forum Event 2017 How many treatment sessions on average do you do in a week?

30 HAWTHORN HEALTH INITIATIVE Forum Event 2017 How many new clients do you typically see in a week? 8% 4% 2% 86%

31 HAWTHORN HEALTH INITIATIVE Forum Event 2017 If you have been practising more than three years, are you aware of a change in the number if clients who are approaching you? 38% 17% 2% 43% No - Remains the same Prefer not to answer Yes - Decreasing Yes - Increasing

32 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Where do your clients normally hear of you from? (multiple answers could be picked) Recommendation from current or past client / friends and family Recommendation from other practitioners Your Organisation or Association Lecturing / presentations

33 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Which of the following best describes why you believe your clients choose you? Recommended by family / friends 38 Recommended / referred by their doctor 10 They have a chronic illness that is not responding well to conventional medicine 29 To complement their conventional medical treatments 21 Dissatisfaction with conventional medicine / doctors 26 They are taking a greater responsibility for their own personal health needs 26 They are following natural lifestyle choices in their healthcare 21 They are following the latest health and fitness trends 1 They have seen marketing / adverts for a specific treatment 2 They have read about a specific treatment, you or your therapy 16 They are responding to the greater public awareness generally of the benefits of natural healthcare 9 Social media 5 Attended a talk or a lecture 7

34 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Where do your clients normally hear of you from (multiple answers were allowed) 50 Recommendation from current or past client / friends and 40 family Recommendation from other practitioners Your Organisation or Association

35 HAWTHORN HEALTH INITIATIVE Forum Event 2017 How often do you refer your clients to natural healthcare practitioners / fitness professionals? 19% 6% 75% Never Someti mes Often

36 HAWTHORN HEALTH INITIATIVE Forum Event 2017 How often do you refer your clients to conventional medical practitioners? 13% 4% 83% Never Someti mes

37 HAWTHORN HEALTH INITIATIVE Forum Event 2017 How often do you give general lifestyle advice? Never 33% 4% 17% Occasionally 46% Throughout the therapeutic process With every client

38 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Would you be interested in a website specifically for Natural Health Professionals that is a hub for sharing, including info on business and research into Natural Medicine, networking opportunities and events? 31% No 69% Yes

39 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Would you be open to involving your clients in a research project to gain greater understanding into the benefits of visiting a Health & Wellbeing practitioner? Unsure 28% Yes 49% No 23% No Yes Unsure

40 HAWTHORN HEALTH INITIATIVE Forum Event 2017 Client/patient health tracking and big data research

41 Data collection and ownership

42 Data processes Quantifiable self data Qualified self data (Multi-channel data) Healthcare choice data Data aggregation Pattern recognition Motivation Self-improvement Research

43 Quantifiable self - general trends 1 st level of meaning: gratuitous movement data 2 nd level of meaning: motivates self-improvement 3 rd level of meaning: motivates better decisions about health at point of choice/decision

44 Collaboration for pilot development

45 Collecting big [health] data: what do we need? Patient-centred, patient-owned (non-profit, cooperative structure) Should be empowering, motivating and increase engagement Quick and simple Broad scope Should not require specialist, high-cost equipment Multiple systems of electronic data capture Baseline and ongoing assessments Characterisation of healthcare system Cross-cultural / (multiple languages) International scientific/medical advisory panel Adaptation of existing/proven systems

46 Proposed big [health] data collection system Individual s Healthcare System Practitioner-mediated interventions Practitioner-guided self-care Other self-care Baseline assessment Characterisation of system Follow-up/Ongoing assessments

47 Handling bias Sampling (selfselected) Data (response)

48 The Hawthorn project

49 3 key data channels ABOUT ME - Weight, height, waist, hip, chest - Optional: BIA/body comp MY HEALTH - Self-reported health status - SF-12 (Physical and Mental Health Composite Scores, PCS & MCS) MY HEALTHCARE - About your healthcare professionals - Reasons for visiting a healthcare provider - Attitudes to different types of healthcare - Individual empowerment - Mono- vs multi-therapeutic treatments - Experience - Value for money

50 About Me Coding for anonymity Algorithm links vital stats to epidemiological data sets to determine metabolic risk category 8 body shapes 4 metabolic risk categories

51 Body shapes/ metabolic risk categories

52 My health SF-12 General health status Current physical health Physical health over last 4 weeks Emotional health/feeling over last 4 weeks Physical pain over last 4 weeks COMPOSITE SCORE = HEALTH STATUS = RESILIENCE

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54 Tracking screens (dev version)

55 Data ownership/privacy

56 Establishing big data capture for research and health transformation [1] Agreement on approaches across a broad range of modalities Cooperation with patients/clients Collaboration with international researchers/institutions Collaboration with associations and practitioners Pre-trial/pilot: Proof-of-concept Establish health data cooperative(s) Funding required for large-scale roll-out

57 Establishing big data capture for research and health transformation [2] Electronic data capture e.g. MIDATA, Filemaker (re Dr Peter Davies) Analysis and communication of findings via scientific collaborators/multi-institutions (e.g. UK, NL, USA, Autralia, China?) Key Opinion Leaders (medical/scientific/political) Celebrity endorsement Project should sit firmly within LOHAS (Lifestyles of Health and Sustainability) framework Do we need new terminology? e.g. NALSH, Hawthorn???

58 Beta-testing UK Netherlands USA Australia 1000 fully compliant subjects (minimum) over 12 months

59 Supporting approaches Open forum/discussion between practitioners and associations Campaigns / advocacy The power of story: testimonials PR Professionalisation Engagement with the mainstream Database of Individual Patient Experiences

60 Let s just do it! STOP PRESS! ANH Nutritional practitioner conference 7 Oct 2017; Sheepdrove Eco Conference, Ctr, Lambourn, Berkshire RG17 7UU Book via ANHInternational info@anhinternational.org Tel: