Balens 2017 CPD Event Building Healthcare Networks in your Local Community Robert Verkerk PhD Founder & Executive Director, Alliance for Natural Health International
Building healthcare networks in your local community - Hawthorn Health Initiative Rob Verkerk BS c MS c DIC PhD F ACN Alliance for Natural Health International www.anhinternational.org ANHInternational @ anhcampaign * @ VerkerkRob
Who’s the flat earther? CAM practitioner? S keptic?
Conclusive S tatus of evidence ? evidence therapy does not work (cause and effect not demonstrated) Conclusive evidence therapy works (cause and effect demonstrated)
Crisis = time of opportunity & change
Change ahoy… Negative Positive
Three Horizons International Futures Forum www.int ernat ionalfut uresforum.com
BAU – is it working?
Individual Community
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?
The EBM hierarchy
S ix biases against patient and carers in EBM
RCT vs TR W RCT TRW • S ingle/ double-blind • S elf-selected • Randomised + control population • Mean effects • No control population • Eliminates P-T and • P-T effect social relationships • Hawthorne Effect • Eliminates Hawthorne • S elf-care incl effect diet/ lifestyle, physical • Outliers ignored activity, restoration • Biases (Greenhalgh et • Includes concomitant al, 2015) treatments = MEASUREMENT OF • Patient experience EFFICACY OF DIFFICULT TO MEASURE THERAPEUTIC = SYSTEM OF INTERVENTION HEALTHCARE
What are we most interested in? Patient experience Adapted from slide presented by Edzard Ernst at CAMexpo 2007
S pecific therapeutic effect vs total effect?
What determines outcomes? Time with practitioner Time without practitioner
Average vs best practitioner effect
Health status: multi-factorial How much influence does a CAM intervention have, compared with choices made as part of our self-care routines?
HHI: Getting started 1 2
HAWTHORN HEALTH INITIATIVE Forum Event 2017
HAWTHORN HEALTH INITIATIVE Forum Event 2017 New Website ~ Community & Membership, Research & Resources, News & Views www.HawthornHI.org
HAWTHORN HEALTH INITIATIVE Forum Event 2017 Research ~ Pilot Questionnaire for Therapists “ Not everyt hing t hat can be count ed count s, and not everyt hing t hat count s can be count ed.. ” - 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.
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 Manipulative Therapy inc. Osteopathy & 11 2 Shiatsu Chiropractic 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 Sports Therapy, Personal Training & 2 Conventional Medicine and Dental 1 Fitness
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… 0 10 20 30
HAWTHORN HEALTH INITIATIVE Forum Event 2017 How many hours a week on average do you normally practise? 30 20 10 0 0-15 16-25 25-37.5 37.5– 40 Over 50
HAWTHORN HEALTH INITIATIVE Forum Event 2017 How many treatment sessions on average do you do in a week? 30 20 10 0 0– 5 6-10 11– 20 21– 30 40+
HAWTHORN HEALTH INITIATIVE Forum Event 2017 How many new clients do you typically see in a week? 0– 3 2% 8% 4% 4– 8 9– 86% 15
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? No - Remains the same 38% 43% Prefer not to answer 2% Yes - Decreasing 17% Yes - Increasing
HAWTHORN HEALTH INITIATIVE Forum Event 2017 Where do your client s normally hear of you from? (mult iple answers could be picked) Recommendation from current or past client / friends and family Recommendation from other practitioners Your Organisation or Association Lecturing / presentations 45 20 20 14 9 6 1 1
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
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 30 from other practitioners 45 20 Your Organisation or 10 Association 2 2 14 9 6 0 1
HAWTHORN HEALTH INITIATIVE Forum Event 2017 How often do you refer your clients to natural healthcare practitioners / fitness professionals? Never 6% 19% Someti mes Often 75%
HAWTHORN HEALTH INITIATIVE Forum Event 2017 How often do you refer your clients to conventional medical practitioners? Never 4% 13% Someti mes 83%
HAWTHORN HEALTH INITIATIVE Forum Event 2017 How often do you give general lifestyle advice? Never 4% 17% 33% Occasionally 46% Throughout the therapeutic process With every client
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? No 31% 69% Yes
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? No Unsure 23% No 28% Yes Yes 49% Unsure
HAWTHORN HEALTH INITIATIVE Forum Event 2017 Client/ patient health tracking and big data research
Data collection and ownership
Data processes Quantifiable self data • Qualified self data • (Multi-channel data) • Healthcare choice data • Data aggregation • Motivation Pattern recognition • S elf-improvement Research
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
Collaboration for pilot development
Collecting big [health] data: what do we need? Patient-centred, patient-owned (non-profit, cooperative structure) S hould be empowering, motivating and increase engagement Quick and simple Broad scope S hould 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
Proposed ‘ big [health] data’ collection system Individual’s ‘ Healthcare S ystem’ • Practitioner-mediated interventions • Practitioner-guided self-care • Other self-care Baseline Follow-up/ Ongoing Characterisation assessments assessment of system
Handling bias S ampling Data (self- (response) selected)
The Hawthorn proj ect
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