News Feature



Dubai Healthcare City pioneers integration of CAM and clinical medicine

Over the past few years Dubai Healthcare City (DHCC), working quietly behind the scenes, has made major inroads in the integration of conventional clinical medicine and Complementary and Alternative Medicine (CAM) at DHCC. Its progress regarding the regulation of practise, the licensing of practitioners and the establishment of a procedural coding system is nothing short of pioneering, not just in the region, but globally.

Worldwide CAM has not been properly regulated for several reasons, one of which is that there is insufficient clinical research in CAM and any new research proposals struggle find funding. In the United States, in particular, big pharmaceutical companies tend to dominate the research funding landscape and wields considerable political clout. The US Government provides considerable funding for new research in a wide range of medical specialties, yet research into potential CAM medications/ treatments, which could possibly pose a threat to certain pharma industry drugs, seldom see the light of day. Without regulation and licensing of CAM practitioners, conventional medical physicians are, understandably, reluctant to refer patients for CAM therapies as quality and efficacy of practise cannot be assured.

Regulation


DHCC has initiated, through its Center for Healthcare Planning and Quality (CPQ), a system of regulated CAM, which is the practise of CAM, the licensing of practitioners and facilities, all overseen by a governing structure. In 2006 DHCC began working with a range of consultants around the world to find out the status of CAM globally in an effort to select appropriate CAM services for Dubai and the region, from numerous available worldwide. DHCC conducted a local public survey to gauge the use and perceptions of CAM locally and to find out what the public’s needs were and what more could be done to fulfil these needs. DHCC also conducted a survey looking at physicians’ perspectives on CAM to find out what they thought of CAM services, whether they would be interested in a referral system and whether they would be interested in an integrative system – as this is one of the goals of DHCC, to integrate clinical medicine and CAM.

DHCC then set up a Steering Committee to initiate the CAM system at DHCC. It was tasked with deciding which services were required and with developing the rules and regulations for each service. After assessing all the consultants’ reports, the surveys and looking at available CAM-related evidencebased medicine worldwide, the committee approved 12 CAM services. These include: Ayurveda, Chiropractic, Guided Imagery, Homeopathy, Massage, Naturopathy, Osteopathy, Pilates, Tai Chi, Traditional Chinese Medicine, Unani, and Yoga.

Rules and regulations were developed for each of the services as well as the criteria required for practitioners wanting to register and practise CAM at DHCC. Registration requirement are stringent and generally require several years of education at a recognised institution, and an interview with DHCC’s CAM Council, which was established in 2007 upon the completion of the Steering Committee’s role.

CAM Council

The CAM Council is responsible for overseeing CAM practises within DHCC. The Council reviewed and approved all CAM rules and regulations and the list of CAM services. Importantly, it is also tasked with providing recommendations to DHCC’s Licensing Board for the licensing of CAM practitioners and their facilities in DHCC.

Members of the CAM Council include internationally respected CAM practitioners: Dr Andrew Weil, Chairman of the CAM Council, is Director of the Program in Integrative Medicine of the College of Medicine, University of Arizona. He is regarded as the father of Integrative Medicine in the US and is the author of many scientific articles and several books, including a number of best sellers. Dr Weil also writes a monthly newsletter, Dr Andrew Weil’s Self Healing – www.drweil.com; Teresa Hale, the founder of the Hale Clinic, a world-renown CAM clinic in London; Dr David Riley, the Editor-in-Chief of Alternative Therapies in Health and Medicine and the Medical Director for the publishing company Innovision Health Media. He is board certified in Internal Medicine, a specialist in Homeopathy and a certified yoga instructor. He has a keen interest in the evidence-based integration of conventional and alternative therapies; Dr Nishiti Joshi, the founder of the Joshi Clinic in London, is a conventional doctor specialised in Osteopathy; Dr Maria Alonso, Assistant Director at Dubai Herbal and Treatment Centre in Dubai, is a conventional doctor specialised in Traditional Chinese Medicine as well as Preventive Medicine.

CAM codes

In conventional medicine there are separate codes for diagnosis and procedure that have been adopted by numerous countries around the world. For diagnosis they are referred to as ICD-10 codes. ICD-10 is the latest version of the World Health Organisation’s “International Statistical Classification of Diseases and Related Health Problems”, which is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases. The 10th revision provides a set of more than 155,000 different codes. For procedures there are CPT-4 codes. The “Current Procedural Terminology” is a list maintained by the American Medical Association to provide unique billing codes for services rendered. The current version is the CPT-4. The diagnostic codes ICD- 10 can be used within CAM, but there is no recognised coding system in place to capture procedures with the purpose of providing a billing code system for services rendered. These are useful, most obviously, to standardise billing for medical procedures to facilitate the payment and reimbursement processes of health insurance companies.

However, ABC Coding Solutions, a US-based company, initiated the development of a procedural coding system for CAM. DHCC hooked up with the company and offered to run their coding system as a threemonth pilot project at certain clinics in DHCC and Dubai Herbal Treatment Centre. The pilot programme was a huge success and DHCC, in partnership with ABC Coding Solutions has gone on to develop many more codes specific to CAM procedures. These have now been made mandatory for use by all 20 CAM professionals practising in DHCC.

A spokesperson for DHCC says they are now working with various health insurance companies to have them cover all CAM services offered in DHCC. This will be a major breakthrough when this is achieved and will certainly cement DHCC’s position as a global pioneer in the integration of CAM and clinical medicine.


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ate of upload: 30th Sep 2009

                                  
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