Boosting the Evidence Base of Chinese Medicine Through Acupuncture EHR
This is a great time to be an acupuncturist. Here in the United States, acupuncture and Chinese Medicine are becoming recognized for their ability to improve health and daily functionality. More insurance plans are covering acupuncture, and the range of “treatable” conditions is expanding. The Affordable Care Act (“Obamacare”) is helping to boost the acupuncture industry by including it as part of their essential health benefits offerings (in AK, CA, MD, NM, NV, & WA). One area that is struggling to keep up, however, is research on the efficacy of TCM.
Reviewing the evidence base on the efficacy of TCM
While studies examining the biomedical effects or what conditions acupuncture is effective for are increasing in frequency, the current available published research does not reflect what acupuncturists see in their clinical results.
Let’s take for example randomized controlled trials (RCT’s) with Sham acupuncture. These studies have been designed to examine the effect on a particular condition by comparing a “control/ Sham” group to an experimental group of participants. While this style of research makes it possible to test acupuncture within the same medical model that pharmaceuticals are tested in, the results have been mixed.
Some studies show specific acupoints to be more effective than Sham, while other studies show only slight differences in effects between Sham and specific acupoints. In the end, the data coming from acupuncture RCTs is not reflecting the clinical results seen every day by acupuncturists.
In a wider context, this type of research is failing to create a strong evidence base with which acupuncturists and doctors can refer to and “prove” that acupuncture and Chinese medicine is effective in treating a wide range of conditions.
Enter the Electronic Health Records
EHRs have the greatest potential to benefit the TCM industry because they increase our evidence base through trillions of pieces of collected medical data. Aside from its practice management/ note taking benefits, effective acupuncture software can collect, organize, and maintain a wide range of analyzable data.
Patient demographics, vital signs, history of presenting illness, previous medical history, family history, treatment protocols, and most importantly, treatment responses are all collected and codified in the software of EHRs.
Since the inception and implementation of EHR technology, lawmakers, programmers, and scientists have anticipated the role that EHR data will play in future medical research. Laws regarding the use of EHRs (HIPAA, HITECH) have provided mechanisms by which this data is collected anonymously (with no risk to the patient privacy or safety) and catalogued for future research. This data can then be collected and maintained in the “Health Information Exchange”- databases that will allow researchers to conduct studies using clinical data without needing to perform RCTs. A new field of research called Health Informatics takes computerized medical data and analyzes it for trends.
Acupuncture and Chinese medicine can benefit from the collection of our clinical data
In order for our industry to see this benefit, however, Acupuncturists need to use EHRs so that our data can be collected and studies can be done showing the effectiveness of Chinese medicine. If enough data is collected, research can show the effectiveness of acupuncture on specific conditions, with certain patient populations, and compare results against other medical modalities.
What if we could compare a cohort of low back pain patients who received acupuncture versus patients who received steroid injection therapy? If the data is available, we might be able to show that acupuncture is more effective, which would make us the standard of care, before steroid injections!
Widespread adaptation and use of acupuncture practice management software will contribute this data, build our evidence base, and clinically demonstrate the effectiveness and efficacy of our medicine.
Blog post by Thomas Meade