2019 Conference Program

Join us as we explore how best to strengthen AOM Education. By fostering access to advanced evidence informed acupuncture practice, we will optimize outcomes, effectively collaborate in interdisciplinary teams, and ultimately improve patient care. 

What makes an excellent research curriculum? How can we integrate research evidence into teaching? How to engage students in active learning that enables them to participate as leaders of the profession? How to overcome the challenges to cultivating a culture of research in our colleges? How best to foster evidence informed practice, while incorporating the key tenants of the medicine? Based on successful models of research AOM education, we will work together to develop curriculum guidelines that help catapult acupuncture into the 21st century."

Presented by AOM Educators:

Heidi Most, D.Ac., L.Ac., Dipl.Ac. Maryland University of lntegrative Health

Carla Wilson, PhD, DAOM, L.Ac. ACTCM at California Institute of Integral Studies (CIIS)

Anna Smith, DACM, LAc, Dipl.O.M. Pacific College of Oriental Medicine and Foundation for Acupuncture Research, Inc.

Kenneth Glowacki, DACM, L.Ac National University of Natural Medicine

Facilitated by Dr. Rosa N Schnyer, DAOM, IFMCP, LAc and Dr. Lee Hullender Rubin, DAOM, MS, LAc, FABORM

Pre-Conference Special Interest Group 2 – Acupuncture in a Health Care System: Research Opportunities and Obstacles

This workshop is for acupuncturists who work in a health system or hospital setting in order to provide a space for collaboration, networking and strategic initiative. Each two-hour segment consists of two sessions, as follows.

The Risks and Rewards of Using the Electronic Health Record (EHR) for Research

Jeff Dusek, PhD, Director of Research, Connor Integrative Health Network, University Hospitals, Cleveland, OH

One of the major transformations in healthcare has been the growth and reliance on the electronic health record (EHR) in healthcare.  The EHR is truly ubiquitous in 21st century hospitals. 

Clinicians both applaud the interconnections allowed by use of the EHR and bemoan the extra clicks to required to complete their daily charting. 

Researchers, on the other hand, are rarely involved in development of elements of the EHR and yet have a desire to unlock the riches held within its electronic tables and notes. 

It is the dependence on the clinical tool (the EHR) for research purposes that befuddles many researchers. 

The goal of this talk will be to provide some helpful hints and education to assist researchers who are considering requesting data from the EHR treasure trove.  The talk will review both risks and rewards of using data from the EHR for research and provide some potential ways to be an active participant in the EHR build at their own institutions.  

Developing an EHR Template across Systems for Clinical Care and Research

Helen Ye, MS, LAc., UCSF Osher Center for Integrative Medicine

As increasing numbers of acupuncturists work in institutional settings, electronic health records (EHR) are a fundamental aspect of documenting patient care; however multiple EHR systems are used across settings and institutions, and EHR training in acupuncture educational institutions is minimal. 

The result:  poor consistency of documentation practices within institutions and extreme variances between them.  

Documentation practices need consistency for patient care purposes, research, and to accurately reflect the work, skills and training of acupuncture and Chinese medicine providers in Western medicine environments.

In addition, the tremendous potential for “data mining” through EHR systems is severely constrained without common templates that allow for consistent data gathering of patient care.  

The University of California at San Francisco’s (UCSF) Osher Center’s Chinese medicine team has worked to develop consistent documentation practices with templates and shortcuts for frequently used content and tools within EPIC, one of the country’s largest and commonly used EHR systems in large institutions, to be published in the Journal of Alternative and Complementary Medicine. 

If researchers and practitioners are able to develop a consensus template(s) across institutions, data gathering for multiple research projects can be leveraged to a much larger degree; patient outcomes and best practices can be better monitored and identified, providing further support for the profession, as well as education and training programs and policy decisions.

This session will allow the opportunity to explore these possibilities through the presentation of UCSF’s work on their EHR, and a panel discussion to provide input on moving this fundamental shift in paradigm for all acupuncture practitioners and researchers in institutions across regions. 

Following this presentation by Helen Ye (35-40 minutes) will be a response panel including Claudia Citkovitz and other systems-based acupuncturists.

Pre-Conference Special Interest Group 1 (continued)

Acupuncture Research Educators Roundtable – see above for description.

Pre-Conference Special Interest Group 2 (continued)

Acupuncture in a Health Care System: Research Opportunities and Obstacles - see above for description

Integration of Acupuncture into Health Systems: Where are the tipping points?

Arya Nielsen, PhD, LAc., Icahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health

Integration of acupuncture into health systems is not a uniform process.  At each institution, choices are made as to which inpatient or outpatient units will offer the service, which patients are eligible, and who makes the decision to refer.  These decisions are the inflection points determining how quickly integration proceeds, and several factors can tip them in one direction or another.  The acupuncture evidence base is one key factor; others include perceived benefits of acupuncture (by patients or care providers), cost data, and the potential for acupuncture to help with specific challenges already identified — from the need to provide smoking cessation services to the current opioid epidemic, or the paucity of treatment options for conditions such as pain, threatened miscarriage and irritable bowel syndrome. 

This session, intended for acupuncturists working in health care systems as well as researchers, will explore these three factors in practical terms.  

Following a 30-minute overview of clinical areas where acupuncture’s evidence of benefit is strongest, Arya Nielsen, Claudia Citkovitz, and the panel will discuss areas of systems-based practice where acupuncture’s clinical impact appears to be strong despite lack of research to date, and areas where acupuncture may be useful in addressing patient care problems previously identified by the institution.  

Integration of Acupuncture at the Veteran’s Administration

Juli Olson, Doctor of Chiropractic, Masters of Acupuncture and OM, Diplomate in Acupuncture (NCCAOM), Licensed Acupuncturist

Justin Heesakker, Doctor of Acupuncture and OM, Diplomate in Oriental Medicine (NCCAOM), Licensed Acupuncturist

The purpose of this talk is to share what is happening in the Veteran’s Administration, regarding the integration of acupuncture in the largest healthcare system in the United States.

We will talk about challenges and opportunities of rolling out acupuncture on such a large scale across a large area. This is a very exciting time where a large group of veterans now have access to acupuncture care that previously would have had to pay out of pocket, and new possibilities are opening for large-scale acupuncture research.

In 2017, a list of approved evidence-based Complementary Integrative Health (CIH) methods of care were added to the Veteran’s Benefits Package. Included are acupuncture, biofeedback, clinical hypnosis, guided imagery, massage, meditation, tai chi/qi gong and yoga. In 2018, the Veteran’s Administration created a Qualification Standard for Licensed Acupuncturists so they may be hired as full time federal employees. Developing policies and offering best practices allows for greater acceptance of the profession and quick integration.

The growth of acupuncture is expected to continue at a quick pace. In order to meet the immediate demand for acupuncture services, the VA has widely trained non-acupuncture providers in Battlefield Acupuncture (BFA). Policies have been developed to improve access, including allowing multiple disciplines to train and provide BFA, eliminating written consent for auricular acupuncture and utilizing note templates in the EHR to collect research data specific to BFA.

In preparation for the decision to add acupuncture to the Veteran’s Benefit Package, the VA underwent a systematic review of the literature culminating in the Acupuncture Evidence Maps published by the VA’s own Health Services Research and Development branch in 2014.  In collaboration with the Department of Defense acupuncture has been included in several VA/DoD Clinical Practice Guidelines (CPG). 

As acupuncture becomes more widely available, the ability to measure both subjective and biometric outcomes, conducting clinical research on a large scale will be possible through the electronic health and designed notes. Additionally, capturing utilization & cost data provides an opportunity to examine cost effectiveness for acupuncture, CIH and the Whole Health model.  The Whole Health framework is a patient-centered care model that emphasizes a patient’s own goals for their health with resources and skill building to help them achieve those goals.

Symposia Panel 1: Patient Centered Acupuncture Research in the Real World

Moderator – Peter Wayne, PhD, Osher Center for Integrative Medicine, Brigham and Women’s Hospital and Harvard Medical School

Paula Gardiner, MD, MPH, Department of Family Medicine and Community Health, University of Massachusetts Medical School – Integrative Medicine Group Visits: A Patient-Centered Approach to Reducing Chronic Pain and Depression in a Disparate Urban Population

Arya Nielsen, PhD, LAc, Icahn School of Medicine, Mount Sinai Hospital – Acupuncture Approaches to Decrease Disparities in Outcomes of Pain Treatment - A Two Arm Comparative Effectiveness Trial; Group vs Individual acupuncture

Lynn DeBar, PhD, MPH, Kaiser Permanente Washington Health Research Institute - A Naturalistic Experiment Evaluating the Impact of Medicaid Treatment Reimbursement Changes on Opioid Prescribing and Patient Outcomes Among Patients with Low Back Pain

Response panel and audience discussion

Featured Posters: Oral Medley

Moderator: Peter Wayne, PhD

8:35am -  8:40am

Session one - Opening Plenary: The Science of Acupuncture for Chronic Pain – the abridged summary

Moderator: Jun Mao, MD, MSCE – Chief, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center

Subject matter experts will present an abridged overview of the scientific evidence re: acupuncture for pain.

• Basic Research: Mechanisms of acupuncture (animals) - Rick Harris, PhD, Associate Professor, Chronic Pain and Fatigue Research Center, Anesthesiology, University of Michigan; Associate Professor, Division of Rheumatology, Internal Medicine, University of Michigan
• Translational Research (humans) - Vitaly Napadow, PhD, LicAc, Associate Professor, Harvard Medical School; Director, Center for Integrative Pain NeuroImaging; Co-President, Society for Acupuncture Research
• Safety, Efficacy and Comparative Effectiveness - Hugh MacPherson, PhD, Professor of Acupuncture Research at the Department of Health Sciences, University of York; Chair of Trustees at the Northern College of Acupuncture; Clinical Director at the York Clinic for Integrated Healthcare
• Cost Effectiveness – Claudia Witt, MD, MBA Professor and Chair of the Institute for Complementary and Integrative Medicine at the University of Zurich and University Hospital Zurich; Professor at the Center for Integrative Medicine University of Maryland School of Medicine; Researcher, Institute for Social Medicine, Epidemiology and Health Economics at the Charité – Universitätsmedizin Berlin.
• Evidence-informed patient care - Jun Mao, MD, MSCE, Integrative Medicine Specialist, Board-Certified Family Physician, and Licensed Acupuncturist, Memorial Sloan Kettering Cancer Center

Audience Questions

Session two - Delivering Care: Voices of Patients and Providers

Moderator: Rosa Schnyer, DAOM, LAc

Panelists: 2 patients (TBD), Ben Kligler, MD; Tristin Adie, NP

This panel will humanize the research by giving voice to patients and providers who will share their experiences illustrating the benefits and challenges of receiving, coordinating and getting access to acupuncture.

Audience members will also be invited to share their voices.

Session three –  Plenary Presentation - Access to Acupuncture

• Patricia Herman, ND, PhD, Senior Behavioral Scientist, RAND Corporation, Pardee RAND Graduate School
• Claudia Witt, MD, MBA
• Josh Plavin, MD MPH - BCBSVT and Scott Strenio, MD – VT DVHA (Medicaid) 

Session four – Implementation Science Research Opportunities to Advance Acupuncture

Dave Clark, Dr.P.H. – NCCIH Program Director

This session will provide a brief introduction to core concepts of implementation science research and opportunities for acupuncture. NCCIH priorities for implementation science research will be discussed along with current funding pathways.

Session five - Using Research to Advocate for Evidence-Based Health Care Policy (A “top down” approach to dissemination)

Moderator: Ben Kligler

This panel will provide real world examples of dissemination of research findings via interaction with health care policy makers.

Robert Davis - Vermont BCBS

Laura Ocker - Oregon Medicaid

Arya Nielsen - Joint Commission

Panel Discussion and audience questions

2:30pm - 3:30pm

Session Six – Getting the word out: Improving the Dissemination of Acupuncture Research to Providers and Patients (panel discussion) (A “bottom up” approach to dissemination)

Moderator/Presenter: John Weeks 

Panelists:  

Mel Koppelman – Evidence Based Acupuncture

David Miller – American Society of Acupuncture

Matt Bauer – Acupuncture Now Foundation

Narda Robinson - American Academy of Medical Acupuncture
 

Thoughts about Sessions 1 through 6: a conversation with Helene Langevin, Remy Coeytaux, and Robert Davis

Session seven - 3 Concurrent Sessions
Parallel sessions

• Dr. Johannes Fleckenstein - Gender-dependent mechanism in acupuncture analgesia
• Dr. Maurits van den Noort - Gender-differences in the acupuncture treatment of Parkinson’s disease
• Dr. Peggy Bosch - Gender-differences in the acupuncture treatment of patients with schizophrenia

• Li-Wen Lin - Acupuncture analgesia in mice: from peripheral to central nervous system mechanisms
• Florian Beissner - Point-specific effects of electroacupuncture on the autonomic nervous system: New insight from an fMRI study of the human hypothalamus
• Younbyoung Chae - The role of cognitive factors in acupuncture actions

• Lee Hullender Rubin, DAOM, MS, LAc, FABORM - Acupuncture won't help you get pregnant: an overview of the current evidence
• Lisa Conboy, MA, MS, ScD - Why acupuncture therapy assists with behavior change-the case of assisted reproduction
• Beau Anderson, PhD, MA (Ed), LAc - New research approaches for assessing acupuncture therapy effectiveness in assisted reproduction

SAR Dinner and Networking

NOTE: Dinner tickets are SOLD OUT

MC: SAR Co-President – Rick Harris

Dinner Speakers:

• Richard Hammerschlag, PhD, Dean Emeritus of Research, Oregon College of Oriental Medicine; Institute Scholar Emeritus, The Institute for Integrative Health; Adjunct Professor, Dept of Neurology, Oregon Health & Science University
• Helene Langevin, MD, Director, National Center for Complementary and Integrative Health at National Institutes of Health

Session eight - Featured plenary presentation: Clinical trial of acupuncture for urinary stress incontinence

Liu Baoyan, PhD - Vice President of Traditional Chinese Academy of Sciences (CACMS); President of the Chinese Acupuncture Society; President of the World Federation of Acupuncture Society; Traditional Medicine Consultant World Health Organization

Session nine - Symposia Panel: Embracing the overlap between acupuncture and neuromodulation: A bird’s eye view from NIH and Industry

Introduction: Vitaly Napadow, LAc, PhD

• Wen Chen, PhD, Acting Branch Chief and Program Director, Basic and Mechanistic Research in Complementary and Integrative Health, Division of Extramural Research, National Center for Complementary and Integrative Health, National Institutes of Health

• Ben Pless, Executive in Residence at Partners HealthCare Innovation, Boston, MA - "The future of neuromodulation device development informed by the science of acupuncture - an Industry perspective"

Oral Presentations 1: Basic Science 

Chairperson: David Carr

Oral Presentations 2: Clinical Research

Chairperson: Lou Kazal

Oral Presentations 3: Basic Science

Chairperson: TBD

Oral Presentations 4: Clinical Research

Chairperson: TBD

• Non-needling data from study of acupuncture for chronic pain in Vermont Medicaid patients (Robert Davis, MS, LicAc, Co-President, Society for Acupuncture Research, University of Vermont Medical Center) 
• Pragmatic trial designs to identify specific effects beyond needling and their impact (Hugh MacPherson, PhD, Professor of Acupuncture Research at the Department of Health Sciences, University of York; Chair of Trustees at the Northern College of Acupuncture; Clinical Director at the York Clinic for Integrated Healthcare)
• Neural mechanisms supporting patient/clinician therapeutic alliance during acupuncture (Vitaly Napadow, PhD, LicAc, Associate Professor, Harvard Medical School; Director, Center for Integrative Pain NeuroImaging)