Samueli Institute is a non-profit research organization supporting the scientific exploration of healing processes and their role in medicine, with the mission of transforming health care worldwide.
 
 
 

IM Rand Samueli Institute Chair for Policy Research

The Rand/Samueli Institute Policy Center for Complementary, Alternative and Integrative Health Care was established to accelerate the adoption of CAM and Integrative Medicine (IM) within the conventional health care enterprise, through specific health services research. The Center’s mission is to improve private and public decision-making on CAM/IM, by supplying policymakers and the public with the results of objective, empirically based, analytic research which will significantly advance the integration of biomedicine and CAM/IM.

While complementary, alternative and integrative health approaches continue to gain acceptance and inclusion in many settings in society, the underlying scientific understanding of their effects still requires more robust and sustainable inspection. Patients play an essential role in driving the expanded use of CAM/IM, but little is known about the pathways by which they seek care or the decision-making process they use in determining whether or not to use CAM/IM. Even less is known about what is actually done for them during a clinical encounter that uses these therapies.

We also have little clear understanding of the extent to which CAM/IM is integrated into traditional biomedical care, even though this is a practical and growing reality. Patients who use CAM/IM or who mix CAM/IM with biomedicine treatments raises quality, safety and efficacy issues that have not been adequately addressed, particularly when they don’t inform their providers about their choices. Essential economic concerns also exist: a) when CAM/IM is used with but not coordinated with biomedicine, and b) because CAM/IM is not covered by private insurance or government payers; a situation made worse for underserved populations who cannot afford the benefits of such care.

The Institute of Medicine (IOM) report on CAM notes that decisions about the use of specific therapies should primarily depend on whether they have been shown to be safe and effective. But acceptance of CAM and IM evidence is plagued by extreme opinions. For some practitioners personal experience or knowledge is proof enough; for others, no amount of evidence is sufficient. Some who use CAM proselytize; some trained specifically in CAM disciplines retain skepticism for biomedicine; and many who oppose CAM accuse its practitioners of the worst kind of quackery.

Despite its widespread use (some 35% of American adults in recent years), NIH funding for CAM represents .02% of its total research investment. In addition, funding for health services research is only 1.5% of the total for all biomedical health research: a mere 0.1% of the total spent in the US for health care.

In effect parallel systems of health have evolved in the US since the 1970s: conventional biomedicine (or “mainstream” health care) and complementary, alternative and integrative medicine. Historically these systems have not communicated well with each other. This is clearly not in the interest of patients, the health care professionals or the public. A more rational approach is required to define and understand all stakeholders’ common benefits and risks.

The Rand/Samueli Institute Center is addressing this need in a comprehensive way that will establish which conditions CAM/IM providers are treating and the therapies they are using; how patients are choosing these therapies; whether they are using them in conjunction with biomedicine or exclusively; what positive outcomes they are receiving at what costs; and what adverse effects they might suffer.

The work of the Center will establish an effective strategy for advancing both the methodologies and the body of knowledge needed to establish the proper place for CAM/IM in the health care system. This will entail careful studies of use, cost benefits, efficacy, effectiveness, efficiencies, quality of care, appropriateness of care, outcomes (including patient satisfaction, quality of life and health status), and technology assessments.

The Center will accomplish these objectives by analyzing trends and outcomes, identifying and evaluating CAM/IM programs and their contribution to health and healing, evaluating policy options, and bringing together representatives of different interests to debate alternative solutions to research and policy problems.

The Center’s primary areas of focus include:
  • Producing rigorous research on CAM and IM – this includes descriptive studies that identify the kinds of care and healing provided by CAM and IM practices. The Center will establish a comprehensive definitional and descriptive base for the study of effective integrated medicine systems.
  • Providing research services to the US Department of Defense, Veterans Administration and other health delivery organizations that are investing in CAM/IM portfolios.
  • Producing innovative research methods – this includes the development of appropriate evaluation methodologies for: a) the health encounter and its outcomes, and b) the application of components of a multi-dimensional model of healing practices.
  • Evaluating health care systems’ performance – this includes policies related to regulation, quality of care, financing and costs related to the integration of CAM/IM in biomedicine.
  • Developing an international research program to determine the value and effects of traditional and indigenous healing practices where they present global significance.
  • Evaluating the roles of CAM/IM practices in specific populations, such as the aging, minorities and the underserved.
  • Building the Center’s research resources through grant and contract applications and philanthropy.
  • Attracting established researchers in other fields to the field of CAM/IM.
  • Contributing to the development of national and international policies related to CAM/IM.
Formation of the Center builds on the 2007 RAND/ Samueli Institute partnership that jointly established a chair and program in Integrative Health Medicine research. The Center is located at RAND in California.