The problem we solve: Fee for service in chronic pain care has failed to yield results and the expenses have been enormous, as much as economic costing >240 billion US dollars for low back pain alone as well as an increased number of problems secondary to addiction to opioid medications including a high death toll due to overdose.
About our solution: The concept of a medical home is not new. Adopting a system in a medical home for the underserved population of chronic pain sufferers can solve the issue of rising cost, over utilization and better results. We offer early interventions with behavioral changes via nutrition (anti-inflammatory diet), exercise physiology, acupuncture which has scientific evidence of its benefits in chronic pain and a conservative approach to interventional pain medicine to be applied only after failure of other therapies or to facilitate other therapies.
Progress to date:I have established a small office setting that is already seeing patients. One of my patients has sent letter to a CEO of an HMO medical system in the area in an attempt to help me find a partnet because she has seen first hand the excellent results and potential to save costs to the system.
I have presented at local meetings the concept with excellent feedback. Traction has been slow but I am confident as there is more knowledge of this concept and as health insurance cost sharing with patient increases more and more people will be interested in a lower cost alternative to care.
I am working with 2 experts in the field of wellness nutrition and excercise physiology who would join the project but I do not have the funding to support this venture with them.
We would like to establish a center that has an integrated space for Physical therapy, acupuncture, medical interventions and office space.
In an ideal situation, we would like to establish a brand and proof of concept so that we can partner with third payers and establish a capitated system and phase away from fee for service to maximize savings.
Creator: Mauricio Garcia Jacques
Education: Harvard Medical School Residency in Anesthesi
Bio: I'm a public health specialist and physician who has the goal to develop a system to lower cost of caring for patients with chronic pain symptoms using integrative approach to health care.
Hospital Affiliation: ACHE Institute of Houston
Title: Founder
Advanced Degree(s): MD MPH
ACHE Institute of Houston
Location: 7332 Southwest Freeway
775
Houston, TX 77074
Founded: 1
Website: http://Www.acheinstitute.com
Product Stage: Prototype/MVP
YTD Sales: Working on it
Employees: 1-2
Health care costs are steadily increasing and in the case of chronic pain conditions the results are not necesarily better with more spending. We want to offer an integrative approach to pain control offering therapies with proven record of effectiveness, optimizing its results and providing most therapies in the same system with open communication between providers. Lack of coordination of care is a classic complaint in the current system and we want to offer an alternative in the field of pain care which is typically not understood by most providers.
Offer an integrative program for pain management to their patients with improved satisfaction.
Insurance companies can help us develop a system to transition from expensive fee for service to a risk sharing strategy to treat painful conditions. Save money as a community wellness approach as our user base grows!
This approach is excellent to boost morale and promote wellness in your workplace with one of our workshops.
Intellectual Property Summary
This is a service venture with no IP.
Clinical Information
Arch Intern Med. 2012 Oct 22;172(19):1444-53. doi: 10.1001/archinternmed.2012.3654.
Vickers AJ1, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, Sherman KJ, Witt CM, Linde K; Acupuncture Trialists' Collaboration.
CONCLUSIONS:
Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture.
Nutr Clin Pract. 2010 Dec;25(6):634-40. doi: 10.1177/0884533610385703.
The emerging role of chronic inflammation in the major degenerative diseases of modern society has stimulated research into the influence of nutrition and dietary patterns on inflammatory indices. Most human studies have correlated analyses of habitual dietary intake as determined by a food frequency questionnaire or 24-hour recall with systemic markers of inflammation like high-sensitivity C-reactive protein (HS-CRP), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α). An occasional study also includes nutrition analysis of blood components. There have been several controlled interventions which evaluated the effect of a change in dietary pattern or of single foods on inflammatory markers in defined populations. Most studies reveal a modest effect of dietary composition on some inflammatory markers in free-living adults, although different markers do not vary in unison. Significant dietary influences have been established for glycemic index (GI) and load (GL), fiber, fatty acid composition, magnesium, carotenoids, and flavonoids. A traditional Mediterranean dietary pattern, which typically has a high ratio of monounsaturated (MUFA) to saturated (SFA) fats and ω-3 to ω-6 polyunsaturated fatty acid (PUFAs) and supplies an abundance of fruits, vegetables, legumes, and grains, has shown anti-inflammatory effects when compared with typical North American and Northern European dietary patterns in most observational and interventional studies and may become the diet of choice for diminishing chronic inflammation in clinical practice.
PMID:
21139128
DOI:
[PubMed - indexed for MEDLINE]
Falla D1, Lindstrøm R, Rechter L, Boudreau S, Petzke F.
BACKGROUND:
Although exercise can be effective for relief of neck pain, little is known about the effect of exercise on the neural control of neck muscles.
METHODS:
A randomized controlled trial was conducted on 46 women with chronic neck pain to investigate the immediate effectiveness of an 8-week exercise programme on pain and directional specificity of neck muscle activity. At baseline, the patients completed questionnaires including the neck disability index (NDI) and performed a circular contraction of their head in the horizontal plane at 15 N force, with continuous change in force direction in the range 0-360°. Electromyography (EMG) was recorded from the sternocleidomastoid (SCM) and splenius capitis (SCap) muscles. Tuning curves of the EMG amplitude were computed, which depicts muscle activity over a range of force directions. The mean point of the tuning curves defined a directional vector, which determined the specificity of muscle activity. Patients were randomly assigned either to a training or control group.
RESULTS:
A significant between-group difference in the change in NDI was observed. A reduction in NDI was observed following training (pre: 18.2 ± 7.4; post: 14.1 ± 6.5; p < 0.01) but not for the control group (pre: 17.5 ± 6.3; post: 16.6 ± 7.4). The training group showed higher specificity of muscle activity post-intervention (pre: 18.6 ± 9.8%, post: 24.7 ± 14.3%; p < 0.05), whereas no change occurred for the control group (pre: 19.4 ± 11.9%, post: 18.2 ± 10.1%).
CONCLUSION:
An exercise programme that aims to enhance motor control of the cervical spine improves the specificity of neck muscle activity and reduces pain and disability in patients with neck pain.
© 2013 European Federation of International Association for the Study of Pain Chapters.
Regulatory Status
NO FDA clearance required, combination of approved interventions.
How we will use the funds raised
I will use the funds to lease space to accomodate our treatment center to include a Gym area, clinical offices and a procedure room with medical equipment for interventions. The funds will also support the nutritionist salary and the excercise physiologist salary. I will not use funds to support my salary (MD pain specialist) as I will work part time elsewhere to support the venture as I have been doing thus far.
Thank You
The health care system is changing rapidly and patients will be underserved if we do not adapt quickly. This venture I believe is ready for the future, can be self sustaining, once its established, and will have the capacity to adapt through any changes in the third payer environment.
This is an adaptation of medical home to a private practice setting. It will fuel others to follow and not give up to mayor hospital systems which are rapidly expanding and buying other smaller practices making the system even more expensive.
This is us, making an effort to improve healthcare, outcomes and costs.
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