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A Health Science Process Initiative For The U.S. Global Healthcare Initiative

Presented to the College of Graduate Health Studies in partial fulfillment of the requirements for the Doctor of Health Science Degree A.T. Still University June 3rd, 2018 by John Barton MBA

Introduction The successful implementation of a Health Science Process Initiative (HSPI) is necessary for the U.S. Global Healthcare Initiative (GHI) to realize national improvements in the quality and safety of care. “Country ownership” is to be modeled in the U.S. for developing meaningful processes and outcomes for the reduction in cost associated with the GHI for global recipients of HSPI. Increasing quality and safety while reducing the cost of healthcare is the primary orientation of planning an HSPI and is the foundation of leading and managing the new program which includes developing the mission, goals, objectives, and policies necessary for successful program implementation and integration. Historically diagnostic errors have plagued health cares ability to navigate the terrains of corrective whole body therapies but the HSPI utilizes proven whole-body kinematic strategies for integrative intervention.

Background In 2007 The Exercise is Medicine (EIM) Initiative was introduced by the American College of Sports Medicine to institutionalize physical activity in healthcare. Lobelo, Stoutenberg and Hutber (2014) states physical inactivity is the fourth leading global cause of mortality and the past decade of research demonstrates physical activity can increase and improve function and health when directed from the healthcare setting in the form of counseling, exercise prescriptions and referrals. Physical activity though is a means to address the symptoms of the much deeper and systemic issues of a body that is sedentary and out of equilibrium or homeostasis (Mothes, Leukel, Jo, Seelig, Schmidt and Fuchs, 2017).

Homeostasis is the definition of biological health, function and the stable state of equilibrium between the interdependent systems of the body; a property of cells, tissues, and organisms that allows the maintenance and regulation of the stability and constancy needed to function properly. These processes and systems of the body are mostly regulated by Ca2+ which is manufactured in the skeletal system and subsequently transported throughout the body by systems for systems (Schneider, Taboas, McCauley and Krebsbach, 2003). The Endogenous Cannabinoid System (eCBs) regulates homeostatic mechanisms of the body and can be modulated primarily by integrative physical activity, manual therapy, nutrition and engaging in intellectual activities.

Global initiatives already exist for physical activity, nutrition, education and a necessary component of cultivating a healthier global community is implementing an initiative for protocols cultivating structural homeostasis. The inference is that a skeletal system that is in homeostasis is better able to provide homeostatic messengers for the aggregate when functioning optimally and yet historically no emphasis has been placed on the importance of maintaining systemic structural homeostasis by modulating the skeletal system towards a healthier orientation (Heifets and Castillo, 2009). By reorienting national and global healthcare leadership and management towards a HSPI global initiative, the GHI can experience a positive global healthcare benefit and impact for the least amount of resources or cost. Benefits to the recipients of HSPI are increased homeostasis represented by reduced nociception and increased function.

The development of an HSPI program is a resource and resolution for the GHI and a vital addition to the emerging trend in healthcare initiatives. The World Health Organization lists the 125 health topics that it is invested in addressing from A-Z on its website and a HSPI is positioned to provide field support for many of the topics listed.The GHI provides funding for existing U.S. global health programs to increase efficiency and effectiveness from its current budget and programs as opposed to creating new programs that require new funding and the HSPI would be a way to maximize efficiencies associated with current projects designed to address physical, physiological, psychological initiatives and topics. These perceived planning and budget constraints present no challenges to implementing HSPI and are conducive to the organizational environment shared by the GHI and the planners of HSPI.

The U.S. executive branch chiefly administers U.S. global health activities and would be responsible for planning and making decisions associated with HSPI in conjunction with the HSPI management committee. The Department of Health and Human Services (HHS) global affairs division, particularly the Centers for Disease Control and Prevention would also provide diplomatic support in Implementing U.S. global health efforts.

U.S. global health initiatives have been implemented in at least 60 countries like Africa, Asia, Latin America, the Caribbean, the Middle East, Europe and Eurasia through bilateral support. Although more support is directed to countries with an increased burden of incidence, other decision making factors include willing and able partner governments, positive relations and goodwill with host countries. (Cooper, A. (2016). Governing Global Health: Challenge, Response, Innovation. Routledge).

Those mostly impacted by HSPI are human beings in one of the more than 60 countries where U.S. Global initiatives are active, specifically those with increased nociception and diminished skeletal function. Increased nociception and diminished skeletal function are historically associated with human beings seeking and necessitating some type of corrective therapy as opposed to surgical intervention.

Corrective therapies already exist in global health initiatives but as of yet are not trained or educated to address increasing homeostasis and skeletal function through a process approach. There are some therapies that possess elements of HSPI but lack the primary ubiquitous protocols that make HSPI unique. The solution is to train the already present practitioners to apply HSPI to what they are already doing, labor-intense occupations dominate in third world countries and a HSPI designed to decrease nociception and improve function is a necessary component of impacting global healthcare.

Mission Statement The Health Science Process Initiative creates equality in human rights by providing improved safety and quality for all.

Vision Statement The Health Science Process Initiative vision is to develop integrative strategies to promote systemic homeostasis; health and wellness for every country, community and human being.

Value Statement The Health Science Process Initiative is guided by an unrelenting desire to globally promote: Equality – healthcare excellence through a one earth, one body orientation. Health – a synergistic effect of homeostasis through physical activity, nutrition, education and integrative touch.

Goals And Objectives Patient Care – all individuals who access GHI care will receive HSPI which is not limited to touch therapy for reducing nociception and increasing function. Education – all individuals or organizations currently providing patient care will be trained in the Health Science Process Initiative and this knowledge will be explained during patient care.

Research – all individuals receiving or providing care will be part of the ongoing HSPI that collects and disseminates data for information and information for knowledge.

Policies The scope of service for HSPI are as follows:  Integration of whole body kinematics into the current body of modalities to decrease nociception and increase function a. visually assess natural/genetic alignment and skeletal type b. visually assess asymmetry of shoulder-girdle, pelvic girdle, axial complex, cranium and extremities. c. confirm visual observation by palpation while prone, supine, sideline and standing d. confirm visual observation and palpation with walking analysis e. determine direction of correction and modulation for segmental deviations causing increased nociception and decreased function. f. provide a treatment plan of care for each individual based on diagnostic measures

Conclusion In a HSPI, dysfunctional patterns and segmental deviations are the primary issues to be able to identify and resolve. These primary issues are the primary cause of increased nociception and decreased function in deviations from structural homeostasis. The GHI and WHO have qualified practitioners in the field providing patient care but are subjected to the diagnostic errors that plague Western medicine and forms of corrective therapies and intervention. The ability to address pain management intervention in third-world countries with improved safety and quality is the objective of the HSPI . The U.S. GHI exhibits “Country ownership” to be modeled in the U.S. for developing these meaningful processes and outcomes for the reduction in cost associated with the GHI for global recipients of HSPI (Liebler, Gratto and McConnell, 2017). Increasing quality and safety while reducing the cost of healthcare is the primary orientation of planning a HSPI and is the foundation of leading and managing this new program for health and equality for all. The U.S. GHI predicts that the outcomes of running a national HSPI will provide situational leadership conducive for each region where a program is implemented and integrated into the current body of knowledge and modalities.

References Cooper, A. (2016). Governing Global Health: Challenge, Response, Innovation. Routledge. Heifets, B. D., & Castillo, P. E. (2009). Endocannabinoid signaling and long-term synaptic plasticity. Annual Review of Physiology, 71, 283–306.

Liebler, Joan Gratto, and Charles R. McConnell. Management Principles for Health Professionals. Jones & Bartlett Learning, 2017.

Lobelo, F., Stoutenberg, M., & Hutber, A. (2014). The Exercise is Medicine Global Health Initiative: a 2014 update. British Journal of Sports Medicine, 48(22), 1627–1633.

Mothes, H., Leukel, C., Jo, H.-G., Seelig, H., Schmidt, S., & Fuchs, R. (2017). Expectations affect psychological and neurophysiological benefits even after a single bout of exercise. Journal of Behavioral Medicine, 40(2), 293–306.

Schneider, A., Taboas, J. M., McCauley, L. K., & Krebsbach, P. H. (2003). Skeletal homeostasis in tissue-engineered bone. Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society, 21(5), 859–864.

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