I just had an epiphany and I have to write it down. The approach we took in our ongoing work at UI Health, where we create individualized 5-pillar “action plans” for each patient to help them manage their blood pressure, actually mirrors the traditional Chinese medicine practice! By pure coincidence, after working on it for a few years, this idea came to me on the first day of the Asian & Pacific American Heritage Month. Just like what master Oogway said, there ARE NO accidents! I want to share it, and if you are into service design, blood pressure or chronic condition management, traditional Chinese medicine, or you are in the business of innovating for health care, and are unfazed by this advanced warning of occasional tangents of childhood stories, read on!
What we've been working on
First, a little background. We have been working projects at UI Health for the past three years, focusing on helping patients manage their blood pressure. We are developing programs that could “Voltron” together to help change behavior in a comprehensive way. At the core (the Black Lion), lies our flagship intervention, the "hypertension action planning session". This is an in-person, private conversation that lasts around 30 minutes. A social worker or a pharmacist will sit down with the patient, get to know them, provide information about high blood pressure, and cocreate a plan with them. We end with teaching the patient how to use a blood pressure monitor and help connect it to their phone and the electronic health record. The patient takes the blood pressure monitor home with a clear idea about what to do differently to better manage their blood pressure starting that day. We’ve proven that this approach effectively lowers blood pressure, and we’ve been implementing and expanding the programs at UI Health.
So what’s the key mechanism that makes this intervention tick? At the heart, is a 5-pillar approach, diet, exercise, mental health, taking medications as prescribed, and measuring and documenting blood pressure regularly. The fundamental philosophy here is that most of the health care happens OUTSIDE of the hospital’s walls. When it comes to preventing and managing chronic conditions such as high blood pressure, lifestyle adjustments are key. But why does this have anything to do with traditional Chinese medicine? Let's switch gears.
What's traditional Chinese medicine?
I grew up in China, where traditional Chinese medicine have been evolving and thriving for thousands of years. Even in modern day China, alongside “western medicine”, the traditional way is still a philosophy and very much a way of life that a lot of the 1.4 billion people subscribe to. A few of the key concepts within traditional Chinese medicine came natural for people like my parents, and how they take care of their health, AND mine for my entire childhood.
First, food is medicine, you are what you eat. My parents would tell you that pears take away “fire” and are good to help with coughing; that radishes are good for moving “qi” through your body with the evidence that you would fart more after eating it; that eating too much meat or fish could produce mucus, causing “fire” to build up in your body and weaken your immune system, etc. etc. And quite religiously, when we are in the middle of a course of herbal medicine (VERY bitter herbal tea), we have to avoid consuming 生冷油腻, or the raw, the cold, the oily and greasy. To them, what you eat doesn't replace the bitter teas (the young me wishes), it's part of it. The dining experience with my parents includes free and mandatory education about the medicinal value of key ingredients in the dishes. It's an inside joke now with my son when he would say "good for skin" when happily eating braised pork belly (with skin). Mind you, my mom also believes in medical science as she injects an accurate amount of insulin before every dinner to manage her diabetes. The food thing is just how she operates regardless of that.
Secondly, body movements are important. My grandpa would say to me almost every time he went out for a stroll after each meal, not as justification so much as education for my benefit, 饭后走一走, 能活九十九, a little walk after you dine, one can live to ninety nine (it rhymes in Chinese, so…). When I was growing up, the evening walk was mandatory, barring extreme weather conditions. My parents and I would go walk around the little park with a man-made lake for an hour before returning home for homework/tv/bedtime routines. My parents now terrorize the Chicago Skinner park/UIC areas with their Tai chi moves and brisk walks on sunny days.
Third, your mood is interconnected with your organs, and of course, your health. My parents would tell you that prolonged sadness/anxiety would damage the lungs, and if you have liver issues, it will manifest in frequent outbursts of anger, and so on. It works both ways. Health issues can be interpreted by observing your mood, and you can influence where your health is headed by adjusting your mood.
So where is the connection?
The epiphany I had this morning was that these three aspects of traditional Chinese medicine, food, movement, and mood, mirror the diet, exercise and mental health pillars of our action plan! This is huge! And here is why: This new-found synergy made me believe in traditional Chinese medicine more rationally, and perhaps more importantly, it made me feel more confident about the approach we are advocating here at UI Health for blood pressure control.
I do believe in traditional Chinese medicine, but maybe more in a habitual, cultural, subconscious, almost spiritual way. But this new realization helped me crystalize the trust that traditional Chinese medicine actually takes a very comprehensive and highly personalized approach to health. It’s comprehensiveness resides in considering lifestyle aspects of food, movement and mood instead of just prescribing bitter herbal tea for a week and send the patient home. I am not saying that it’s out of the norm for any primary care physician in the US to tell their patient to pay attention to diet and exercise. I am saying, though, that it’s way more natural, even expected, that lifestyle aspects are within the realm of what’s prescribed by a doctor of traditional Chinese medicine. It’s highly personalized when the doctor 望闻问切, observe, listen, ask, and take pulse of every patient before prescribing a combination of dozens of herbs as the script. The combination depends on not only the patient’s current health and history, but also the season we are in. it’s really more of an art form than science.
Why does this connection matter to me?
We are supported by our own pilot research data. We are encouraged every time we see survey results from patients who went through the programs. We are thrilled when we talk to patients and hear about very small, but potentially live-saving changes that they've made because of the program. Yes, we have been confident as a team in the effectiveness of the program. We have faith that designing health care services that focuses on engaging patients with love and care is the only path forward. But I simply just LOVE that I am finding a connection between what we crafted with human-centered design methods in the last three years in Chicago, and a three thousand year old health care system from where I grew up. It's especially meaningful to have this reflection bubble up in me in the month of May, the Asian / Pacific American Heritage Month.
To read more about our ongoing work at UI Health, follow this link:
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