Although there is increasing recognition of the use of CAM to the public, an increasing desire to integrate such practices with mainstream medicine, and an increasing number of centers of integrative medicine attempting to do this, there is no existing body of research that identifies the barriers to, and factors facilitating, integration. The research team will conduct a case study of a single center of integrative medicine located within a medical hospital. The study will use both stakeholder analysis and system analysis combined with the qualitative method of focus groups and interviewing to yield a rich description of how CAM and mainstream providers, and patients, grapple with the challenge of providing integrative services. The stakeholders include CAM providers practicing in the Center in the hospital, medical physicians in the hospital. CAM providers in the local community, medical physicians in the local community, and patients. The qualitative data collected will be complemented by quantitative data from patient files and structured interviews. The data will then be used to: (I) document the organizational, financial, attitudinal, and logistical factors that act either as barriers to providing integrated care to patients, or act to facilitate integration (and in the case of barriers to examine how best to overcome them); and (2) provide a contextual framework in which to interpret findings from our quantitative analyses of survey data and records. We approach the study of the network system of integrated care knowing it is in constant flux and that key changes are envisioned in both in the Center and within the hospital. Because of that, the study will repeat many of the key informant interviews, and some of the focus groups over a four-year period. Any changes will therefore form part of the case study analysis. A detailed case study, using qualitative and quantitative research methods will yield a rich description that can facilitate future quantitative studies over a broader range of organizational models of integrative medicine.
