The Integrated Taxonomy of Health Care: classifying both complementary & biomedical practices using a uniform classification protocol

Abstract

BACKGROUND: Several taxonomies have been developed over the last twenty years to help map out and describe the inter-relationships of complementary and alternative medicine (CAM) modalities. Several issues are often incompletely addressed in them: 1) having a simple categorization process that clearly isolates a modality to a single conceptual category; 2) clearly delineating verticality—that is, a differentiation of scale being observed from individually applied techniques, through modalities (therapies), to whole medical systems; and 3) recognition of CAM as part of the general field of health care. METHODS: Development of the Integrated Taxonomy of Health Care (ITHC) involved three stages: 1) development of a precise, uniform health glossary; 2) analysis of the extant taxonomies; 3) the use of an iterative process of classifying modalities and medical systems into categories until a failure to singularly classify a modality occurred, requiring a return to the glossary and adjustment of the classifying protocol. RESULTS: A full vertical taxonomy was developed that includes and clearly differentiates between techniques, modalities, domains (clusters of similar modalities), systems of health care (co-ordinated care system involving multiple modalities), and integrative health care. The domains are the classic primary focus of taxonomies. The ITHC has eleven domains: Chemical / substance-based work; Device-based work; Soft-tissue focused manipulation; Skeletal manipulation; Fitness / movement instruction; Mind-body integration / classic somatics work; Mental / emotional-based work; Bioenergy work based on physical manipulation; Bioenergy modulation; Spiritual-based Work; Unique Assessments. Modalities are assigned to the domains based on the primary mode of interaction with the client, according the literature of the practitioners. CONCLUSIONS: The ITHC has several strengths: there is little interpretation used while successfully assigning modalities to single domains; it fully resolves the issue of taxonomic verticality; and it is designed to fully integrate the complementary health care fields of biomedicine and CAM.