We hope the previous sections of Coursera "Everyday Chinese Medicine" have given you the basic understanding of Chinese medicine and integrative medicine. Today, we have five experts from the field of Chinese medicine and integrative medicine to show us the development and future and practice of integrative medicine in our healthcare system. First of all, I would like to introduce Professor Justin Wu, the Chief Operating Officer of the CUHK Medical Center. Second, Dr. Alexander Lau, the Associate Professor and convenor of the Hong Kong Institute of Integrative Medicine. So professor Wu, we know that the CUHK private teaching hospital and the Chinese medicine hospital will be established in 2020 and 2026. Could you share your insight how the CUHK private teaching hospital will add value to the integrated medicine in the hospital settings? Well, the CUHK medical center is the only academic medical private teaching hospital in Hong Kong. So our hospital has the social mission of fostering healthcare reform through clinical excellence, cutting edge technology, as well as innovative healthcare models. So among these various healthcare innovations, certainly, integrative Western and Chinese medicine is one of the main directions. Well, in our experience in Hong Kong Institute of integrative medicine, we have already developed a very robust multidisciplinary team with excellent Chinese medical practitioners, as well as other allied health and Western doctors who have been working well with these Chinese medical doctors. So what we are going to do in the private teaching hospital, is to create a robust clinical management system through good clinical governance, risk management, safety monitoring. We hope that some of these successful healthcare models from integrative medicine can be adopted in our daily clinical practice in the private teaching hospital. So professor Wu, as you have mentioned, do you think that this medical model could help the current medical system of Hong Kong and how could it helps the Chinese medicine hospital as well? Can you share on it? Well, I think what we are going to do in our private teaching hospital about integrative medicine, well, can make a lot of influence on our healthcare system in the future. I think we are working a robust system to govern the delivery of integrative care model and some of the important issues, for example, herb-drug interaction, herb safety and quality, governance and credentialing of practitioners. I think all these are very important issues in order to make a success in our future Chinese medicine hospital. More importantly, I think with these events of innovative integrative care models, we may achieve the triple aims of good population healthcare, namely a good patient experience, lower healthcare cost, as well as an improvement in the general population health. So professor Wu, do you have any clinical scenario that could showcase your vision in this model? Well, actually in the Hong Kong Institute of Integrative Medicine, we have piloted a few healthcare integrative models with promising results. Among these various models, perhaps I would like to share with you our experiences in management of multiple sclerosis. This is a bothersome and debilitating disease that affects a significant proportion of population especially in Western countries and in recent years. We are seeing more and more patients with multiple sclerosis. Well, for these patients, they have a lot of unmet needs with the current conventional healthcare. So I think this is a good area for us to pioneer our integrative model. So perhaps I would like to introduce to you Dr. Alex Lau, who is the champion of this integrative model. Thank you Professor Wu. It's a privilege to be able to share some of our experience working with MS patients as well as working in integrative medicine over the past few years. I think just a brief introduction to multiple sclerosis. It is actually the commonest neurological disease affecting young adults in the world. Actually up to 2.5 million patients are suffering from MS in the world. We're also observing a rising preference of patients in Hong Kong, in many parts of Asia as well. So the main symptoms of multiple sclerosis include weakness or numbness of the limbs, bladder dysfunction, speech problems, and many at times, patients suffer from fatigue and also cognitive impairment. I think there were many advancement in Western medicine perspective over the past two decades. So we were able to significantly reduce say relapse rate, disability but then the majority of the patients are still suffering from troublesome symptoms such as fatigue and also cognitive impairment. So my research main interest is on MS and related disorders. And at the Institute of Integrative Medicine, I have been privileged to work closely with our Chinese medicine practitioners, and in fact, we find out that most, if not all of my patients, have considered trying Chinese medicine as part of their treatment options, because they know that this is a chronic disease, they know that this is a disease of the immune system, and they are very willing to explore treatment options that can further improve their healthcare. So Dr. Alex Lau, is your program driven by protocol or experience-driven? We borrowed the principles of comparative effectiveness research as well as pragmatic clinical studies in the design of our program. So, in fact, we have recommended treatments of herbs as well as acupunctures. But each week the patient is actually visiting our Chinese medicine practitioner, and they can prescribe an individualized treatment program, that is they have individualized herbs as well as the acupuncture points to be given. But then we also organize comprehensive, systematic assessment of the patient. So each patient is assessed by a neurologist, a nurse, as well as the Chinese medicine practitioner. For the cognition assessment, we also prepare a neuropsychological battery for a comprehensive assessment. So at the beginning as well as the end of the program, we did this objective assessment of all patients. With all this big data collection, we also engage our biostatistician, as well as the data scientists to do like a big data approach in evaluation of this multi-disciplinary approach and the effectiveness of such a program. So Dr. Lau, how do you think about integrative medicine the way forward for your disease or as a whole? So, do you think about evidence-based practice and safety for this issue? I think we've gained valuable experiences in our program with multiple sclerosis. I think our research institute provided a very stable platform for our multidisciplinary work. I've been privileged to work very closely with a team of Chinese medicine practitioners, data scientists as well as clinical toxicologists, because we do encounter some adverse events that is they have deranged liver functions after taking herbs and we sat down together and gone through the prescriptions of both the Western medicine as well as the Chinese medicine to see if there is any possible herb-drug interactions issues. At the same time, I think we've been collecting lots of data of the patient's outcomes including patient report outcomes as well as laboratory outcomes. And with this great amount of data, we were able to sit down with our data scientists to work together to see whether this multidisciplinary approach, that is the use of both herbs, acupuncture as well as Western medicine, have contributed to the positive outcomes of our patients. So far we've having very positive results. Almost 90% of our patients have responded favorably to integrative medicine approach, and we are looking forward to the final analysis of our project. So thank you very much Professor Wu and Dr. Lau in this sharing. Thank you.
