States expanding access to technology for addiction treatment

June 11, 2014

Mike Boyle, Associate Researcher
University of  Wisconsin-Madison

For the past 18 months, NIATx, in collaboration with JBS International, has been involved in a SAMHSA-funded project to help a group of five states (Iowa, Maryland, Massachusetts, Oklahoma, and South Carolina) and one county (San Mateo County, California) identify and implement new communication technologies for addressing substance use. The technologies focus on interventions for screening and brief intervention, treatment, and ongoing recovery support. It has been a great learning experience for the project team.

An important step in this process was identifying what technology platforms exist for addressing substance use. Also, the states wanted to know if research supports the use of the interventions. We found tremendous progress over the last decade in the development of new technology for behavioral health interventions. Several of the technologies have been subjected to extensive clinical trials with a variety of populations. And research  results indicate that interventions delivered via technology have equal or better results than services provided solely by a clinician.

Many of these technologies serve as “clinician extenders,” allowing for more efficient delivery of services. Interventions delivered through computers, smartphones, and tablets allow anytime access to treatment modules and/or recovery supports. These programs can provide reports to the clinician, allowing for monitoring of progress, adaptive treatment planning, and intervention as needed. They have the potential for increasing access by removing barriers to services and may lower the cost per episode of care.

The project also identified challenges and barriers to implementing the technologies. The biggest issue is how to reimburse providers for the services. The existing fee-for-service payment system could be used for telephone, telemedicine, or computer services such as “virtual worlds,” where a clinician delivers services directly to a patient in real time.

Payment mechanisms such as case rates or episode of care payments could work for services that patients can access on their own via the Internet. A case rate or episode of care payment can capture the organizational costs of using the technology, such as licensing or purchasing fees, training and support time, and monitoring time by clinicians.

Other challenges include competing priorities for the state and providers, incorporating the technology into the existing workflow, and potential resistance to the changes required.

Please join us for the free webinar on Tuesday, June 17 to find out more about these innovative technologies and what states are doing to implement them.

Adopting Innovative Technology to Support Recovery

Tuesday, June 17

1:00 ET/12:00 noon CT/11:00am MT/10am PT

Michael Boyle is an Associate Researcher at the Center for Health Enhancement Systems Studies at the University of Wisconsin–Madison and provides consulting services. He was formerly President and CEO of Fayette Companies, a behavioral health organization located in Peoria, Illinois, and is the Director of the Behavioral Health Recovery Management project. Boyle recently served on a National Quality Forum committee charged with defining an episode of continuing care for a substance abuse treatment encounter. He has authored several articles and book chapters. His current activities include integrating mental health, addiction and primary care services, implementing evidence-based clinical practices within recovery oriented systems of care, and exploring technologies to support behavioral health treatment and recovery.

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