June 11, 2014
Mike Boyle, Associate Researcher
University of Wisconsin-Madison
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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