A Mobile App for Integrating Addiction Treatment and Primary Care: Seva

December 11, 2015
Andrew Quanbeck, Ph.D.
Associate Scientist
Center for Health Enhancement Systems Studies/NIATx

Technology, evidence-based practices, and health care integration are important issues in addiction treatment today. A research project underway at The Center for Health Enhancement Systems Studies is combining all three.

With funding from the National Institute on Drug Abuse, we’re studying how to implement an evidence-based mobile intervention for addiction treatment into primary care. This research is another example of our increasing focus on the best ways to implement evidence-based practices and technologies in healthcare. The integrated system we have developed is called Seva (say’-va), the a Sanskrit word for “selfless caring." 

We'll study the organizational change resulting from implementing Seva in three federally qualified health centers: Access Community Health Center in Madison, Wisconsin; Partnership Health Center in Missoula, Montana, and the Institute for Family Health in Bronx, New York.  

Treatment and Recovery Support

Seva consists of treatment and recovery support elements, delivered in a smart phone or mobile tablet. The treatment component is based on the Therapeutic Education System (TES), a web- and mobile-based curriculum for addiction treatment with 65 interactive, multimedia, skill-building modules, including basic cognitive behavioral recovery support skills (e.g., refusing drugs, managing thoughts about drug use), life re-structuring skills (e.g., increasing recreational activities), and skills for preventing HIV, hepatitis, and sexually transmitted infections. 

Seva’s recovery support elements are based on A-CHESS, the evidence-based smartphone program designed by our Center to help people in recovery from drug and alcohol addiction prevent relapse. A-CHESS helps patients meet the challenges they often face, such as loneliness and isolation, managing the treatment regimen, and getting informal support. A-CHESS also addresses issues such as cravings and building coping skills for high-risk situations.

Clinician DashboardAlthough Seva was built from two existing programs, TES and A-CHESS, the Seva user experiences one seamless system with many links between elements. Patient-entered data are also uploaded and presented via a web-based dashboard that clinicians can use to monitor the status of their Seva users. The dashboard includes items that patients self-report, such as sleep troubles and relationship problems that may signal an imminent relapse; whether they have attended recovery meetings or completed other elements of the treatment plan; and relapse risk and protection factors. The dashboard can be customized for each clinic to display indicators that clinicians deem important for clinical decision-making. 

Implementation and Impact

Because Seva has an established evidence base, our research focuses on implementation and organizational impact. The implementation model we’re testing is distinguished by several characteristics: 
  • preparing the environment for implementation; 
  • using an organizational coach
  • rapid-cycle testing
  • an early effort to address sustainability
Results of this implementation research will ultimately speak to the role of mobile health technology in healthcare.  

What do you see as the role of mobile health technology in healthcare? 

No comments:

Post a Comment