Got Technology?

February 10, 2016

Maureen Fitzgerald
ATTC Network Coordinating Office/NIATx

Back in 2004, NIATx Director Dave Gustafson got together with a group of creative thinkers from around the world. Their goal was to create a vision for the addiction treatment system of the future.  The result, after a couple of days of serious brainstorming, was a vision for addiction treatment that included virtual counselors and technology tools to track moods, manage cravings, and prevent relapse.

Dave wrote about that vision in Automating Addiction Treatment, published in Behavioral Healthcare in 2009. At the time, he and his team were just starting to develop A-CHESS, a mobile app to help people with alcohol dependence maintain their recovery after leaving residential treatment.

Today, the features dreamed about in that meeting in 2004 are part of A-CHESS and other mobile apps developed for addiction treatment and recovery. As Dave comments recently in the New York Times piece, Staying Sober After Treatment Ends:

A-CHESS Display 
"...evidence is that people in recovery need three things: social connection, motivation ("the desire to keep on keeping on") and confidence that they know how to cope with their struggles. Apps can help with all three."

Developing health information and communication technologies has become a major focus of research and development for the Center for Health Enhancement Systems Studies, which houses NIATx. For example:
  • A-CHESS is being adapted as a tool for integrating substance use disorder treatment with primary care. (See related post by Andrew Quanbeck.) 
  • A study team in Boston is testing a Spanish-language version of A-CHESS, called CASA CHESS, to reduce relapse and increase medication adherence among Latinos with co-occurring disorders.
  • Another A-CHESS project combines mobile health with medication-assisted treatment for opioid use disorders.
  • NIATx Deputy Director Todd Molfenter conducted a pilot study to test states' readiness to implement technology. A follow-up study will expand on that work to explore barriers to technology use in addiction treatment--and how to address them. 
  • The NIATx process improvement model is guiding development of other mobile health applications. 
  • Center scientist Dr. Esra Alagoz and a NIDA Clinical Trials Network team are developing a mobile app to help extend Motivational Interviewing training beyond initial face-to-face workshops. 
Are we there yet? 

A-CHESS and other mobile apps today include features such as sensors, which were hard to even dream of in 2004. 

"I guess we never would have envisioned the number of sensors already built in to smartphones, like GPS, cameras, sound, and balance," says Dave. " Their potential to give just-in-time information on health status is a game-changer."

While technology is changing health care, Gustafson acknowledges that we're still a long way off from a transformed addiction treatment system. 

"In some senses, the Affordable Care Act and Wellstone legislation are creating an environment where health care providers must respond to the needs of people with substance use disorders, and payment for such services is much closer to becoming reality," comments Dave. "And with primary care being expected to take on behavioral health services and medication-assisted treatment, the world of addiction is looking more like the world of other chronic diseases."

"One of the big challenges is designing systems that will be attractive and useful enough to be used for the long haul," says Dave. "We are getting better at that, but we're not there yet."

Keeping pace with technology

Another challenge for anyone interested in health care technology? Keeping up! Health care  technology is evolving so quickly that it's hard to stay up-to-date with the latest trends. Fortunately, the National Frontier and Rural ATTC offers great ways for you to stay informed about the latest technology innovations in behavioral health. The latest is their Telehealth & Technology Community Group: a members-only technical assistance community for behavioral health professionals.

Launching on February 16, 2016, this community page will be packed with content on the latest advances in online technology services and the use of specific technologies. It will also be a great place to network--you can join conversations with telehealth and technology experts from around the country.
Join today by requesting to become a new member. Then pass the news on to your friends and colleagues and share this free resource.

Along with NFAR's new Telehealth & Technology Community Facebook page, you can stay in the know about telehealth with:
  • The National Frontier and Rural ATTC Telehealth Tuesdays. Tune in the second Tuesday of each month to find out more about the latest trends in telehealth for addiction treatment and recovery. 
  • Using Technology to Enhance Addiction Treatment, Thursday, February 25, 3:00 ET.  This Free webinar is hosted by the SAMHSA-HRSA Center for Integrated Health Solutions and the American Telemedicine Association. Featured presenters include Nancy Roget, Director of the National Frontier and Rural ATTC. 
  • SAMHSA'S TIP 60: Using Technology-Based Therapeutic Tools in Behavioral Health Services.  Download the digital version for free from the SAMHSA website. Section 3 of this publication is a comprehensive literature review of the therapeutic use of communication technologies for behavioral health conditions. 
Is your agency using technology to help patients achieve and maintain recovery? What resources do you use to stay up-to-date on the latest trends?  Share your story in the comments section below.

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