Telehealth

This peer reviewed journal article OUD treatment and pregnancy outcomes among pregnant patients receiving OUD care through a telehealth addiction treatment program in the US. The patients identified in the study received buprenorphine or buprenorphine and naloxone treatment. 

The study tested a care coordination model in six rural primary care sites during the peak of the COVID-19 pandemic, July 2020 to January 2021. Each clinic tracked patients with opioid use disorder (OUD) as they received medication treatment delivered by an external telemedicine provider.

The guide from the National Council for Mental Wellbeing aims to support harm reduction organizations operating in virtual environments and summarizes some of the strategies that harm reduction organizations have developed and found to be effective at maintaining connection while doing harm reduction work virtually. Harm reduction continued during the COVID-19 pandemic and organizations effectively changed the way services were delivered, primarily through telework. 

The Drug Enforcement Administration (DEA) announced proposed rules for the prescribing of controlled medications via telemedicine beyond the end of the COVID-19 public health emergency. One rule addresses the expansion of induction of buprenorphine via telemedicine encounter while the other covers telemedicine prescribing of controlled substances when the practitioner and the patient have not had a prior in-person medical evaluation. While opioid use disorders occur at similar rates in both rural and urban areas, medication assisted treatment (MAT) prescribers have been disproportionately located in urban areas. The public will be able to comment on the proposed rules until March 31st. 

The Substance Abuse and Mental Health Services Administration released a notice of proposed rulemaking that would allow certified opioid treatment programs to begin prescribing the drug via audio-only or video-enabled telehealth. See additional information under Policy Updates below. The proposed changes come on top of recent findings by HHS of the positive impact of its revised Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder that removed two longstanding requirements for obtaining a waiver to treat up to 30 patients with buprenorphine: 1) the requirement for specific training, and 2) the need for otherwise eligible clinicians to certify their ability to provide or refer patients for counseling and other services. Rural primary care providers have obtained the DEA waiver at a lower rate than urban clinicians; decreased burden and greater flexibility in the guidelines, along with broader use of telehealth could help close that gap.

The study explored opportunities for enhanced screening using telehealth and electronic patient-reported outcomes at five HRSA-funded Ryan White HIV/AIDS Program clinics in Alabama – one of seven mostly rural states prioritized for the federal Ending the HIV Epidemic Initiative. While there were concerns among survey respondents around lack of in-person interaction, the study revealed opportunities to expand technology use in rural areas.

Cohort-Specific Sessions/Activities and Day 2 Wrap-Up

This session highlighted the ways in which data from RCORP consortia are used, how service capacity and access have changed, and whether there is evidence that the health status of rural residents is improving. Additional data on telehealth utility, COVID-19 vaccination efforts, and drivers of MAT retention were highlighted. (Repeated from Day 1 Session 4A on Tuesday, April 5th).

Presenter(s): Mary Roary, PhD, MBA, Director of the Office of Behavioral Health Equity, Substance Abuse and Mental Health Services Administration