Online Program

Implementation of an electronic information system to enhance practice at an opioid treatment program

Monday, November 4, 2013

Lawrence S. Brown Jr., MD, MPH, FASAM, START Treatment and Recovery Centers, Brooklyn, NY
Steven Kritz, MD, Addiction Research and Treatment Corporation, Brooklyn, NY
Issues: Electronic information systems have been touted to achieve desirable healthcare outcomes; though not in substance abuse treatment settings. Addiction Research and Treatment Corporation, an outpatient opioid treatment program provides primary medical care to 2,750 minority adults in New York City. We received funding to study system implementation.

Description: Implementation presented roadblocks, categorized as Change Management, Hierarchy of Corporate Objectives, Process Mastering, Training Issues, Information Technology Governance, Electronic Security, and Communication and Collaboration. Overcoming these roadblocks was critical to successful implementation. Quality, Satisfaction, Productivity, and Financial Performance were evaluated utilizing a pre and post-implementation research design. We then utilized system capabilities to provide detailed outcomes data for HIV viral load, hemoglobin A1C for diabetes mellitus, and hypertension for all patients treated by our staff.

Lessons Learned: For Quality, pre-implementation annual medical assessments and annual, 30-day, and 90-day multidiscipline assessments were timely for 83% and 70%, 72%, and 42% of cases. Post-implementation timeliness was 97% and 96%, 87%, and 70%; all significantly improved. Hepatitis C viral load was performed in 85% of cases pre-implementation and 81% post-implementation; a non-significant decrease. For Satisfaction, there was no change for patients and a non-statistically significant upward trend post-implementation for staff. Productivity declined post-implementation; reaching statistical significance for counselors. Financial Performance did not change significantly. Outcomes for HIV viral load, hemoglobin A1C for diabetes mellitus, and hypertension showed gradual and sustained improvement over time.

Recommendations: Despite study results that were less robust than expected; it provided insight into how information systems can enhance outcomes management.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public

Learning Objectives:
Evaluate the implementation of an electronic information system in the context of a substance abuse treatment program that provides behavioral health and primary medical care, including HIV services for an underserved population Describe the logistical challenges and roadblocks to implementing an electronic information system Discuss the findings of a research study of system implementation; and outcomes measures derived from the system

Keyword(s): Information Technology, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I provide training and care in this area and I also conduct research in this area
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.