Using Telemedicine to Combat the Opioid Epidemic

September 18, 2018

By: Adm. Brett P. Giroir, M.D., Assistant Secretary for Health

Summary:

HHS has developed materials to help clarify how clinicians can use telemedicine as a tool to expand buprenorphine-based MAT for opioid use disorder treatment.

Combatting the opioid crisis is a top priority for the Trump Administration and the U.S. Department of Health and Human Services (HHS).  We are making progress. Just last week we released the 2017 National Survey on Drug Use and Health (NSDUH) data, which showed significantly more people received treatment for substance use disorder in 2017 than in 2016; this was especially true for those with heroin-related opioid use disorders.  In addition, the number of people who initiated use of heroin in 2017 was less than half of the number in 2016.

While these are promising data, we know there is still much more work to be done, especially in rural areas that have been hard hit by the opioid epidemic.  This is particularly true in some rural and remote areas of the country where patients with opioid use disorder (OUD must travel long distances to receive treatment; and there are too few clinicians available to provide medication-assisted treatment (MAT)- an essential component in the treatment of OUD.

HHS is committed to improving access to MAT for OUD and is working on a variety of strategies to improve access to this life saving treatment through increased funding to states and communities, payment policy changes, and education, training and technical assistance.  One such area is to help providers understand how telemedicine can be used, in certain circumstances, to expand access to buprenorphine-based MAT.

Working with the Drug Enforcement Administration (DEA), HHS developed materials to help clarify how clinicians can use telemedicine as a tool to expand buprenorphine-based MAT for opioid use disorder treatment under current DEA regulations.   The information, including a clinical practice example that is consistent with applicable DEA and HHS administered authorities, can help to increase access to buprenorphine by utilizing telemedicine to expand provider’s ability to prescribe MAT to patients, including remote patients under certain circumstances. This especially will support access to buprenorphine in rural areas where there may be a smaller number of providers with a DATA 2000 waiver—which allows qualified practitioners to prescribe buprenorphine for the treatment of OUD in settings other than a federally regulated opioid treatment program.

Sadly, this information is not widely known among healthcare providers and other stakeholders; and many have been reluctant to utilize telemedicine for prescribing MAT. That is why we are taking this opportunity during Prescription Opioid and Heroin Epidemic Awareness Week (September 16-22, 2018) to make sure everyone knows that effective treatment is available, including via telemedicine, to help combat the opioid epidemic in the U.S. Beyond telemedicine, health information technology (health IT) can be leveraged in many ways to combat the nation’s opioid crisis. The Office of the National Coordinator for Health IT (ONC) has resources for healthcare providers to learn more about health IT tools to combat the opioid epidemic through the Opioid Epidemic and Health IT chapter in the Health IT Playbook and ONC’s Educational Module for Behavioral Health Providers – PDF.

Please share this information with your colleagues and networks as we are hopeful that we can help eliminate this perceived barrier to treatment.

Announcements from the Federal Office of Rural Health Policy

HRSA Awards Rural Communities to Combat the Opioid Crisis. This includes $25.5 million to over 120 rural organizations to increase access to substance abuse prevention and treatment services serving rural populations across the country. Specifically, $19 million was awarded to 95 organizations under FORHP’s Rural Communities Opioid Response Program-Planning and nearly $6.5 million to 26 rural organizations to expand the reach of the Rural Health Opioid Program. In addition, nearly $400 million is going to support 1,232 health centers across the country. To learn about HRSA-supported resources, please visit HRSA’s Opioid Crisis page.

State of Obesity 2018 Report.  The Robert Wood Johnson Foundation and the Trust for America’s Health have released the 15th annual State of Obesity report, announcing an “urgent need to increase evidence-based obesity prevention programs.” Based on data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, the report finds that adult obesity rates are at or above 35 percent in seven mostly-rural states:  Alabama, Arkansas, Iowa, Louisiana, Mississippi, Oklahoma and West Virginia.  Also this week, the U.S. Preventive Services Task Force released a final recommendation on behavioral weight loss interventions.


Funding Opportunities

Small Rural Hospital Transition Project – October 24.  Nine rural hospitals will be selected to receive on-site technical assistance for the transition to value-based care and Alternative Payment Models.  Applicants may select either a financial operational assessment or quality improvement project.  Preview questions in advance of the application period opening September 25th and get helpful hints for submitting a successful application.


NQF Final Report:  Rural-Relevant Measures for Healthcare Quality.  For the first time, the National Quality Forum (NQF) has released a set of quality measures for rural hospitals and ambulatory care facilities to improve quality of care and access in rural areas.  The measures were developed by a subgroup of the Measures Application Partnership (MAP), which formed a Rural Health Workgroup to provide recommendations from a rural perspective.

2018 Rural Hospital and Clinic Financial Summit Report. With the support of the Federal Office of Rural Health Policy, the National Rural Health Resource Center developed this report following a Summit of key rural hospital and clinic stakeholders to identify the most important financial indicators and strategies to transition to value-based payment. This report is designed to help rural hospital and clinic leaders meet this transition with financial success.

What does your community hospital mean to you?

What does your community hospital mean to you? Share your story to win up to $15,000.
We want to invite your hospital to join athenahealth’s My Hospital, My Community Contest. The goal is to capture and share personal stories from community hospitals across the country to help showcase the invaluable work you do and draw national attention to the importance of rural healthcare.
Every time someone from your community answers the question “what does your community hospital mean to you” your hospital will be entered to win 1 of 5 cash prizes. The grand prize-winning hospital will receive $15,000, and second- through fifth-place winners will receive $7,000, $5,000, $2,000, or $1,000 respectively plus free marketing and PR support.
Join the My Hospital, My Community Facebook group today by visiting https://bitly.com/mhmc2018. Share your own story, then encourage your providers, staff, and patients to enter by October 19. Remember the more submissions in support of your hospital, the better.
If you want to learn more about the contest and or receive a My Hospital, My Community tool kit for your hospital please emailcommunityhospitals@athenahealth.com.

Abstracts now being accepted for the 2019 Community and Public Health Conference

The Pennsylvania Public Health Association (PPHA), the Pennsylvania Office of Rural Health (PORH), and the Penn State College of Medicine’s Public Health Program are offering a one-day conference, Invigorating Public Health in Pennsylvania through Community-based Initiatives which will highlight community and public health issues for diverse and underserved populations. Abstracts are now being accepted on topics that address:

• Community and public health strategies;
• Best practices in improving the health of special and underserved populations, with a special focus on migrant and immigrant farmworkers; and
• The use of data-driven and evidence-based practices in public and community health.

Click here to submit an oral or poster abstract for the conference.

Welcoming New Providers and Staff to Your RHC

Clinics often have specific protocols for on-boarding new providers and staff. As your clinic is participating in MORE Care, there is additional material to cover. Reviewing the past 6-18 months can be overwhelming. Let us help!

If your clinic has welcomed a new provider or staff member, please contact Kelly Braun at kub277@psu.edu. Not only would we like to ensure that your new team member is on our e-mail list, but we also would like to help introduce your new team member to MORE Care. Also, don’t forget that Smiles For Life offers a free, online curriculum on oral health. We recommend courses 1, 2, and 6 for new providers. Smiles for Life can be accessed here.

RHC Administrator Presents Clinic’s MORE Care Journey

Micah Gursky, Rural Health Clinic Administrator at St. Luke’s Miners, presented his clinic’s MORE Care experiences to the St. Luke’s Miners Hospital Performance Improvement (PI) Council on September 12. Micah recapped the team’s progress within the learning collaborative and discussed the health system’s plans to continue to expand on their work with oral health integration and coordination.

Fall for Smiles!

As part of their Fall for Smiles campaign, Oral Health America has released a one-page sheet that includes oral health tips for the entire family! You might find this page helpful as you review self-management goals with your patients. To access the Fall for Smiles Oral Health Tip Sheet, click here.