substance abuse ehr treatment

MAT or MBT?

In March 2019, the National Academies of Sciences, Engineering and Medicine released a report titled “Medications for Opioid Use Disorder Saves Lives”. It can be read for free online here or purchased as an eBook from The National Academies Press.

The 156-page report arrives at these seven conclusions (sourced directly from the report linked above):

 

  • Opioid use disorder is a treatable chronic brain disease.
  • U.S. Food and Drug Administration–approved medications to treat opioid use disorder are effective and save lives.
  • Long-term retention on medication for opioid use disorder is associated with improved outcomes.
  • Lack of availability or utilization of behavioral interventions is not a sufficient justification to withhold medications to treat opioid use disorder.
  • Most people who could benefit from medication-based treatment for opioid use disorder do not receive it, and access is inequitable across subgroups of the population.
  • Medication-based treatment is effective across all treatment settings studied to date. Withholding or failing to have available all U.S. Food and Drug Administration–approved classes of medication for the treatment of opioid use disorder in any care or criminal justice setting is denying appropriate medical treatment.
  • Confronting the major barriers to the use of medications to treat opioid use disorder is critical to addressing the opioid crisis.

 

If you’re reading this, you most likely have experience in the provision of OUD treatment services and were nodding your head in agreement at each one of the conclusions as you read it.

Evidently, Mark Parrino, President of AATOD, agrees…to a point. In his May 2019 analysis of the report he says that the report is both “thoughtful and comprehensive” and suggests “the report has great value and should be widely read“.

However, he also expresses disapproval of the term “Medication-Based Treatment”, as it pertains to opioid use disorder, and disagrees with some of the report’s recommendations for which he says are “divorced from the evidence stated in the report and there are contradictions in different sections of the recommendations“.

Over 15 years ago, the Substance Abuse and Mental Health Services Administration (SAMHSA) coined the term “Medication Assisted Treatment” (MAT) indicating that clinical support services should be used in conjunction with the medication.

While the report projects an understanding that opioid use disorder is a complex disease and not simply a neurological disorder, Mr. Parrino notes that “Like most complex illnesses, it has a number of behavioral components.” and asserts that “this represents a contradiction in the approach of medication being the treatment“.

As for the report’s recommendations, he specifically disagrees with this assertion in the report’s assertion in its seventh conclusion that a major barrier to treatment is “Current regulations around methadone and buprenorphine, such as waiver policies, patient limits, restrictions on settings, and other policies that are not supported by evidence or employed for other medical disorders.

Mr. Parrino suggests “The true limitation to access to the availability of OTPs are based on zoning board restrictions, legislative interventions, moratoriums on opening new OTPs and the lack of third-party reimbursement.

Agree or disagree with its recommendations, one thing this study’s conclusions do is prove that these are not just beliefs of people involved with opioid use disorder treatment…they are facts.

 

substance abuse ehr software

SMART Software COVID-19 Support Announcement

As COVID-19 makes its way across the globe, it’s affecting our communities in different ways. One that is acutely affected is the healthcare community. As we continue to monitor Coronavirus (COVID-19) developments closely, the health and well-being of our clients, partners, and our employees is of utmost importance to us. As a partner to your business, we also understand the critical need to limit any impact this health event could have on our service to our clients. We are focused on our preparedness efforts to maintain a safe work environment for our staff while also sustaining business operations.

Our leadership is working to ensure our ability to continue essential work and deliver the products and services you rely on. We plan to continue to serve you 24/7, as you serve your patients through this time of crisis. We have a plan in place that is managed by a dedicated team who are committed to keeping our operations running smoothly so that we can provide you with the best possible service. This is an unprecedented situation. We are following the lead of the CDC with regard to important COVID-19 containment precautions, such as limiting travel and maintaining social distance.

Our plan includes the following:

  • We have ensured that our staff can work from home as needed in order to prevent the spread of any illnesses so that we can continue to provide support 24/7 for all customers.
  • All Tier 1 and Tier 2 customer support teams are able to perform their roles remotely while still maintaining proper levels of security and privacy.
  • We ask that you continue to use our Software Support portal to submit incidents. We will continue to operate as normal.

https://support.smartmgmt.com/

We hope you, your families, and staff stay healthy through this time. If you have additional questions, please contact your Partner Success Manager.

In the case of an emergency, please call 800.942.4540 or 401.780.2300.

substance abuse ehr software

Alexa! Remind Me to Take my Medication at 6:00PM Everyday

The Health Information Management Systems Society, HIMSS, has been publishing tidbits for over a year now regarding how “connected home assistants” like Amazon Alexa, Apple Siri and Google Assistant are making their way into the healthcare space.

One year ago, Consumer Intelligence Research Partners (CIRP) released estimates that reported the number of “smart speakers” installed in the U.S. reached 66.7 million by the end of 2017 and grew by 78%, rising to 118.5 million units installed by the end of 2018 across 28% of the 128 million households in the U.S. Projections are that 75% of households will have a smart speaker installed by 2025.

The apps that drive this technology are installed on smart phones and tablets. Nearly 266 million people in the U.S. have a smart phone and that’s expected to grow to 285 million by 2023.

Couple the large-scale availability of the technology with cloud solutions setting a new paradigm with privacy and security and the expansion of these services  into the healthcare sector seems to be a natural migration.

Imagine your iPhone or Android phone vibrating at 6:00PM with a reminder for you to take your medication. Or, consider being able to say “Siri! Add an appointment in my calendar for 8:00AM on October 12 for my physical exam with Dr. Smith.” and then automatically receiving an alert on your phone one week prior to that reminding you to get your bloodwork done.

As for the technology making its way into substance abuse treatment, we’re not quite there yet, but the study referenced in this Technology Networks article indicates that the future could be promising. One could imagine the usefulness of this technology not only for getting at-risk people help at the moment they need it, but also keeping patients in treatment engaged with their treatment and their treatment provider.

Substance Abuse EHR Software

Does 42 CFR Part 2 Need an Overhaul?

A March 4, 2020 post from the Pennsylvania Recovery Organizations Alliance, backing up earlier posts on March 2 and one from November 2019, refueled the discussion as to whether 42 CFR Part 2 should be made more compatible with HIPAA.

Some believe that, while the 2018 revisions to 42 CFR Part 2 provided some modernization of the 1975 law, it didn’t go far enough. A case in point is an October 2019 letter to SAMHSA penned by Maeghan Gilmore, Chair, Partnership to Amend 42 CFR Part 2:

“Care coordination and case management are essential for whole-person, integrated approaches to care, which have been proven to produce the best outcomes for patients. However, these activities depend on the effective and timely sharing of information. Including care coordination and case management under the definition of health care operations in Part 2 would reduce the likelihood of barriers or delays, promoting more integrated care for patients…that it 42 CFR Part 2 should align with HIPAA to ensure that all of a patient’s treatment providers have access to their entire health record.”

An earlier attempt at overhauling 42 CFR Part 2 was the bipartisan Overdose Prevention and Patient Safety Act (H.R. 6082 (115)). This bill passed the House in 2018 but later died in the Senate for fear that “it would discourage patients from seeking SUD treatment for fear of facing discrimination or potential legal consequences”.

In April, 2019, a new bipartisan bill to amend 42 CFR Part 2 regulations was introduced in both the House and Senate. Nearly a year later this latest attempt has yet to make it past the status of “introduced” in either house.

It’s likely to meet the same fate as the last attempt, for reasons best articulated by Alison Knopf of the Addition Treatment Forum, in her November 2018 blog post. She asserts that the proposed bills put the 42 CFR Part 2 regulations “under siege”.

For this Congress, anyway, it’s unlikely that any changes to 42 CFR Part 2 regulations will be made. Depending on the results of the November 2020 elections, though, that could change in the 117th Congress. Time will tell. If you are looking for more information on substance abuse EHR software, reach out today. 

Substance Abuse EHR Software

Six Ways SMART’s EHR Increases Productivity

 SMART’s EHR software, powered by Amazon Web Services, is a cloud-based solution designed to help manage outpatient substance abuse treatment programs, primarily for treatment of opioid use disorders (OUDs) using medication-assisted treatment (MAT).

The SMART EHR aids in enhancing the effectiveness and efficiency of the treatment program through its patient-centered design, “100% paperless” capability, workflow automation, enhanced communication across the multi-disciplinary team and vital management-level reporting to support accreditation and regulatory compliance.

The implementation process for new software partners is fast and efficient, intended to get your treatment team up and running quickly, with virtually no down-time, resulting in a successful startup and future success. The process begins with a kick-off meeting followed by a full needs assessment, system settings evaluation, installation, training, go-live with on-site assistance, post-installation training and the eventual transition to customer support and account management. Our partners enjoy SMART’s unparalleled support services, available 24x7x365 with 5-to-5 coverage on weekdays. “We’re here when you’re there”.

SMART’s EHR will help you:

1. Save on resources:

SMART’s platform saves on operational and equipment costs, virtually eliminates software update costs, scales as needed and substantially reduces the burden on your IT resources.

In compliance with HIPAA HITECH and 42 CFR Part 2, SMART’s EHR utilizes fully encrypted data management and provides safe and secure access by authorized individuals anywhere. Risk is minimized while maximizing access, availability, efficiency and disaster recovery in a way that is simply not possible with on-premises solutions.

Ours is a high-performance solution developed with a deep, experience-based understanding of substance abuse treatment. Its ease of use and speed at accessing patient data allows staff to monitor and manage productivity, meet accreditation and regulatory requirements and ensure patients receive the services they need when they need them, even in emergency situations.

2. Increased admissions efficiency:

SMART’s ability to provide a “100% paperless” patient record plays a vital role in enhancing patients’ access to treatment. The intake process is based upon SMART’s own three-phased approach of removing barriers to treatment, initiating treatment and keeping the patient engaged for that critical first 90 days.

The pre-admission process helps increase intake capacity with its customizable screening questionnaire. It gathers all the necessary contact and insurance information, schedules intake appointments and computerizes required intake forms with appropriate signatures.

The screening tool helps to determine whether each patient who presents for treatment is a good fit for the services offered by the facility. Referrals to other agencies can be made and tracked should the patient require a different level of care.

3. Streamline medication administration while reducing risk

SMART’s dosing feature supports medication assisted treatment (MAT) with methadone and buprenorphine-based medications. The software supports split dosing, flexible take-home schedules (including planned leave such as vacations) and scheduled automated increases or decreases over time.

To virtually eliminate medication errors, the medication administration process employs up to 6 factors of identification for each patient, including the patient’s digitized signature. Individual dose amounts are calculated from the patient’s active medical orders at the time of dispensing with automatic label generation for take-home doses.

The medication administration process is supported by a comprehensive inventory management and reporting system, in full compliance with DEA regulations. Barcode scanning is also offered to facilitate compliance with the FDA’s latest drug supply chain regulations.

4. Promoting collaboration among the team and sharing of patient information.

SMART EHR’s patient chart helps promote patient recovery by keeping the entire treatment team updated on each patient’s status. Among the data collected are:

  • Problem statements, in the patient’s own words
  • Interpretive and diagnostic assessments using a fully customizable questionnaire
  • Treatment plans
  • Direct services such as Individual and Group sessions
  • Medical Orders
  • Urine drug screens
  • Medical problems, conditions and diseases (ICD-10 and DSM-5)
  • Allergies
  • Prescribed medications
  • Infectious diseases
  • Vital signs
  • Treatment alerts and notifications
  • Billing and collections data
  • …and more

5. Controlling lab costs and accelerating availability of drug screening results

SMART’s EHR aids in guiding treatment decisions based on toxicology screening results for oral fluid or urine samples.

Fully randomized toxicology screenings can be scheduled at the patient level for intervals from weekly to the minimum 8 times per year required by federal regulations.

Lab results for toxicology screens as well as GC/MS confirmatory tests are recorded in the patient’s chart as soon as they are available. This is typically within 24 to 48 hours but could be sooner, depending upon the lab’s capabilities.

Available reports include specimens due, positive results, negative results, summaries by drug category, statistical summaries and more.

6. Maximizing revenue opportunities

SMART’s patient billing system manages both self-pay patients and patient responsibility for third party payers’ unpaid balances. Self-pay patients are billed automatically with balances constantly monitored and regular alerts to remind patients when payments are due.

SMART’s integral and comprehensive 3rd party billing automatically bills for services provided and eliminates the need for a clearinghouse by directly generating EDI files certified by Optum Insight to be fully compliant with HIPAA 5010 standards.

Revenue cycle management tools and reporting support both cash- and accrual-based accounting methods, manage aged accounts receivable, help minimize time-to-payment and maximize collection percentages.

SMART’s EHR helps staff organize and conduct daily operations, increasing productivity and enhancing the attainment of executive level goals. Enhance the performance of your treatment programs, improving both business and treatment outcomes.

Increase admissions capacity, realize the efficiencies of paperless charts, streamline patient dosing while reducing risk, promote collaboration amongst your team, control costs, accelerate laboratory results and maximize revenue. Contact SMART today.