Opioid Use Disorder | A Population Health Collaboration

By Hannah Lambalot | Categories: | Comments Off on Opioid Use Disorder | A Population Health Collaboration

The 2016 Pennsylvania Opioid Data Dashboard reported 21,878 individuals covered by Medicaid with a diagnosis of Opioid Use Disorder (OUD). Of those suffering from OUD, only 11,591 (52.9%) received medication-assisted treatment (MAT). Temple University Health System developed an approach, in collaboration with the City of Philadelphia, the State of Pennsylvania, and various community-based organizations (CBO) focused on OUD through bridging medical care, behavioral health treatment, and addressing social determinants of health (SDoH).

With a one-million-dollar grant, Temple University built a hub and spoke network for the delivery of MAT in a primary care setting. The main goal of the program was to establish a hub and spoke model aimed at delivering and expanding best-practice treatment of OUD. The hub, led by OUD treatment experts, was charged with engaging other medical practices to launch best practice treatment at those sites. Best practice treatment of OUD includes medications to mitigate the effects of opioid withdrawal. A specific waiver is necessary to prescribe certain medications; as part of this program, clinicians attained this waiver in order to prescribe medications such as Buprenorphine. To monitor quality, a goal was set to decrease the readmission rate of patients with OUD, regardless of primary diagnosis.

To help patients overcome SDoH, Temple aimed to formalize relationships with community-based organizations (CBOs) to address food insecurity, housing insecurity, transportation, and pharmacy support. The Philadelphia Office of Homeless Services and Resources for Human Development specializes in housing placement for those with housing as a barrier. Philabundance delivers hot meals to recovery group sessions. In addition, they run a catering service called Philadelphia Community Kitchen which is a 14-week culinary training program open for enrollment to low-income adults and people in recovery. The program delivers 40 meals a week to the Temple hub and spokes. Sustainable food sources, such as SNAP benefits, are identified through case management. The Southeastern Pennsylvania Transit Authority provides subway/bus passes at no cost to the program’s patients. Temple also partnered with Uber/Lyft to provide rides for more medically complex patients. These services are available for appointments or any related service for their recovery. Lastly, Temple partnered with their outpatient pharmacy to be able to pay for medications that patients cannot otherwise afford, with grant funding.

Baseline objectives included the addition of spoke sites and the total number of patients treated from July of 2018 through May of 2019. The most powerful results were the increase in the number of patients who accepted treatment. The hub increased the capacity to see new patients by 267%. The spoke locations increased the ability to see new patients by 82.7%. Temple established warm handoff protocols for the organization’s emergency departments and crisis response center; warm handoff improved by 20% during that time. A total of 110 providers were trained in three sessions provided by the program. The program educated 22 Skilled Nursing Facilities providers and improved the OUD acceptance rate from 16 % to 28%.