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Using 42 CFR part 2 revisions to integrate substance use disorder treatment information into electronic health records at a safety net health system.
Tillman, Alexandra R; Bacon, Emily; Bender, Brooke; McEwen, Dean; Blum, Joshua; Hoag, Matthew; Scott, Kenneth A; Everhart, Rachel; Hanratty, Rebecca; Podewils, Laura J; Close, Carolina; Mills, John; Davidson, Arthur J.
Afiliación
  • Tillman AR; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA. alexandra.tillman@dhha.org.
  • Bacon E; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Bender B; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • McEwen D; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Blum J; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Hoag M; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Scott KA; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Everhart R; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Hanratty R; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Podewils LJ; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Close C; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Mills J; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
  • Davidson AJ; Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
Addict Sci Clin Pract ; 19(1): 48, 2024 06 07.
Article en En | MEDLINE | ID: mdl-38849888
ABSTRACT

BACKGROUND:

Regulations put in place to protect the privacy of individuals receiving substance use disorder (SUD) treatment have resulted in an unintended consequence of siloed SUD treatment and referral information outside of the integrated electronic health record (EHR). Recent revisions to these regulations have opened the door to data integration, which creates opportunities for enhanced patient care and more efficient workflows. We report on the experience of one safety-net hospital system integrating SUD treatment data into the EHR.

METHODS:

SUD treatment and referral information was integrated from siloed systems into the EHR through the implementation of a referral order, treatment episode definition, and referral and episode-related tools for addiction therapists and other clinicians. Integration was evaluated by monitoring SUD treatment episode characteristics, patient characteristics, referral linkage, and treatment episode retention before and after integration. Satisfaction of end-users with the new tools was evaluated through a survey of addiction therapists.

RESULTS:

After integration, three more SUD treatment programs were represented in the EHR. This increased the number of patients that could be tracked as initiating SUD treatment by 250%, from 562 before to 1,411 after integration. After integration, overall referral linkage declined (74% vs. 48%) and treatment episode retention at 90-days was higher (45% vs. 74%). Addiction therapists appreciated the efficiency of having all SUD treatment information in the EHR but did not find that the tools provided a large time savings shortly after integration.

CONCLUSIONS:

Integration of SUD treatment program data into the EHR facilitated both care coordination in patient treatment and quality improvement initiatives for treatment programs. Referral linkage and retention rates were likely modified by a broader capture of patients and changed outcome definition criteria. Greater preparatory workflow analysis may decrease initial end-user burden. Integration of siloed data, made possible given revised regulations, is essential to an efficient hub-and-spoke model of care, which must standardize and coordinate patient care across multiple clinics and departments.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Trastornos Relacionados con Sustancias / Registros Electrónicos de Salud / Proveedores de Redes de Seguridad Límite: Adult / Female / Humans / Male Idioma: En Revista: Addict Sci Clin Pract Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Trastornos Relacionados con Sustancias / Registros Electrónicos de Salud / Proveedores de Redes de Seguridad Límite: Adult / Female / Humans / Male Idioma: En Revista: Addict Sci Clin Pract Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido