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In recent years, we have seen a worst-case scenario emerge in the addiction treatment industry: the need for treatment has skyrocketed while the number of clinical staff has rapidly declined.
With an estimated 60 million people use substances in the US that would benefit from treatment — and more than 100,000 overdose deaths Last year alone, the need for substance use disorder (SUD) treatment has never been greater.
At the same time, employee turnover in the industry is: as much as 50%, with about 25% of those who have left reporting that they have no intention of returning to the field. As a result, Dr. Rahul Gupta, director of the Office of National Drug Control Policy, predicted a staff shortage of as much as 150,000 providers within the next five years — a significant deficit that will no doubt endanger millions of people and cost countless lives.
While staff recruitment and development must remain a top priority, we also need urgent and innovative solutions that can provide essential temporary care options.
Technology plays a vital role in giving people the help they need and acts as a force multiplier for the current workforce. Despite the beneficial impact of technology today, behavioral health will need to intensify the use of technology to meet increased demand with an ongoing and increasing shortage of critical staff. Here’s how:
1. Artificial Intelligence (AI) chatbots enable crisis intervention
Individuals suffering from mental illness and substance use disorders experience varying levels of crisis that can literally be life or death. The reality is that staff are not constantly available 24 hours a day to screen all calls to determine what routine or crisis calls are. chatbots can be successfully used to answer simple phone calls regarding appointments and other treatment-related questions, freeing up staff to interact directly with individuals experiencing an emergency or seeking care.
Chatbots that use AI to engage individuals during a crisis or engage in the aftermath can be a vital lifeline. Today’s chatbot technology is so advanced that it feels like you are talking to a real person, with many patients unable to tell the difference. Because it is accessible 24/7, we can reach people when they need it most with fewer resources. In addition to immediate crisis intervention, chatbots can be used by providers to check in with patients after crisis stabilization to re-engage if someone is destabilized again.
2. Virtual Technology Improves Patient Outcomes
The field of substance use disorder treatment has lagged behind the larger medical community in monitoring and responding to patient outcome indicators. In fact, there is currently no clearly defined or agreed upon consensus on optimal outcomes. To make this successful, providers must create benchmark results to aim for, while identifying the interventions needed to achieve them. One way to do this is by working with key partners to develop and integrate technology that can better collect and respond to information.
3. Virtual technology extends access
One of the few silver linings of the COVID-19 pandemic is the global rollout of virtual therapies. The pre-COVID-19 reliance on physical treatment environments created unique access challenges for people in need of care who were unable or unwilling to attend in-person treatment. Microsoft Zoom is now fully HIPAA compliant, providing better access to counseling services in treatment deserts such as rural communities, or in places where it is not safe to enter treatment such as areas with high levels of criminal activity. It also allows patients to seek treatment from the privacy of their own home and receive specialized treatment for specific conditions from healthcare providers outside their geographic area, which is critical when travel is not feasible.
Fortunately, well-designed virtual services have proven to have positive outcomes consistent with face-to-face treatment in most applications and insurers are fully adopting this new modality, making it a mainstay of modern addiction treatment.
4. Wearable devices provide support
Wearable devices like the Apple Watch and others have revolutionized the healthcare and fitness industry, providing insight into vital data such as heart, respiratory and temperature readings, and helping to encourage wellness habits to minimize the risk of cardiovascular disease.
Likewise, they can be used to monitor addiction by encouraging positive behavior and identifying indicators that can signal the risk of relapse. They can also be set up for geofencing, to give alerts if someone in recovery ventures near places that are not good for their sobriety. It can also provide reminders and reinforcement of positive behaviors such as exercising, meditation, attending meetings, and other stress management tools.
Wearable devices also provide clinicians with the ability to monitor the blood pressure, heart rate and breathing of patients in care for immediate response in the event of a medical emergency.
5. Streamlined documentation systems reduce friction
For healthcare providers, the documentation requirements for SUD treatments are huge, and every minute spent on administrative work is a minute less for patients. Unfortunately, most EHRs are not optimized for clinicians in this area, and this creates workflow inefficiencies and bottlenecks that prevent clinicians from seeing patients.
The industry is revitalizing documentation systems with new products that streamline the process to be more efficient and person-centric. This allows clinicians to be more involved with patients, and it helps to reduce burnout and administrative frustrations for healthcare providers, with the aim of keeping them from leaving the company.
6. Digital Communities Maintain Recovery Connections
We know both anecdotally and through research that long-term involvement with patients contributes significantly to the success of recovery. In fact, extending the patient interaction to 12 months provides a 60-80% success rate, compared to just 30% for a 90-day admission.
Despite the huge potential of technology to revolutionize addiction treatment, we must also recognize that there are still some significant hurdles for both healthcare providers and patients. First, affordability is an issue for many providers. While large organizations are going all-in on technology and seeing better outcomes, greater efficiency and greater patient involvement, most facilities are relatively small and lack the resources – both human and financial – to build and maintain advanced technologies.
While some cannot afford it, others simply do not believe in it and prefer to continue with only face-to-face treatment options. And because not all payers support technology transformation, it is difficult for providers to justify the investment.
On the patient side, lack of device access and connectivity can be a hurdle. After all, if you’ve lost your job and maybe even your house through addiction, it’s hard to afford a mobile device and the internet. Others may not be tech savvy or inclined to learn a new tool, especially when they’re already faced with so many other challenges.
Even with these obstacles, we can still make a huge impact by leveraging technology to reach more patients with life-saving treatments. Using technology for better outcomes, access to care and efficiency is not only an opportunity, but a necessity. With the US on track to see 150,000 overdose deaths this year, now is the time.
Thomas Britton is the CEO of US Addiction Centers
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