4 ways that telemedicine can address the opioid crisis

In what is now a national crisis, 33,000 people died in 2015 alone from opioid-related overdoses. Unfortunately, we do not have the capacity to treat all of those in need. According to a recent Surgeon General report, only 1 in 10 people with substance use disorder (SUD) receive any treatment. Increasing the availability of care — especially medication assisted treatment —is critical to overcoming this crisis.

In his declaration of the opioid crisis as a public health emergency, President Trump specifically called out telemedicine as a potential tool that can be used to increase access to treatment, stating that the declaration “allows for expanded access to telemedicine services, including services involving remote prescribing of medicine” commonly used for SUD or mental health treatment.

{mosads}The benefits of technology were again highlighted in the final report issued by the President’s Commission on Combating Drug Addiction and the Opioid Crisis, which recommended further research of technology-assisted monitoring and treatment for patients with SUD.

Here are four ways that telemedicine can help to address the opioid epidemic:

1. Telemedicine can help to extend the reach of care teams. With so few patients receiving treatment from a limited number of providers, there is an acute need to increase access to care. Telemedicine enables patients to be retained in care, even if they live far from a treatment center or travel for work. For example, Impact Healthcare — a SUD treatment facility in Jackson, Tenn. — is using mobile technology to keep in touch with patients while also reducing the amount of time that they have to spend commuting to and from the office. This process is saving some patients hours of travel time

1. Leverage asynchronous technology — meaning that patients and providers can be “online” at different times — allows providers to use their time more efficiently. This eliminates many of the logistical barriers that patients and providers often face, such as scheduling an in-person visits, taking off time from work, or missing appointments. Asynchronous technology makes it possible for care and treatment to take place at times that are convenient for both the patient and provider.

3. Telemedicine can provide more information about a patient’s response to treatment, enabling providers to make data-driven decisions about his or her care plan. The data derived through technology can provide greater insight into whether a patient is retained in care as well as more frequent touch points between the patient and provider — even when the patient is not physically in the office.

4. Telemedicine provides a more timely response to problems with adherence and allows providers to more clearly identify exactly why, when, and where a patient has problems taking his or her medication without having to wait until they come in to talk about it. The adherence issue can be identified and addressed almost immediately and at the “point of need.”

There are policy issues that must be addressed in order to fully utilize the potential of telemedicine. Most importantly, reimbursement for remote patient monitoring must be optimized to incentivize the use of this technology that can greatly expand access and save other health care costs. Other regulatory questions, such as whether the provider has to first visit with a patient in person, must be clarified between the states and federal government.

During a public health emergency, a person’s ability to obtain treatment for opioid use disorder should not depend on access to transportation, proximity to a provider, or the ability to take time off of work. Given the availability of effective, safe, and accessible technology, telemedicine must be considered as a necessary part of the solution to this crisis.

Robert C. Bollinger, MD, MPH, is a Professor of Infectious Diseases in the Department of Medicine of the Johns Hopkins School of Medicine, with joint appointments in the Department of International Health of the Bloomberg School of Public Health and the Johns Hopkins School of Nursing. He is the founder of emocha, a mobile health technology. Bollinger and the Johns Hopkins University are entitled to royalties related to emocha technology; Bollinger is a consultant to and holds an equity stake in emocha.