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Telemedicine to Help Rural Docs Tackle Opioid Abuse

A three-year AHRQ project will use Project ECHO's hub-and-spoke platform to train rural providers in three states who are dealing with an upsurge in abuses and overdoses.

By Eric Wicklund

- Federal officials are investing in telemedicine to fight the nation’s growing opioid abuse epidemic in three states.

The Agency for Healthcare Research and Quality (AHRQ) is launching a three-year, $9 million effort to train rural healthcare providers in medication-assistant treatment (MAT) therapy. The project will make use of mHealth apps, online training and specialist consults to help primary care physicians treat an estimated 20,000 residents fighting opioid addiction.

A key component of the program is Project ECHO, a telemedicine training model launched in 2011 in New Mexico that pushes education and peer support through a hub-and-spoke model to rural healthcare providers. The platform has been adopted in several states and is now being proposed as a national network in the Expanding Capacity for Health Outcomes (ECHO) Act, unveiled in April by Sens. Brian Schatz (D-Hawaii) and Orrin Hatch (R-Utah).

The AHRQ effort targets Oklahoma, Colorado and Pennsylvania, where officials say the opioid abuse epidemic is particularly hard-hitting. In Muskogee County, Okla., for instance, more than 10 opioid-related deaths for 10,000 people have been reported over the last few years, while more than 1,300 are thought to be in need of treatment in a county that has no MAT-certified physicians. And in Bent, Colo., the number of overdose deaths has doubled from 10 to 20 per 100,000 since 2002.

In Oklahoma, state officials are joining forces with the American Institutes of Research, the American Society of Addiction Medicine and Project ECHO to reach providers in 28 counties. Led by Susan Hell, MD, the project builds on the state’s current efforts with a platform that includes new pain treatment guidelines, community addiction recovery centers, public awareness campaigns and support for medication that helps combat drug abuse.

In Colorado, the AHRQ is supporting a 24-county project overseen by the University of Colorado in Denver and Jack Westphal, MD, a family physician who was recently certified in MAT therapy. This program will combine the Project ECHO telemedicine platform with face-to-face coaching to give primary care providers the training and support needed to use MAT therapy. Officials hope to use this as a model for other states in the future.

And in Pennsylvania, the AHRQ is supporting a 23-county project overseen by the state’s Department of Human Resources and Office of Mental Health and Substance Abuse Services and the University of Pittsburgh. Led by Dale Adair, MD, the program will combine on-site support and training with online services and resources, including telepsychiatry and teleconsults, targeting Medicaid patients with opioid addiction problems.

The AHRQ’s research initiative is the latest in a federal effort to train healthcare providers to identify and tackle opioid abuse. Just last week, the U.S. Department of Agriculture noted that several telehealth programs among the 36 targeted for new Distance Learning and Telemedicine (DLT) grants are focused on that issue.

"Using technology for educational opportunities and medical care can provide services that are often unavailable in rural areas," Vilsack said in a press release announcing $23.4 million in federal grants. “For example, opioid and other substance misuse disproportionately affect rural areas, and telemedicine is proving to be an effective tool for treating patients when experts otherwise would be unavailable. Hospitals, schools and training centers across the country are successfully using telecommunications to deliver specialized care to area residents."

Dig Deeper:

Project ECHO Poised to Become a National Telehealth Model

State Monitoring, Predictive Analytics May Cut Opioid Abuse


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