The Agency for Healthcare Research and Quality (AHRQ), part of the U.S. Department of Health and Human Services (HHS), is investing $9 million over three years in an initiative to improve opioid addiction treatment in rural primary care practices, including the use of telemedicine.
The grants will help support primary care practices in 75 rural counties in Oklahoma, Colorado and Pennsylvania and includes the use of Project ECHO, an effort that links community providers with specialist care teams at academic medical centers, or other forms of teleconsultation. Project ECHO started at the University of New Mexico and now dozens of academic medical centers in the U.S. operate teleECHO clinics that address more than 40 health conditions. Globally, teleECHO clinics are running in 10 countries.
According to the AHRQ announcement, the initiative will bring together teams of state health departments, academic health centers, researchers, local community organizations, physicians, nurses, and patients to bring Medication-Assisted Treatment (MAT) to primary care practices in rural counties in Oklahoma, Colorado and Pennsylvania.
MAT is evidence-based therapy for assisting people with opioid addiction in primary care offices. MAT involves using both medications and behavioral support to empower people to manage their addiction, according to the AHRQ announcement.
“The practices involved in the initiative will provide access to MAT to over 20,000 individuals struggling with opioid addiction using innovative technology, including patient-controlled smart phone apps, and remote training and expert consultation using Project ECHO,” the AHRQ announcement stated.
Project ECHO is a tele-health program started with AHRQ support that links specialists at an academic hub to primary care providers working on the frontlines in rural communities.
“Together with their grantees, AHRQ will build a blueprint for how other communities and primary care teams can overcome the barriers of providing MAT and ensure access to care across America’s rural communities,” the agency stated.
The grants will fund a project with the American Institutes of Research in partnership with the State of Oklahoma, Project ECHO from New Mexico, and consultants from the American Society for Addiction Medicine. According to AHRQ, rural Oklahoma includes some of the communities most affected by the opioid epidemic. Led by Susan Heil, M.D., the project will build on efforts already underway in Oklahoma to address opioid abuse, including the development of pain treatment guidelines, public awareness campaigns, initiatives to support the distribution of a medication called naloxone (which blocks the high from opioid abuse), and the creation of community-based comprehensive community addiction recovery centers.
The project will expand access to thousands of people living in 28 rural counties in the northeast, north central, and south central parts of the State. The project will engage hundreds of physicians, providing customized and ongoing training for physicians and members of their teams to support them in providing MAT to their patients.
Another project that will benefit from grant funding involves the University of Colorado, Denver. Under the leadership of Jack Westfall, M.D., the project will expand access to MAT across 24 counties in eastern and southern Colorado. The team will provide primary care practices with comprehensive training and support for delivery of MAT in their rural primary care practices using face-to-face practice coaching and an ECHO tele-training model, the AHRQ announcement stated.
The third award will go to the Pennsylvania State Department of Human Services in partnership with the Pennsylvania Office of Mental Health and Substance Abuse Services and the University of Pittsburgh. Led by Dale Adair, M.D., the goal of the project is to double the number of primary care physicians delivering high-quality MAT in 23 rural Pennsylvania counties. The initiative, which has a special focus on people covered by Medicaid, will link primary care practices with community-based substance-use disorder health homes. The grant will blend onsite practice support with online physician MAT training with ongoing expert teleconsultation and expanded access to tele-psychiatry services to people with opioid abuse disorders living in rural communities.