One-Third of ACOs Use Digital Health Tools to Treat Patients With OUD

A new study of accountable care organizations (ACOs) suggests the use of digital health tools is relatively uncommon when treating patients with opioid use disorder (OUD).

When digital tools are used, they are generally seen as a complement to other treatment modalities, according to the report, which was published this month in JAMA Network Open.

Digital health resources have been billed as a way to overcome some of the traditional barriers to OUD treatment, such as lack of transportation and the limited availability of trained mental health clinicians. However, the study authors said public health officials need to be mindful of equity concerns as they roll out digital health solutions, “including understanding the clinical settings in which they are offered.”

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They said because the currently available data on that topic are relatively scant, they decided to help fill the knowledge gap by looking at data from the 2022 National Survey of Accountable Care Organizations (ACOs). The survey was sent to 505 US organizations with Medicare and Medicaid ACO contracts, and responses were collected between October 1, 2021, and June 30, 2022.

A total of 304 respondents from 276 organizations responded to the survey. Fifty-three percent of respondents were from hospitals or health systems, 24.2% were from physician- or medical group-led organizations, and nearly 8% were safety-net organizations.

When asked if they used a digital health technology for patients with OUD, one-third of respondents (33.5%) said they use at least 1 technology. Those included remote mental health therapy and tracking, virtual peer recovery support systems, and digital recovery support for adjuvant cognitive behavioral therapy. Of the 3, remote mental health therapy and tracking was the most used digital health tool, with 26.5% of respondents saying they use it.

The study investigators said the responses suggest the real-world deployment of digital health technologies for OUD is insufficient to meet the need. Although in theory, organizations with fewer resources might be more likely to need (and thus utilize) digital health tools, the authors said the data suggest the opposite.

Organizations that had an addiction medicine specialize or a registry to track mental health were found to be more likely to use digital health tools, whereas otherwise similar organizations without those assets were less likely to use digital technologies for OUD.

The authors said policy initiatives could be used to help fix the “mismatch” between the need for digital health technologies and the actual deployment of such tools.

“For example, policy makers and payers might test policies and reimbursement schemes that support health care organizations without local SUD (substance use disorder) treatment resources to integrate digital health technologies for OUD into their practices and workflow,” the authors said.

While the study provides a general overview of the prevalence of digital technologies in treating OUD, the authors conceded that they did not have the data to understand more granular details about current usage. For example, the survey data did not enable investigators to understand how often organizations were offering such tools to patients, nor how often patients were accepting the services.

Absent that data, however, the fact that organizations that already have significant OUD resources are more likely to use digital health tools suggests that they see digital health tools as one of many methods by which to help patients, not as a standalone strategy, the authors said.

“Future studies should examine implementation facilitators to realize the potential of digital health technologies to support organizations facing practitioner shortages and other barriers to OUD treatment delivery,” they concluded.

Reference

Miller-Rosales C, Morden NE, Brunette MF, Busch SH, Torous JB, Meara ER. Provision of digital health technologies for opioid use disorder treatment by us health care organizations. JAMA Netw Open. Published online July 3, 2023. doi:10.1001/jamanetworkopen.2023.23741