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Over the past few years, we’ve seen a worst-case scenario developing in the addiction treatment industry: The need for treatment has skyrocketed while the number of clinical personnel has rapidly declined.
With an estimated 60 million people in the U.S. using substances 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 high as 50%, with roughly 25% of those who’ve left reporting that they are not planning to return to the field. As a result, Dr. Rahul Gupta, director of the Office of National Drug Control Policy, has predicted a staffing shortage of as many as 150,000 providers within the next five years — a considerable deficit that will no doubt put millions of people at risk and could cost countless lives.
While workforce recruitment and development must remain a top priority, we also need urgent and innovative solutions that can provide essential stop-gap care options.
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Technology is playing a pivotal role in getting people the help they need and acts as a force multiplier for the staff currently in place. Despite the beneficial impact of technology today, behavioral health will need to intensify its use of technology to meet increased demand with a continuing and intensifying shortage of critical staffing. Here’s how:
1. Artificial Intelligence (AI) chatbots enable crisis intervention
Individuals suffering from mental illness and substance use disorders experience varied levels of crisis that can, literally, be life or death. The reality is that staff are not consistently available 24 hours a day to screen all calls to determine what are routine or crisis calls. Chatbots can be successfully employed to answer simple calls related to appointments and other treatment related questions, freeing up personnel to engage directly with those individuals experiencing an emergency or seeking care.
Chatbots that leverage AI to engage individuals during a crisis or keep them engaged in the aftermath can provide an essential lifeline. Today’s chatbot technology is so advanced that it feels as if you are talking to a real person, with many patients unable to tell the difference. Because it’s accessible 24/7, it allows us to reach people when they need it most with fewer resources. In addition to the immediate crisis intervention, chatbots can be leveraged by providers to check in with patients after crisis stabilization to reengage if one has again destabilized.
2. Virtual technology improves patient outcomes
The field of substance use disorder treatment has lagged behind the larger medical community in tracking and responding to patient outcome indicators. In fact, there is not currently a clearly defined or agreed-upon consensus on optimal outcomes. To make this successful, providers need to create benchmark outcomes to strive for while identifying the interventions necessary to achieve them. One way to do this is by working with key partners to develop and integrate technology that will better gather and respond to information.
3. Virtual technology extends access
One of the few silver linings to the COVID-19 pandemic has been an industry-wide rollout of virtual therapies. The pre-COVID-19 dependence on brick-and-mortar treatment settings provided unique access challenges for people needing care that were unable or unwilling to attend in-person treatment. Microsoft Zoom is now fully HIPAA-compliant, allowing greater access to counseling services in treatment deserts such as rural communities, or in places where getting to treatment isn’t safe, such as areas with prevalent crime activity. It also allows patients to seek treatment from the privacy of their own home and get specialized treatment for specific disorders from providers outside their geographic area, which is critical when travel isn’t feasible.
Thankfully, well-designed virtual services have proven to have positive outcomes consistent with face-to-face treatment in most applications and insurers are getting fully on board with this new modality, ensuring it will become 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 industries, providing insight into vital data like heart, respiratory and temperature metrics and helping to incentivize wellness habits to minimize the risk of cardiopulmonary diseases.
Similarly, they can be used to monitor addiction by incentivizing positive behaviors and spotting indicators that could signal the risk of relapse. They can also be set up for geofencing, to provide warnings if someone in recovery is venturing near places that aren’t good for their sobriety. It can also provide reminders and reinforcement of positive behaviors like exercising, meditation, attending meetings and other stress management tools.
Wearable devices also present the opportunity for treatment providers to monitor the blood pressure, pulse, and respirations of patients in facility-based care to allow for an immediate response in the event of a medical emergency.
5. Streamlined documentation systems reduce friction
For providers, the SUD treatment documentation requirements are massive, and every minute spent on administrative work is one less minute spent with patients. Unfortunately, most EHRs are not optimized for clinicians in this field, and this creates workflow inefficiencies and bottlenecks that take clinicians away from seeing patients.
The industry is working to revitalize documentation systems with new products that streamline the process to be more efficient and person-centered. This allows clinicians to be more engaged with patients, and it helps to reduce burnout and administrative frustrations for providers, with the goal of deterring them from leaving the business.
6. Digital communities maintain recovery connections
We know both anecdotally and through research that long-term engagement with patients contributes significantly to recovery success. In fact, extending patient interaction for up to 12 months creates a 60-80% success rate, compared to just 30% for a 90-day inpatient stay.
Despite the tremendous potential for technology to revolutionize addiction treatment, we must also acknowledge there are still some significant hurdles for both 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 higher patient engagement, the majority of facilities are relatively small and don’t have the resources — both human and financial — to build and maintain advanced technologies.
While some can’t afford it, others simply don’t believe in it, preferring to continue with only face-to-face treatment options. And, because not all payers support tech transformation, it’s difficult for providers to justify making the investment.
On the patient side, lack of access to devices and connectivity can be a hurdle. After all, if you’ve lost your job and maybe even your home because of addiction, it’s hard to afford a mobile device and internet service. Others may not be tech-savvy or inclined to learn a new tool, especially when already facing so many other challenges.
Even with these obstacles, we can still make an enormous impact by leveraging technology to reach more patients with life-saving treatments. Leveraging technology for better outcomes, increased access to care and efficiencies is not just an opportunity but an imperative. With the U.S. on track to see 150,000 overdose deaths this year, the time is now.
Thomas Britton is the CEO at American Addiction Centers
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