Language: English

This case study shares how the Colorado Department of Human Services Behavioral Health Administration (BHA) used federal State Opioid Response grant funds to implement a mobile health model to bring medication-assisted treatment to rural and underserved areas.

This cohort analysis includes clinical service data from the first 15 months of The Spot mobile clinic, from September 4, 2018, to November 23, 2019. The Spot co-located with the Baltimore syringe services program in five locations across the city. Descriptive data are provided for patient demographics and services provided, as well as percent of patients retained in buprenorphine treatment at one and three months. Logistic regression identified factors associated with retention at three months.

In this quality improvement study, comparable to office-based telemedicine programs, 58.51% of patients treated in a mobile telemedicine treatment unit remained in treatment at 90 days. Longer retention was significantly associated with reduced opioid use. These findings suggest that the combination of telemedicine and mobile services is a unique approach to extend access to medications for opioid use disorder to rural areas and is especially relevant in a postpandemic climate; this model demonstrates feasibility and lays the groundwork for adoption in rural populations.

UMass Memorial Medical Center and community partners deployed a mobile addiction service, called the Road to Care. Using this approach, multidisciplinary and interprofessional providers deliver holistic addiction care by centering patients’ needs with respect to scheduling, location, and convenience. This program also extends access to buprenorphine and naloxone among people experiencing homelessness. They demonstrated that a community-based mobile addiction service, anchored within a major medical center, can provide high-volume and high-quality overdose prevention services that facilitate engagement with additional treatment.

The primary goal of this toolkit is to provide clinically relevant information to support high-quality delivery of outpatient OUD care via telehealth, while reducing barriers to starting and maintaining both medication and psychosocial treatments. This toolkit is intended for clinicians, administrators and policymakers who are involved in delivering, managing and considering telehealth for OUD care.

This toolkit outlines guidelines and protocols that may assist organizations in the planning and implementation of a mobile addictions services program that combines harm reduction and clinical care.