Connecting Primary Care to Substance Use Disorder Treatment Using a Telehealth Collaborative Care Platform

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PROJECT SUMMARY/ABSTRACT Covid-19 has increased the prevalence of substance use disorders (SUD) visits in primary care, which, when coupled with problems of mental healthcare access for vulnerable rural populations, accentuates already existing disparities for these patients. There is an urgent need to improve the timely identification and management of SUD for rural primary care patients. Screening, brief intervention, and referral to treatment (SBIRT) is an evidenced-based strategy to address SUD in the primary care setting, but it is seldom fully used. Building on our experience in depression collaborative care (CC) management and ability to scale telehealth outreach, we built a digitally native integrated behavioral health CC platform using a novel app and provider platform called Senyo Health. We will utilize this SUD CC platform to complement existing CC for depression to deliver SUD care integrated into primary care. We feel this approach will enhance SBIRT care and improve patient-centered outcomes. If our pilot succeeds, we will scale the Senyo Health platform for SUD treatment among rural Midwest Mayo Health System patients. With this study, we will apply two operational strengths of Mayo Clinic to a new domain of care delivery: a demonstrated track record of implementing integrated behavioral health CC to improve the management of depression in the primary care setting and a demonstrated ability to rapidly deploy telemedicine service for all psychiatric and psychological care during the COVID-19 pandemic. Through diverse stakeholder engagement, we will explore specific barriers, facilitators, and optimal implementation processes to adapt and pilot test a digitally native CC platform for SUD. Using a mixed implementation and efficacy study designed, we propose enrolling patients from three clinical sites, including two rural health clinics, to evaluate the intervention's acceptability, feasibility, and potential effectiveness. Building off this initial phase, we will expand our intervention to include four more new clinics continuing the same mixed methods to adapt and improve implementation processes and clinical outcomes. We will then disseminate our acquired knowledge through research publications, web stories, and a manualized process to share with those interested in implementing a virtual CC approach to delivering SUD services in primary care.