Evaluating the Usability, Efficacy and Commercial Utility of a Digital Platform to Deliver Comprehensive Treatment for Opioid Use Disorder

7.项目总结 阿片类药物使用障碍(OUD)是一个国家关注的问题。以药物为基础的治疗(MT)减少阿片类药物 使用、相关危险行为和死亡。尽管有证据支持服用丁丙诺啡的MT，但在超过1/2的时间里 在美国的县(主要是农村)，没有处方医生。病人要么长途跋涉，要么加入等待名单，要么离开 没有MT。护理的其他障碍包括缺乏交通、相互竞争的需求(工作、育儿)和 耻辱。总而言之，缺乏机会和障碍使数百万人得不到治疗。我们的创新解决方案 (Boulder)是一种基于远程健康的治疗解决方案，为OUD提供长期支持。我们的愿景是部署 护理团队(为每个患者介绍临床医生、护士教练、护理倡导者和认证同伴教练)以 提供一系列全面的服务，由拥有数十年经验的成瘾专家监督。 技术使我们能够有效地扩展计划，以满足NIDA的所有指导方针 监督，并提供低门槛、以患者为中心的干预措施(例如，视频用药监测和 私自(在家中)随机观察唾液药物检测。这项提议的长期目标是建立一个 可扩展的解决方案，能够帮助无法获得循证治疗的患者。我们的数字 该计划承诺显著改善患者体验，提高患者的留存率、满意度、 通过提供低门槛、高质量的护理，改善用药依从性和功能结果。以病人为中心 产品已开发完成。在初步测试中，患者报告了高满意度、参与度和可用性，以及 获得护理的机会在三个月内增加了38%。总体目标是评估一名 虚拟平台为我们的治疗创造了必要的范式转变。为了达到这一目标，我们 提出以下目标：第一阶段，目标一：推动博尔德移动平台的开发并获得 患者反馈；阶段II，目标II：确定Boulder对患者参与度、计划保留、 获得护理的机会和护理的连续性；第二阶段，目标三：确定博尔德对阿片类药物使用和 患者功能状态。我们产品的购买者(例如，私人/商业/政府付款人，处于风险之中 提供商组等)按病人、按月提供报酬，实现了可观的成本 通过我们的综合服务节省成本。与典型的按服务收费的医疗服务不同，我们的经济模式与 围绕提供卓越的患者结果的激励。虚拟音响治疗产品的最终用户是 资源有限的患者将免费获得医疗服务。技术使我们的医疗团队、 行为和社会服务提供商为纵向客户带来基于远程医疗的全面护理 将成瘾性疾病的管理直接交给患者，而不是把患者送到看护中心。这个 研究团队包括博尔德公司、成瘾研究和教育基金会和 社区合作伙伴。博尔德目前的投资者提供广泛的支持服务，以确保成功 通过由经验丰富的企业家和领导人组成的全国网络提供指导和指导。

7. PROJECT SUMMARY Opioid use disorder (OUD) is a problem of national concern. Medication-based treatment (MT) reduces opioid use, associated risk behaviors and death. Despite evidence supporting MT with buprenorphine, in more than ½ of US counties (mainly rural), there are no prescribers. Patients travel long distances, join waitlists, or go without MT. Other barriers to care include lack of transportation, competing demands (work, childcare) and stigma. Combined, lack of access and barriers leaves millions without treatment. Our innovative solution (Boulder) is a telehealth-based treatment solution offering long-term support for OUD. Our vision is to deploy care teams (Prescribing Clinician, Nurse Coach, Care Advocate and Certified Peer Coach for each patient) to deliver a comprehensive array of services, supervised by addiction specialists with decades of experience. Technology enables us to effectively scale a program that meets all of NIDA's guidelines for appropriate oversight, and provides low-barrier, patient-centered interventions (e.g. video medication monitoring and private (at home) random observed saliva drug testing. The long-term goal of this proposal is to build a scalable solution able to reach patients who are unable to access evidence-based treatment. Our digital program promises to dramatically improve the patient experience, boosting patient retention, satisfaction, medication adherence, and functional outcomes by providing low barrier, quality care. The patient-facing product is developed. In preliminary testing, patients reported high satisfaction, engagement, and usability, and access to care was increased by 38% in three months. The overall objective is to evaluate the ability of a virtual platform to create the necessary paradigmatic shift in OUD treatment. To achieve this objective, we propose the following aims: Phase I, Aim I: Advance Boulder's mobile platform development and obtain patient feedback; Phase II, Aim II: Determine Boulder's impact on patient engagement, program retention, access to care, and care continuity; and Phase II, Aim III: Determine Boulder's impact on opioid use and patient functional status. Purchasers of our product (e.g. private/commercial/governmental payors, at-risk provider groups, etc.) who provide remuneration on a per-patient, per-month basis, realizing substantial cost savings through our integrated services. Unlike typical fee-for-service care delivery, our economic model aligns incentives around delivering superior patient outcomes. The virtual OUD treatment product's end-users are resource-constrained patients who will access care no cost to them. Technology enables our team of medical, behavioral, and social service providers to bring comprehensive telehealth-based care for the longitudinal management of addictive disease directly to the patient, rather than bringing the patient to the care. The research team includes staff and affiliates of Boulder, the Addiction Research and Education Foundation and community partners. Boulder's current investors provide a wide range of support services to ensure success through a national network of experienced entrepreneurs and leaders that provide mentorship and guidance.