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

项目总结/摘要 新冠肺炎增加了初级保健中物质使用障碍（SUD）的患病率，当 再加上弱势农村人口获得精神保健的问题， 这些患者的差异。迫切需要改进及时查明和 农村初级保健患者的SUD管理。筛查、短暂干预和转诊治疗 （SBIRT）是一种以证据为基础的策略，以解决SUD在初级保健环境中，但它很少被充分利用。 基于我们在抑郁症协作护理（CC）管理方面的经验和扩展远程医疗的能力 外展，我们建立了一个数字原生集成的行为健康CC平台，使用一个新颖的应用程序和提供商 名为Senyo Health。我们将利用这个SUD CC平台来补充现有的抑郁症CC 将SUD护理纳入初级护理。我们认为这种方法将加强SBIRT护理， 以患者为中心的结果。如果我们的试点成功，我们将扩大Senyo Health平台用于SUD治疗 在中西部马约卫生系统的农村患者中。 通过这项研究，我们将把马约诊所的两个业务优势应用到一个新的护理领域： 实施综合行为健康CC以改善 初级保健环境中的抑郁症，以及为所有人快速部署远程医疗服务的能力 2019冠状病毒病大流行期间的精神病和心理护理。通过各种利益相关者的参与， 我们将探索具体的障碍、促进因素和最佳实施流程，以适应和试点测试 数字原生CC平台。使用混合实施和功效研究设计，我们建议 从三个临床站点，包括两个农村卫生诊所招募患者，以评估干预措施的效果。 可接受性、可行性和潜在有效性。在这一初步阶段的基础上，我们将扩大我们的 干预措施，包括四个新的诊所继续相同的混合方法，以适应和改善 实施过程和临床结果。然后我们将通过以下方式传播我们获得的知识： 研究出版物，网络故事，以及与那些有兴趣实施 在初级保健中提供SUD服务的虚拟CC方法。

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.