The alarming increase in substance use disorder (SUD) prevalence within the US population has led to dire consequences, particularly in acute care settings. Hospitals are witnessing a surge in injection-related infections, with endocarditis cases rising nearly tenfold in the past decade. And many are struggling to respond adequately.
Critical care providers face significant challenges in treating endocarditis patients who use opioids, including managing their inevitable withdrawals upon admission. Further, the lack of coordination and visibility between traditional and behavioral health providers results in substandard care and leaves many SUD patients untreated.
An analysis of public endocarditis claims data has exposed a concerning reality—80% of hospitals treating these patients have SUD facilities within the same zip codes that provide opioid medication as part of their treatment. Despite this proximity, the lack of coordination and interoperability across the healthcare ecosystem creates a divide between acute care providers and SUD treatment facilities.
This disconnect significantly impacts the quality of care delivered to SUD patients, leaving their underlying conditions unaddressed and exacerbating the long-term consequences of addiction. The fragmentation of care leads to critical gaps in treatment, jeopardizing patients’ chances of recovery.
The Importance of Interoperability
Simply expanding care access is not enough to tackle the complexities of the opioid crisis. To ensure comprehensive and effective treatment, providers must prioritize coordinated care across different settings, incorporating a complete representation of the patient’s medical history and needs. Achieving this requires fostering interoperability and implementing technology solutions that facilitate seamless data sharing between acute care providers and SUD treatment facilities.
The Interoperability Roadblocks Ahead
Nonetheless, a decades-long behavioral health technology gap exacerbates the problems with the current care equation. Compared to their traditional health counterparts, behavioral health, and SUD treatment facilities are often burdened by limited funding.
Nearly a third of SUD and behavioral health providers still manually track outcomes or use a homegrown solution, perpetuating blind spots in patient treatment outcomes and handicapping clinicians. This funding disparity and insufficiency impede their ability to invest in crucial information technology and digital infrastructure. And a lack of incentives and support for technology adoption has created analytic obstacles, with many providers unprepared to answer basic operational and clinical questions. The reasons for this gap stem from many ingrained and institutionalized realities, including:
The healthcare industry, SUD, and behavioral health treatment providers, in particular, are late to adopt new technologies and processes.
Behavioral health has been conspicuously excluded from the incentives provided by the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009, resulting in limited access to technology and funding in this field.
The persistence of the problem is evident from the ongoing calls for reform by policy centers and industry organizations. A June 2022 report from Medicaid and CHIP Payment and Access Commission (MACPAC) highlighted the critical importance of extending funding through state Medicaid programs to drive health IT adoption and address the gaps in access, outcomes data, and oversight.
Compounding the challenge, behavioral healthcare’s current fee-for-service payment model financially rewards doctors and hospitals based on the volume and cost of services rather than the quality of outcomes. This reality has made it difficult to persuade stakeholders to invest in even the most impactful technology until there is a significant shift toward value-based care models.
Disparate and legacy systems also remain a lasting hurdle.
Many care-critical applications and technologies are still linked to purpose-built bespoke infrastructure, making it difficult and costly to update them. Additionally, these systems are often siloed, limiting care teams’ ability to develop comprehensive insights and hindering effective collaboration.
Regulatory changes and continued private equity investment will likely drive increased interest in outcomes tracking for mental health and SUD providers in 2023. As results and accountability become more critical, these trends will push providers to accountability standards that many are unprepared to meet.
Advocating for Change
Therefore, addressing the technology divide in behavioral health is crucial to improving SUD and mental health treatment outcomes. Stakeholders and policymakers must recognize these disparities and take proactive measures to bridge the gap. By aligning incentives with technology adoption, investing in health IT infrastructure, and promoting value-based care, the industry can effectively empower behavioral health providers to leverage technology for enhanced patient care.
Beyond Endocarditis: Toward a New Paradigm
The challenge lies in the lack of coordination between acute care providers and SUD treatment facilities, hindering the effective response to the rash of endocarditis infections and an ever-growing opioid crisis. As the industry strives to bridge the technology gap and promote value-based care, stakeholders, policymakers, and industry organizations must collaborate on finding solutions.
Advocacy for funding and support to enhance behavioral health technology, fostering interoperability, and transitioning to outcome-based care models are essential to empower providers to deliver comprehensive and effective treatment. Ultimately, these measures lead to improved outcomes for individuals struggling with SUD. And a unified commitment to closing the technology divide holds the key to paving the way for a healthier, more resilient US population and curbing the devastating impact of the opioid epidemic.
