Survey analyses for implementing an electronic information system to enhance practice at an opioid treatment program

Issues: ARTC, an outpatient opioid treatment program providing onsite primary medical care and HIV-related care for approximately 3,000 predominantly minority adults in New York City, is in the process of selecting and implementing an electronic health information system that integrates counseling, social services, medical services, case management, HIV services, dispensing information, and administrative and fiscal data.

Description: Through a NIDA grant, assessment of system performance will be studied. Buy-in by stakeholders (patients, clinicians and managers) was the initial focus of this process. Five specific aims (quality, productivity, satisfaction, financial performance and risk management) with nine related hypotheses were chosen for study based on needs assessment meetings with stakeholders and literature review. The final selection of an electronic information system is informed by specific criteria, including ability to provide relevant data regarding aims mentioned above, information obtained from stakeholders and literature review, and determination as to whether the system will be developed totally in-house, by an outside vendor or as a hybrid. Presentations by vendors were evaluated using specific criteria.

Lessons Learned: A detailed survey of 105 clinician stakeholders was done to determine (1) ability to use the current paper-electronic system; (2) challenges encountered with the current system; and, (3) training needs.

Recommendations: Results of this detailed program description have potential to inform continuing discussions about selection and impact of integrated electronic systems in enhancing healthcare outcomes and agency cost-effectiveness in substance abuse treatment settings for this unique patient population.