Implementation of an electronic information system to enhance practice at an opioid treatment program

Issues: The Addiction Research and Treatment Corporation (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 has selected and will shortly implement an electronic health information system that integrates counseling, social services, medical services, case management, HIV services, dispensing information, and administrative and fiscal data. Assessment of system performance is being studied.

Description: Five specific aims (quality, productivity, satisfaction, financial performance and risk management) with nine related hypotheses were chosen for study evaluation utilizing a pre and post-implementation research design. Determination was made to combine our in-house dispensing and social services program with eClinicalWorks, which became available through participation of ARTC in a grant obtained by NYC Department of Health and Mental Hygiene. Interfacing these two electronic programs has presented a number of challenges that have been addressed via various in-house field groups examining every aspect of the agency's operations and weekly meetings with representatives from the eClinicalWorks vendor and NYC Department of Health and Mental Hygiene. The pre-implementation data collection phase of the study is complete, and data entry and analysis will be finalized by March 2009.

Lessons Learned: Despite careful planning, implementation of an electronic health information system presented a number of unexpected challenges and roadblocks that had to be overcome.

Recommendations: The results of this detailed program evaluation have the potential to demonstrate enhanced healthcare outcomes and generate real cost savings as well as enhanced revenue.