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 implemented 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 was studied.

Description: Four specific aims (quality, productivity, satisfaction, financial performance) with 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 meetings with representatives from the eClinicalWorks vendor and NYC Department of Health and Mental Hygiene. The pre-implementation data collection, data entry, and analysis have been completed. The post-implementation data collection, data entry, and analysis phase of the study will be completed by October 2010.

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: We expect the results of this detailed program evaluation to demonstrate enhanced healthcare outcomes and generate real cost savings as well as enhanced revenue.