Telehealth Model for Improving Access to MOUD
Telehealth is a care delivery model in which providers and patients communicate through technology, such as video, instead of in-person. Telehealth is an effective method of providing MOUD, and rural programs can use telehealth to facilitate access to prescribing, as well as services such as counseling and other MOUD support services. Telehealth also eliminates certain barriers to treatment, including the need for transportation and time spent traveling to providers' offices. Depending on the service, patients may be able to use telehealth to access MOUD services from their homes or other remote locations. Additionally, rural programs can use telehealth to connect patients to other services during an in-person clinical appointment.
Smartphone apps are a telehealth tool that can support outpatient MOUD treatment. Smartphone apps can help providers and patients to connect between in-person visits. They may offer medication reminders, progress tracking, surveys, scheduling, and other functions. For patients with smartphone access, apps can provide convenient tools and access to resources to support MOUD treatment.
For additional information about telehealth in rural areas, see the Rural Telehealth Toolkit.
Examples of Rural Telehealth for MOUD
- Boulder Care has developed a completely virtual MOUD program. Patients communicate with program staff through video calls and messaging using the Boulder Care smartphone app. This evidence-based program has a 92% retention rate in the first 12 months of treatment.
Implementation Considerations
There are a number of barriers to providing telehealth services in rural areas. Lack of access to high-speed broadband internet, as well as other connectivity considerations in rural areas, can make it challenging to provide telehealth services. Even where broadband is available, some people may be without internet due to homelessness or cost. People may also lack access to devices, including smartphones. During intake, programs can screen patients to gauge access to and availability of technology such as internet and smartphones.
Another consideration regarding rural telehealth for MOUD is comfort and preference regarding use of telehealth services. Some physicians prefer in-person visits so they can build a relationship with the patient, ensure successful initiation of care, and manage ongoing treatment. Similarly, some patients may prefer in-person visits instead of using technology.
As a result of the COVID-19 pandemic public health emergency, many rural programs have expanded their use of telehealth services for MOUD. More information regarding policies that apply to MOUD services and programs is available in Policy Considerations.