The Alaska Department of Health and Social Services (DHSS), http://dhss.alaska.gov Division of Behavioral Health, recently released the new resource “Medication Assisted Treatment Guide” to help healthcare providers in Alaska offer Medication Assisted Treatment (MAT) services to treat Opioid Use Disorders (OUD). MAT has been proven to work in treating OUDs in combination with counseling and behavioral therapies.
According to Dr. Anne Zink, Chief Medical Officer for DHSS, “MAT is the most effective current treatment for opioid addiction which means that increasing access to MAT is an important step needed to address Alaska’s opioid epidemic.”
Currently, MAT resources are inadequate and misallocated across the state and as a result, many people suffering from opioid addiction do not have access to an authorized MAT provider due to geographic or other barriers in the state. Section V in the Guide discusses how to use telemedicine to provide authorized MAT services more effectively to people suffering from opioid addiction.
According to the Guide, there is already a well-established telemedicine system in Alaska through the Alaska Native Healthcare System. Nearly every Alaska Native village health clinic has telemedicine equipment that connects via secure video conferencing software to other Alaska Native clinics or hospitals in the state.
Typically, when an individual is in need of MAT for OUD, if possible, the patient can travel to the prescriber’s clinic for the first face-to-face visit. After the visit, if prescriptions are needed and the prescriber works for the Alaska Native healthcare system, MAT medications can be mailed to the patient’s home or village clinic from the Alaska Native Medical Center pharmacy.
If follow-up visits are needed, they may be conducted via telemedicine since a licensed provider is not required to be physically present with the patient at the follow-up visit. The first step is for the patient to check into their local village clinic. The local provider, medical assistant or community health aide/practitioner (CHAP) then collects vital signs, collects urine for drug screening, and other labs as indicated.
If a routine follow-up visit is needed, the patient is then connected via Vidyo to the MAT provider at a distant site for a routine follow-up visit. After the telemedicine visit is finished, the MAT prescriber will communicate with the local provider regarding the follow-up care plan and send a copy of the visit information to the village clinic if the patient has authorized the release of the visit information. The prescription is then sent to the pharmacy to be mailed to the patient.
It is useful to have a Memorandum of Agreement (MOA) in place between remote and prescribing clinics to discuss responsibilities. It is also helpful for MAT prescribers to meet initially with the staff in remote clinics to educate the staff on OUD and MAT
Go to http://dhss.alaska.gov/dbh/Pages/Initiatives/EvidenceBasedPractices/MAT.aspx to view the report on the Division of Behavioral Health’s website.