Success Stories: Statewide Outcome Improvements
Within the challenging landscape of addressing the needs of their residents with substance use disorder (SUD), states are driven by a commitment to enhance health outcomes, ease system burdens, and achieve cost efficiencies.
Following are summary highlights from case studies where CHESS Health’s services and solutions, principally its evidence-based Connections App, were deployed statewide to support states in their efforts to address the crisis of drug and alcohol addiction, including the opioid epidemic, in their communities.
Oklahoma: Improving SUD Treatment Outcomes with Fewer Readmissions
Background: Oklahoma’s rural landscape, disparate systems, lack of access to care, and disconnected recovery support resources presented a unique challenge to addressing the state’s burgeoning SUD crisis. Leadership within the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) sought a solution to facilitate continuous engagement, coordinate care across support services, and bolster short and long-term recovery outcomes.
Scaling a Proof of Concept
Oklahoma’s experience with CHESS Health began in 2016 with a narrow project supporting an innovative and nationally recognized prison diversion program, Women in Recovery (WIR). This program partnered with CHESS Health to provide ongoing peer support and engagement. Almost immediately, WIR participants touted the program as positive and essential in providing timely encouragement and assistance during pivotal moments between in-person treatments.
In 2019 and 2020, the success of the Connections App in the WIR program led ODMHSAS to fund its use by select behavioral health providers, including several of the large agencies that would go on to become CCBHBCs. ODMHSAS collected valuable outcomes data that reinforced the solution’s efficacy and potential for statewide expansion.
After the success of the eRecovery solution, ODMHSAS engaged CHESS Health’s eIntervention solution, a program that facilitates connected, collaborative, and coordinated care through a streamlined and documented SUD referral process. This program was deployed across multiple stakeholders including emergency rooms, detox facilities, crisis centers, departments of corrections clinics, state departments of health clinics, and SUD providers including all of the CCBHC’s in the State.
Insights, Outcomes & Next Steps
Oklahoma’s success is largely attributed to the statewide promotion and adoption of the eRecovery & eIntervention solution, advocated by a local champion who collaborated closely with CHESS Health’s onboarding and client success teams. This champion facilitated introductions and reinforced the goal of these solutions being widely adopted to meet the state’s goals around improved outcomes and reduced costs.
Using claims data on over 2,200 Oklahomans in SUD support programs, ODMHSAS analyzed readmissions and care plan adherence of those who were enrolled in eRecovery compared to those in a similar cohort but not enrolled in the program. The results were remarkable. Individuals using eRecovery stayed in outpatient treatment an average of 37 more days and were 24% less likely to be readmitted to detox, residential or inpatient care. After this initial result, the state scaled the solution widely. To optimize the state’s investment and promote broad utilization, the eRecovery program has been embedded in their state Peer Certification program. Today, the recovery solution is contracted for use across multiple entities including ODMHSAS, Prosper OK, Oklahoma Department of Health, Comanche Nation, Choctaw Nation, and Oklahoma Foundation Medical Quality (OFMQ).
eRecovery is currently used by over 120 state contracted providers and promoted to patients in the state’s Federally Qualified Health Centers (FQHC), specialty and treatment courts, and re-entry programs. Today there are more than 3,500 patients enrolled in the program.
They are expanding their focus to drive additional adoption with additional service areas including adult protective services staff and child welfare workers and to reach more rural populations. They are also considering the addition of our contingency management solution to further incentivize individuals to enroll or continue to remain engaged and actively participate in the recovery program.
eIntervention is deployed in over 100 locations, including all ten state department districts and over 40 private providers. Additionally, many non-Certified Community Behavioral Health Centers’ (CCBHC) residential, detox, and outpatient clinics have adopted the tool. The closed-loop referral program has been used to support an average of over 4,900+ individuals per year since its initial deployment in 2021, including over 780 referrals from those leaving the state’s justice system.
The focus is further expanding to include prevention tools. The Oklahoma Department of Mental Health’s (ODMH) prevention team is rolling out the ePrevention program which is an evidence-based automated screening, brief intervention, and referral to treatment (SBIRT) solution.
West Virginia: Boosting Recovery by Reducing Isolation Among Individuals with Substance Use Disorder
Background: West Virginia was ground-zero for the explosion of the opioid epidemic in the United States. According to a 2019 study published in Health Care Management, West Virginia was considered the epicenter of the opioid crisis, reporting the highest rate of overdose related deaths in the nation. 1
Although the State was making progress in the fight against the opioid epidemic, the lockdowns required by Covid-19 pandemic had the potential to undo the state’s efforts by forcing separation, increasing isolation, and reducing access to recovery supports.
Addressing an Urgent Need
West Virginia’s state leadership, including the Governor’s Office and the Department of Health and Human Resources’ Office of Drug Control Policy, acknowledged the pressing concern of isolation and disconnection from support during the pandemic and immediately recognized the need to address this critical issue as being central to their ongoing strategy in combating the state’s opioid crisis. They were seeking a dynamic and inclusive solution; one that could be quickly and seamlessly deployed and integrated across rural and urban landscapes to effectively reduce isolation, bolster coping skills, and support sustained recovery.
Rapid and Expansive Deployment
West Virginia University (WVU) researchers, who were familiar with CHESS Health’s mobile engagement and care management program, recommended eRecovery to the state’s Department of Health and Human Resources (DHHR). The immediate focus was on mass and rapid deployment of the Connections Smartphone app and peer engagement program, both of which are core components of the eRecovery solution. These tools would offer a pivotal lifeline and foster sustained engagement during this time of isolation. Additionally, CHESS Health’s ability to rapidly deploy meant immediate support for those who were struggling with the lack of access to in-person treatment and recovery support services.
eRecovery – Multi-modal care management solution including the patient-focused Connections app, moderated peer engagement, and dashboard.
Insights, Outcomes & Next Steps
To date, over 7,800 patients have been enrolled in and use the Connections app. In a Recovery Improvement analysis from those using the app, key quality of life indicators showed marked improvements; program participants reported a 29% increase in their quality of life measure through engagement in work, school, or volunteer activities and significant reduction in risk factors including a 19% reduction in sleep difficulty, 24% reduction in drug and alcohol cravings, 30% reduction in known exposure to risky situations, 27% reduction in relationship trouble, and 20% reduction in feeling depressed.
Program success is attributed to focused, state-wide commitment to implementation of CHESS Health’s evidence-based programs. West Virginia has a CHESS Health Implementation workgroup consisting of individuals from the Department of Health & Human Resources, Office of Drug Control Policy, West Virginia University Office of Health Affairs, and Rural Health, all of whom partner with CHESS Health’s onboarding and client services teams to continually identify effective outreach and implementation strategies to reach and engage providers and at-risk populations. This approach has resulted in continued success, including ongoing growth in onboarding, increased provider engagement, expanded patient enrollment including a specific focus on college student enrollment.
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