The Future of Opioid Treatment: Embracing Hybrid Care Models
Healthcare was forced to drastically shift as a result of the COVID-19 pandemic, which highlighted the efficacy of virtual and hybrid healthcare for opioid treatment programs.
During the pandemic, SAMHSA found that take-home methadone flexibilities in particular could increase engagement and improve patient satisfaction, with few incidents of misuse or medication diversion.
At the same time, take-home doses present a challenge for OTPs who want to maintain open lines of communication with patients and ensure patients remain engaged with their treatment. Providers also have concerns that increasing take-home medication will lead to instances of misuse or diversion.
A hybrid care model that combines in-person visits with telehealth can provide the flexibility and accessibility patients need, while still allowing for regular patient-provider interactions.
In this article, we'll explore how OTPs can implement a hybrid model for better treatment engagement and retention.
Reduce Barriers to Treatment for Opioid Use Disorder
For many patients, daily, in-person visits to OTPs present significant challenges, and in some cases, barriers to long-term treatment success. Major roadblocks include:
Travel: Patients need to travel to and from the clinic. This is particularly burdensome for those living in rural areas or lacking reliable transportation.
Research published by BMC Health Services Research highlights the impact of this barrier, showing that just a 10-minute drive reduces methadone treatment plan completion rates by 33%. Given that patients in the study had an average drive time of 11.32 minutes, travel remains a critical barrier to care.
Scheduling: Scheduling difficulties are very common, especially for patients trying to juggle multiple jobs or care for young children.
Clinic Hours: Daily hours of operation for OTPs are limited, with most clinics only open from 5 am-2 pm, further complicating access to care.
According to SAMHSA,
“Most people who could benefit from treatment do not receive it due to systemic barriers and access issues which are even greater for historically underserved communities. Low barrier care is a model for treatment that seeks to minimize the demands placed on clients and makes services readily available and easily accessible.”
A low barrier care model centers around making treatment more accessible by addressing these patient challenges. Embracing hybrid care is a practical, impactful way to practice these principles. Instead of traveling to the clinic daily, for example, patients can receive the same level of care at home or at work by making use of telehealth services.
Minimize Risks While Issuing Take-Home Methadone
From the more than 200,000 doses recorded on the Sonara® platform, we’ve found that ~85% of take-home methadone doses are taken as prescribed. However, without a way to monitor patients’ at-home doses, OTPs struggle to identify those patients who are not using methadone as prescribed and need a higher level of care and supervision.
Some OTPs have questioned the need for remote dosing tools like Sonara since they can legally prescribe two weeks of take-homes after two weeks of treatment. However, this one-size-fits-all approach overlooks the importance of informed clinical decision-making, personalized care, and the benefit of observed dosing - up to a point. Just because a patient is eligible for take-homes doesn’t mean unsupervised take-homes are safe and appropriate for every patient.
Hybrid care is the best of both worlds for OTPs and their patients, increasing flexibility without increasing risks to patients or their communities. Plus, if OTPs determine that additional support is necessary, it’s easy to transition patients back to more frequent, in-person visits with the same care team.
“Sonara has provided not just increased access for our patients, but has given our providers more security in feeling like they can expand take-homes. It’s just the level of support they needed to feel confident in this step.”
- Nicole Ross, Regional Director at BHG
Expanding Access to Care
Sonara’s hybrid care platform makes it easier than ever to connect patients with the care they need, anytime, anywhere. From remote patient intake to virtual counseling and callbacks, Sonara creates higher retention rates and increased patient satisfaction without sacrificing engagement or safety:
Complete Timely, Efficient Intakes
Long wait times and logistical barriers can prevent individuals from accessing care when they need it most. By creating a smooth and efficient intake process with the help of Sonara, OTPs can ensure patients can begin treatment without unnecessary delays.
Sonara supports remote patient intake, allowing clinics to expedite the initiation of treatment by connecting patients with an off-site provider while they’re in the clinic. This approach helps reduce wait times, accommodate walk-in appointments, and facilitate same-day methadone prescribing.
Issue Take-Homes with Confidence
For many patients, frequent in-person visits to an OTP can create challenges that interfere with personal lives, work, and childcare. While take-home methadone doses provide a solution, providers need ways to ensure adherence and maintain patient-provider connection.
Sonara’s Virtual Dosing Window™ enables patients to record their methadone doses remotely, providing care teams better visibility into treatment adherence while saving time that would otherwise be spent on clinic travel.
Sonara’s hybrid care platform also facilitates virtual callbacks, which allow providers to check in with patients over a video call instead of requiring them to come into the clinic. This improves callback response rates, simplifies scheduling, and decreases in-clinic wait times by reducing the number of time-consuming, in-person check-ins at the distribution line.
Reducing NEMT with Hybrid Care
Hybrid care improves treatment efficiency by reducing dependence on transportation. Fewer rides support patient retention and expand equitable access to life-saving medication while maintaining high standards of care. By delivering care remotely, Sonara helps OTPs reduce reliance on NEMT, leading to substantial savings for health plans and state programs.
In 2024 alone, Sonara prevented 100,998 trips to and from treatment centers, easing the burden on both patients and providers. For patients, this means the flexibility to balance work, family, and recovery. For providers and payors, it translates to higher retention rates, reduced costs, and better overall outcomes.
Maintain Patient Engagement Throughout the Course of Treatment
As patients progress through treatment, it’s not uncommon for them to become less connected to their providers. For instance, if an individual qualifies for 28 take-home doses, they may only interact with their provider once a month - to pick up their take-homes and attend counseling. Hybrid care addresses this issue by allowing for more consistent interactions between patients and their care teams, even when using take-home methadone.
Sonara’s platform includes tools designed to keep patients connected to their care teams. Remote counseling allows clinics to stay compliant with state’s counseling requirements while improving access to care for patients who may struggle to attend in-person visits. Additionally, Sonara’s secure, two-way messaging system allows providers to check in, answer questions, and provide support between visits.
Hybrid Care: The Path Forward
Hybrid care represents an opportunity to address many of the challenges associated with opioid use disorder treatment. By integrating tools like Sonara’s hybrid care platform, OTPs can confidently issue take-homes while maintaining necessary oversight. This not only enhances flexibility for patients but also provides care teams with greater visibility into patient adherence and engagement.
Sonara is committed to supporting OTPs with the tools needed to safely and effectively deliver OUD treatment. Contact us today to learn how we can partner together to make this a reality.
