As always the VTSBIRT team is thankful for our medical partners, colleagues throughout ADAP & AHS, and stakeholders for their continued efforts in helping to make SBIRT a productive and worthwhile project!
Implementation = To date more than 26,400 patients have been screened illustrating 65% report no risk in their substance use; 15% of patients screened at risk for alcohol/drug use b) 11% of patients were positive for risk of depression with close to 3/4 of this group having co-occurring substance use risk. Over 1250 brief interventions were completed representing 57% of all patients screened at risk for using drugs and or alcohol warranting an immediate response. Currently a total of four clinics for the uninsured, two hospital emergency departments, and two large community health centers (medical homes) are involved in VTSBIRT. Additionally, CVMC woman’s health clinic and Northwest Medical Center Emergency Department will be joining the effort within the next 2 months.
Evaluation – By utilizing a back-up Vermont SBIRT data base our evaluation team & collaborating providers continue to be productive in providing quality information for both continuous improvement and theme based quarterly data reports. The year two second quarter report is now out and focused on Health Disparities. The report illustrates some interesting aspects of SBIRT –The report is shared with SBIRT providers and VDH stakeholders involved in the project. Additionally, main findings included young adults and males are at greater risk for substance use and Tobacco risk remains the highest at 21% of the patients screened. Note: Vermont’s tobacco risk propelled us to further our collaborative efforts with the Tobacco Prevention Unit including to now link and offer training and resources through the new 802Quits website.
HIT – Patient automated screening is a strong if not essential priority for SBIRT & behavioral health integration for many reasons. The demands of universal screening for behavioral and medical health including moods, medication adherence, substance use, diet and a range of other wellness indicators increasing places near impossible time demands on Vermont providers (especially the smaller ones). VTSBIRT is continually trying to help support our providers to investigate their ability to develop patient automated screening. There are a number of hurdles to accomplishing this essential HIT task – EHR vendor readiness and associated continued costs as well as provider IT management time demands. It is a truly a catch 22 because all of our providers understand the tremendous advantage in terms of time and workflow efficiencies but struggle to find a way to make the change happen. Our HIT consultant & our state Hit coordinator, along with a team of stakeholders recently reinvigorated efforts are working on a new initiative to generate solutions to the 42 CFR part 2, issues in order for SBIRT to smoothly become part of the VHIE.
Success with this task – will increase sustainability for behavioral health grant related changes & remove many clinical obstacles to advance behavioral integration.
Training – Our main priorities this period is to hire a new trainer/QA coach, continue supporting our practice sites and collaborate with a new BCBS initiative to help train five new primary care practices so they can adopt SBIRT. We also are preparing for a OneCare Vermont medical conference on SBIRT next winter. Several interviews have been completed and we are in the midst of second rounds. This next period we plan to review the responses to our TA/training surveys sent out on Survey Monkey. To date we approximate based on participation the following:
Provider Training in SBIRT
Ø Introduction to SBIRT 224
Ø Trained in Brief Interventions 106
Ø Trained in Brief Treatment 50
Ø Cultural competency 46
Ø Online Courses TBA (100+)
Our Health Disparity consultant Maria “Mercedes” Avila PhD and CLC trainer was recently appointed to the Governor’s Workforce Equity and Diversity Council (GWEDC) – congratulations! There are a new set of cultural competency trainings underway in different regions statewide. Erin will be meeting with Dr. Avila to develop specific dates for new training and sending out emails throughout the VDH, AHS and SBIRT stakeholders.
Sustainability/outreach – In conjunction with our marketing consultants HMC, Megan Trutor, our provider champions & the VDH communications committee, we are now engaged in a new and exciting marketing initiative. Our team is producing two sets of outreach marketing tools – a) short local provider focused videos & b) a general “fact sheet” – card. The goal of these tools is to highlight SBIRT as a excellent and efficient approach for behavioral health integration. Our medical champions (Mark Depman MD, Heather Stein MD & Cheryl Flynn MD) were filmed last week – so we are eagerly waiting for the “first cut” of their efforts. Additionally, our project director recently visited North Carolina’s SBIRT program and came away with a defined collaboration project between the two grantees to develop a sustainability document clearly illustrating possible reimbursement models dependent on different medical settings and reimbursement approaches. The Sustainability model will be utilized with our federal and private insurers and our provider agencies to help inform them of the true costs and reimbursement methods that will promote and ensure successful integration.
Health Disparity – The first set of SBIRT “ cultural community outreach trainings occurred” – In order to reduce health disparity – we now have a team of ethnically diverse outreach members that are interacting within their own communities to identify and refer people at risk.