Developing a strategy for telehealth for substance use disorder treatment
Learn key processes and methods to use telehealth for substance use disorder treatment.
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Establish key processes
Procedures concerning referrals, patient confidentiality and privacy, prescribing controlled substances, and treatment plans are important in creating a comprehensive and robust strategy for telehealth treatment for SUD.
- Referrals. It is important that the provider has a referral system in place to offer the patient information on various treatment programs. These include SUD treatment programs, “dual-diagnosis” treatment programs for patients with co-occurring mental health disorders, and referrals to intensive and medically managed SUD treatment programs. Telehealth may be a component of some treatment programs.
- Privacy. 42 CFR part 2 (“Part 2”) protects patient confidentiality relating to substance use disorder (SUD) treatment records. Part 2 providers may disclose Part 2 records only based on a patient’s written consent, which may include a single consent for all future uses and disclosures for treatment, payment, and health care operations until they are revoked.
- Coordination with local pharmacies. The use of medication for SUD, particularly for patients with opioid use disorder (OUD), is often an essential and necessary part of treatment.
- Collaboration with correctional facilities. It is important to coordinate with local correctional facilities to facilitate continuity of care for individuals with a SUD.
- Establishment of a treatment plan. A treatment plan provides a patient a roadmap to their recovery process. During the telehealth encounter, a provider needs to establish a process that identifies the patient’s goals for treatment and describes measurable steps towards achieving those goals.
Is telehealth a good fit for your patient?
A first step is identifying which patients will benefit from telehealth. This includes reviewing:
- Patient characteristics. An effective telehealth encounter for SUD requires understanding patient characteristics, such as any vision or hearing limitations or whether they will need a translator or other accommodations.
- Patient preferences. Some patients may prefer telehealth visits while others may prefer in-person care. You should accommodate your patient’s preferences when possible.
- Assessment of the home environment. Is the home a safe place for the patient to receive telehealth services?
- Technology access. Does the patient have a device and a secure internet connection?
- Client technical capabilities. Before using telehealth to provide SUD treatment, it is essential to understand whether the patient has the ability to operate the required telehealth technology. Providers must then determine the level of support they will need.
Assessing patient needs
SUD assessments are processes for determining a diagnosis and developing specific treatment recommendations to address the diagnosis. This includes:
- Client needs. Providers must determine what services are needed. Factors to consider include co-occurring mental health disorders and social risk factors.
- Treatment history. The type and duration of past treatment is important for determining the appropriate course for ongoing treatment. This can help you decide if telehealth treatment is a good fit for your patient.
- Use of medications/medication assisted treatment. Is the patient currently taking medications used to help with SUD treatment, including medications for opioid use disorder (MOUD) such as methadone or buprenorphine?
Screening tools
Asynchronous, computerized assessments and evidence-based screening tools are commonly used modes of telehealth in SUD treatment programs. This includes:
- Online assessments. Computerized or web-based assessments with no live interaction are often used. They are easy to access and can be used during specific points in a patient's treatment.
- Other screening tools. There are a number of screening tools that can be accessed and used online during a telehealth session.
More information:
Getting patients set up with telehealth technology — Health Resources and Services Administration
HIPAA Rules for telehealth technology — Health Resources and Services Administration
Legal considerations — Health Resources and Services Administration
Licensure for behavioral health — Health Resources and Services Administration
Obtaining informed consent — Health Resources and Services Administration
Prescribing controlled substances via telehealth — Health Resources and Services Administration
Telehealth policy — Health Resources and Services Administration
Telehealth for the Treatment of Serious Mental Illness and Substance Use Disorders (PDF) — Substance Abuse and Mental Health Services Administration