2018 marrch rk · 10/31/2018 marrch fall conference presentation 4 risks involved (co-od and opioid...

Hennepin Healthcare Project ECHO

10/31/2018

MARRCH Fall ConferencePresentation 1

Project ECHO: a multi‐disciplinary approach to integrated care expansion for

opioid use disorders

Roxanne Kibben, LADC, MA Project CoordinatorBrian Grahan, MD – not able to make presentation:Nate Erickson, LADC is filling in for him; LADC on ECHO Team

Integrated Opioid and Addiction CareProject ECHOFunded by STR Grant by MN DHS, one of three Project ECHOs in MN


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Learning Objectives

1. Describe two relevant risks involved in caring for persons with co‐occurring disorders who use opioids.

2. List three benefits of using Project ECHO model to increase opioid use disorder care in rural, underserved populations and in complex cases.

3. Distinguish Project ECHO goals and methods from tele‐medicine, webinars and other learning opportunities.

What is ECHO?

• Origins

• Hennepin Healthcare Integrated Opioid and Addictions Care Project ECHO

• Distinctions, Outcomes and Sample

• Discussions


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Sanjeev Arora, MDUniversity of New Mexico

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UNM Project ECHO Founder with MN ECHO Physicians

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Hennepin Health Care’s

Integrated Opioid and Addiction Care

Project ECHO

• Led by Addiction Medicine Physicians

• Interdisciplinary Team

• Expertise with Medication Assisted Tx

• Aim to tele-mentor primary care physicians and teams

• Rural and Under-served Populations

• Integrated Medical Model of Care


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Risks Involved (Co-OD and Opioid Use)

1. Increased mortality2. Navigation through transition off Rx opioids3. Patients suffer 4. Inadequate training for providers re: chronic

pain, OUD, etc.5. Providers risk DEA sanctions, confrontational

encounters and other emotional wellbeing risks

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National Survey on Drug Use & Health (2015)

1.5 million adult Americans who had a serious mental illness in the past year also had misused an opioid during that time.Co‐occurrence:• Greater symptom severity• Higher levels of disability • Poorer course of illness (vs either disorder alone)

Opioids include both heroin and opioid‐based painkillers.

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Other Contributing Factors •Almost 20% of Americans live in rural communities

•Workforce shortage (LADCs, psychiatrists, addiction medicine physicians)

• 100 million Americans with chronic pain

• Those providers who have the X waiver may or may not prescribe MAT

•Drug coverage by third party payers may discourage use of saver opioids, e.g. buccal buprenorphine

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Step 1 – Sign Up

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Receive a Calendar Invite with the Zoom Link

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Zoom Meeting

Link


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Click to Install or Run Zoom on PC or Mobile Device

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All Segments Benefit from Project ECHO


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Doing More for More Patients

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• Less travel: • Saves miles driven, saves money• Saves impact on family / work life• If undocumented, less risk of

interception• Local provider is more likely known

and trusted• Right time, right place and right

care• Fewer visits to specialist (saves

money)

Doing More for Providers

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• Free CME credit• Community of practice • Mentoring and learning together • Personally engaging – fun social

network• New skills/opportunities can

contribute to job advancement• Specialists on speed dial – for

quick consult when needed


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Doing More for the Community Clinics and Community

• Clinician satisfaction and engagement increases

• Clinicians less isolated, less likely to leave

• Health dollars spent in community

• Reduced disparities

• Reduced impact on workforce, days missed, etc.

• Ability to provide specialty care in small town attracts businesses, doctors, etc.

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Doing More for the System (Payers)

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• Increase access • Improve quality• Reduce cost: reduced waste, less

travel, fewer visits, fewer unnecessary tests

• Higher patient functioning reduces Medicaid/Medicare and disability payments

• Improved prevention, health and outcomes reduces downstream interventions


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Outcomes

These ECHO learning loops result in improved knowledge, skills and self‐efficacy among participating providers (Scott, Unruh, Catlin, Merrill .. .)

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MN Project ECHO Hubs and Teams

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Hennepin Healthcare Opioid and Addiction Care • Brian Grahan, MD, PhD, Project ECHO Lead• Roxanne Kibben, LADC, Project ECHO Coordinator• Cameron Weaver, PhD, Psychologist• Nate Erickson, LADC, Addiction Counselor• Gavin Bart, MD, PhD, Chief Addiction Medicine

Little Falls Saint Gabriel’s • Kurt Devine, MD, Family Medicine• Heather Bell, MD, Family Medicine and Prenatal

Wayside Recovery Center• Jessie Everts, Project ECHO Lead• Rebecca Buller, Project ECHO Coordinator


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Nate’s Experience as LADC on Team

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Participating Health Centers

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15 ECHO Sessions From 3/22 – 10/25/18

# for ECHO

Participants Enrolled 200

Health Centers 60

Counties 13

Sessions 15

Average Attendance 23

Total Attendance Overall

107


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Participation by Credential Type

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Fish Pond of ECHO Participation

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241 Contact Hours = Continuing Medical Education


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Medication Assisted Tx – Clinician Bias

BUP is Not a Stand Alone Intervention


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Challenge to Skeptics

Benefits from Project ECHO


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Review: What are the Take‐Aways?

1. What are two risks involved with CoD who use opioids?

2. What are three benefits of Project ECHO

3. Who is Project ECHO different than a webinar/tele‐medicine?

Discussion and Next Steps

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• Website: http://hennepinhealthcare.org/ECHO

• Email:[email protected] [email protected]

• Phone: 612) 873-3060

Are you part of ECHO? Join today:

Every Thu 12:15 – 1:15 pmVia Zoom on PC or Mobile Device

Thank You for Attending!

Happy Halloween!

2018 marrch rk · 10/31/2018 marrch fall conference presentation 4 risks involved (co-od and opioid...

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