Project Office-Based Opioid Treatment (OBOT) in North Carolina is a program developed by the North Carolina Medical Society Foundation. The Foundation’s overall mission is to improve and increase access to care for all North Carolinians.
Opioid Addiction is a treatable disease but it requires significant care coordination and collaboration among providers and care resources. Providers given proper training and surrounded with professionals to share in their patients treatment strategy can successfully treat those suffering Opioid Use Disorder (OUD). With the formation of Project OBOT, the NCMSF has established a coalition of organizations including: NC Association of Local Health Directors, LabCorp, The Recovery Platform, UNC School of Public Health, Project Echo, and MAHEC to facilitate the expansion of Medication Assisted Treatment (MAT).
It is understood that the patient’s medical home is the Primary Care Physician (PCP) ; therefore, by assisting the PCP to become MAT certified, and removing their obstacles of treating OUD patients, we possess the most comprehensive solution to fighting this epidemic. Likewise, pain management doctors must also accept the role of caring for both the abusers of illicitly obtained Opiods and users of physician prescribed Opioids. Through the establishment of research based, data driven pilots , Project OBOT will provide increased patient access by using a care-specific platform for Opioid treatment and recovery.
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Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them and between 8 and 12 percent develop an opioid use disorder. Additionally, an estimated 4 to 6 percent who misuse prescription opioids transition to heroin.
Daubresse M, Chang H, Yu Y, Viswanathan S, et al. Ambulatory diagnosis and treatment of nonmalignant pain in the United States, 2000 – 2010. Medical Care 2013; 51(10): 870-878.
Less than 3% of practicing, licensed physicians in the state of North Carolina have obtained the necessary certification to provide Medication Assisted Treatment (MAT).
Compliance for Physicians and Mid-Levels
1. Provide appropriate training,
a network of care team collaborators, and an automation platform with a visual dashboard indicating areas of patient non-compliance.
2. Coordinating care
through collaboration of the patient’s treatment plan by capturing all pertinent information collected by members of the care team, including mental health physicians, lab results, and drug counselors.
3. Utilize mobile technology,
including telemedicine, to increase engagement and access to care, allowing for anonymity and addressing the stigma of being publicly labeled an “addict”.
4. Reduce no-show appointments
by 1) allowing patients to self-schedule their visits 2) enabling access to providers and counselors using telemedicine services on a computer or mobile device.
5. The platform,
delivered with the joint efforts of the Coalition, allows providers to monitor and analyze the PDMP, view automated SAMHSA-compliant workflows, order tests and obtain results directly from LabCorp, and view a reporting dashboard to quickly understand a patient’s progress with treatment.
Increase Patient Access and Privacy
• Decrease barriers to practice MAT for physicians and mid-levels • Increase Patient Engagement in their own Treatment • Increase Patient Retention • Adoption of telemedicine and mobile technology • Decrease Recidivism
Improve Treatment Compliance of the MAT practicing provider
• Deliver a Training process and certifying of providers consistent with SAMHSA guidelines
• Regular review of PDMP system
• Randomized drug screens
Reduce and Contain Cost for MAT Treatment
• Increase Treatment productivity and efficiency
Enhance Quality of Care
• Engage in Communication and Information sharing with Care Team • Provide effective After Care • Develop an Opioid and Buprenorphine Medication Tapering Process • Create Lab ordering Algorithms to assist with Clinical Decisions
Addresses the SDOH
Make available MAT care entry points for:
• Hospitals • Rehab Centers • Public Health Clinics • Drug Courts, Jails, Prisons • Social Services • Schools • Churches • Physician Practices