Taking addiction care online
For the first time ever, death from an accidental opioid overdose poses a greater risk to Americans than dying in a car crash, with the Centers for Disease Control and Prevention (CDC) reporting that 130 people succumb every day to opioid overdose. Yet, despite the staggering toll the crisis has taken, our health care system is still struggling to respond.
Due to federal regulations, fewer than 7 percent of physicians in the U.S. are able to treat opioid addiction using medication-assisted treatment, an effective method that combines certain medications with counseling and behavioral therapies. Buprenorphine, for example, is proven to reduce the risk of relapse and overdose by nearly half by diminishing the effects of physical dependency on opioids, such as withdrawal symptoms and cravings.
Yet fewer than 30 percent of treatment centers in the U.S. offer buprenorphine. Finding quality care is a confusing process and adds stress for those struggling with opioid use disorder. Many people ready to quit opioids turn to the black market for treatment — in a recent study, 79 percent of people purchasing buprenorphine illegally were taking it therapeutically, and 81 percent said they’d prefer to take medication prescribed by a doctor.
We aren’t only the midst of an opioid crisis. We’re also in the midst of an access crisis.
For these reasons, Robin McIntosh and I founded Workit Health. As people in recovery from addiction ourselves, we grew tired of seeing friends fall through traditional systems of addiction care, largely unchanged since the 1930s. Meanwhile, all around us digital technologies were being developed to treat a myriad of diseases and conditions. You can take your pulse on an app, but finding treatment for addiction requires endless online searches, only to find the nearest behavioral health specialist is hours away.
At Workit Health, our mission is to expand access to gold-standard medication, like buprenorphine, via telehealth. We offer an online program that can be done from anywhere. Take a class and message your counselor while you wait for the kids in the pickup lane at the elementary school. On your lunch break at work, log in and have a video chat with your doctor, then receive your medication e-prescribed to your local pharmacy.
Our process begins with an online assessment. In our research, we found that many of our health plan partners were mismatching their members with expensive, out-of-network care they discovered online. Workit offers brief, expert screenings and referrals to in-network, quality care. This telehealth triage allows for care escalation when necessary and ensures all members of Workit’s digital program receive the right level of care.
Members have access to a counselor 24/7 through Workit’s mobile and web app and work through interactive courses to meet their goals. For community support, members attend online recovery groups facilitated by a counselor. Buprenorphine treatment begins at a single in-person visit and then continues online via videoconference and messaging.
Stringent drug testing requirements act as another barrier to care for those ready to receive medication-assisted treatment. At Workit, the team built an entirely online drug testing system into our digital program, with a focus on ensuring accuracy and limiting diversion. We’ve found this gives members greater autonomy while lowering costs to our partners.
Those without access to transportation, and those living in treatment deserts like rural areas, are especially affected by the current crisis. Workit brings quality addiction care to rural areas, and digital follow-up makes attendance simple for those without transportation. At Workit, care management extends beyond just treating addiction, as counselors act as navigators for housing, employment and other social determinants that influence health and quality of life.
Can a digital program offer the same sort of service as an inpatient treatment program? The outcomes say yes. Over a year-long evaluation, 93 percent of Workit members reached abstinence from opioids after the first month in the program, and 84 percent remained off opioids after 12 months. Digital engagement remains high with members completing an average of three courses a week.
The overdose epidemic has claimed too many of our friends and loved ones. People want simple, accessible addiction treatment that works. It’s finally time to give it to them.
Workit Health is funded in part by BlueCross BlueShield Venture Partners, L.P., a corporate venture fund licensed by the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. The fund invests in promising emerging companies of strategic relevance to Blue Cross and Blue Shield Plans. These companies are bringing creative, cutting-edge solutions to the health care marketplace.
