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Medication Assisted Treatment Community of Practice
Delivering MAT Through a Team-Based Approach
Presentation and Discussion
October 19, 2017
WELCOME
BDAS Commitment
Integrating MAT into Primary Care
Foundation for Healthy Communities
Bi-State Primary Care Association
SAMHSA MAT-PDOA Grant
Sta
te-F
un
de
d
MA
T P
rov
ide
rs
What is the purpose of the MAT CoP?
To promote and support the successful
implementation of an integrated MAT
approach in healthcare settings.
INTRODUCTIONS
Why are you invested in
offering Medication Assisted
Treatment?
Who is in the room?
What are Communities of Practice (CoP)?
• Groups of people who share a common interest in
something they do and learn how to do it better as
they interact regularly. (Lave & Wenger).
• CoPs are created with the goal of gaining and
sharing knowledge, information and experiences
related to a specific topic.
What is the purpose of the MAT CoP?
To promote and support the successful
implementation of an integrated MAT
approach in healthcare settings.
Benefits & Opportunities of the MAT CoP
Resources & Tools
All resources and other materials will be posted on the
NH Center for Excellence website.
http://nhcenterforexcellence.org/resources/community-of-
practice-resources/
Email-Based MAT Discussion Group
Email-based platform
allowing participants of
the MAT CoP to READ
and POST questions and comments.
Technical Assistance
TA specific to medication assisted treatment
may be requested.
http://nhcenterforexcellence.org/center-services/request-ta/
Medication Assisted Treatment
TEAM-BASED CARE
Suzette Barbour, RN Owen Murray, LMFT
Mt. Ascutney Hospital
assisting Connecticut Valley Recovery Services
Office Based Opioid Treatment
MAT TEAM-BASED CARE
Outline
1a Care Model: Objectives and Methodology
1b Care Model: Patient Care Flow
1c Care Model: Care Coordination
1d Care Model: Team-Based Care
2 Case study discussion of team-based care
OBOT MAT Care Model
Objectives and Methodology What: Broad MAT: Abstinence & improved biopsychosocial
functioning
Narrow MAT: Harm-reduction with naltrexone
How: Buprenorphine is prescribed visit-to-visit regardless of visit type
When: Initial Treatment: Twice weekly visits + random call backs
Why: • Much of MAT care is behavioral so session content overlaps
professional disciplines.
• Consensus care decisions and multiple provider contacts provide
multiple perspective and reinforcement.
• Some patients may misuse buprenorphine and/or try to split the
team.
OBOT MAT
Patient Care Flow • Intake
‣ Phone screen, records review and PMP check before intake
‣ Behavioral heath assessment, then MD assessment
• Treatment
‣ Weekly group sessions + weekly MD/therapy/case management sessions.
‣ Reduce/increase treatment frequency or refer to higher level of care as indicated by outcomes.
• Late/Post Treatment
‣ Stable patients provide input on indefinite maintenance or taper. Consider switch to naltrexone after partial agonist TX.
‣ Unstable patients referred to higher level of care.
Ca
re C
oo
rdin
atio
n
MD Prescriber
Nurse/Case Manager
Therapist/ Case
Manager
MAT Care Transitions:
High Risk OB-MAT
IOP
Residential Rehabilitation
Daily Dosing/Methadone
OTP
Housing & Commun-ity Action
Dentistry
Primary Care
Division of Family
Assistance
Child Protective Services
Probation and Parole
Peer Recovery
Employ-ment
Services
Specialty Care
Psychiatry Psycho-therapy
OBOT MAT
Team-Based Care Model
Hallway
Team Meeting
EMR
MD
Assess/Diagnose
Prescribe/Treat
Care Coordination
Panel Management
Therapist/Case Manager
Group/Individual/Family therapy
Care Coordination
Panel Management
Medical Assistant/Urine
Collector
Receptionist
Nurse/Case Manager
Medical Nursing
Administer naltrexone XR
Care Coordination
Panel Management
Case Study Discussion
OBOT MAT Team-Based Care
Suggested Topics to Ponder:
How might you respond to the situation?
How do you coordinate within the team or with collaborators?
Who coordinates externally and how?
Are there changes you hope to make to care coordination?
Case study 1: Intake Phase. Transfer from an MAT
provider without access to team support
Case study 2: Early Treatment. Homeless, unemployed, in
pain and newly pregnant
NEXT STEPS
What worked well with this
meeting?
What changes would you like to see
in future meetings of this group?
What topics related to integrating
MAT in health care settings should
be the focus in upcoming CoP
sessions?
Owen Murray, LMFT Suzette Barbour, RN
[email protected] [email protected]
Lindy Keller, MLADC Regina Flynn, BS
[email protected] [email protected]
Rekha Sreedhara, MPH Anna Ghosh, MPH
[email protected] [email protected]
Rebecca Sky, MPH Allison Piersall, BS
