DR. BARRY KARLIN, CHAIRMAN AND CEO, CRC HEALTH GROUP
NAADAC CONFERENCE KEYNOTE SPEECH
WEST YELLOWSTONE, MONTANA OCT. 7, 2004
- I am pleased to join the President of NAADAC, Roger A. Curtiss, at your annual conference here at the Sun Spree Resort.
- NAADAC is such an important organization. You are the leaders in this field…everyday, working to make treatment available to those facing addiction.
- What an important and critical theme we have at today’s conference, the role of technology in treatment. Each of you provides treatment in a variety of settings including hospitals, private and public treatment centers, private practice and community-based behavioral health agencies. But given the size of the problem, and the number of people suffering from the disease of addiction, how can we provide services to all those who need it?
II. Size of the Problem
- The dimensions of the drug crisis are grave, a real threat to our society and the economy: Addiction is a serious disease—it is the number one public health issue/threat in the United States today.
- Over 50,000 people die each year from drug-related causes. Of the estimated 19 million people suffering from drug abuse, only 3 million receive treatment. Addiction and drug abuse cost American taxpayers $200 billion dollars annually due to direct and indirect expenses of drugs and alcohol addiction. Chemical dependency is a major disruption to our families, our schools, our industry and the social fabric of our communities.
III. Vision for Tomorrow Section: Role of Technology: Solving the size of the problem, lack of access, convenience, confidentiality, anonymity, individualized care, continuum of care, efficiency, high relapse rate, need for a structured program for a long period of time, historically a cookie cutter approach. How can it help us: training, efficiency, expanding our business, expanding access, keeping client in touch with recovery, make treatment convenient
- The past decade has brought a range of electronic communication tools that promised to improve health care: cell phones, videoconferencing, personal chats, emails….tools that are very familiar to all of us.
- Recent research suggests that the public increasingly wants personalized care delivered through a range of approaches. What this means depends on individual preference and the nature of the problem. For example, a recent Harris poll revealed that 90% of survey respondents would welcome the opportunity to communicate with their doctors by email, with 56% of those surveyed stating that ability to communicate with their doctors electronically would influence their choice of doctors. Perhaps more surprising is that 37% indicated that they would be willing to pay for email access to their doctors. This wish to communicate electronically seems to be driven by public perception that email communication offers the potential for quick and convenient access to healthcare advice that can supplement the traditional face-to-face consultation.
- While these tools are very powerful and worthwhile, how do we expand technologically to overcome the obstacles that hinder millions of chemically dependent Americans from receiving treatment and reclaiming their lives? The obstacles include treatment access, the stigma of addiction, privacy and the cost of treatment.
- The question is how can technology mediate the problems?
- The federal government, for example, has leapt into technology for treatment in a nationwide effort to support information sharing. The Drug Evaluation Network System (sponsored by the ONDCP) identifies and links drug treatment facilities and opportunities nationwide. It is based on four principles: nationally representative sampling, flexible information on patient characteristics, local staff references/clinical reports, and a rapid data transfer protocol. This program posts information to a central information system, making it accessible in "real time" to treatment providers
- Technology will help the drug treatment community save time through the adoption of electronic databases and electronic treatment records. The former will allow providers ease of access to patient records. The latter will reduce the thousands of non-value added hours spent in creating paperwork for third party payers and compliance agencies. The transition to technology, moreover, will facilitate report generation, program assessment and can be of great assistance in programs’ strategic planning efforts.
- Internet access to treatment will allow us to reach people who might otherwise have no access, CRCs website and Resource Center, for example have aided countless people in locating appropriate and affordable treatment. And, I might add, we often refer families in need to other providers more appropriate to their needs and financial circumstances.
- Our eGetgoing program allows chemically dependent people to access treatment services outside traditional centers. All of this, I might add at a cost savings to the client and society as well.
- When a technology-based outpatient modality is not appropriate, technology can still provide value to inpatient clients through aftercare access to meetings and professional support.
- Now science combines with common sense is telling us that convenience and privacy via technology can be big motivators in persuading people to complete extremely helpful treatment programs
IV. CRC’s role in moving this vision forward: Expanding business, access, levels of care, individualized treatment, keep clients in touch etc
- Through our day to day work with our clients, we have come to appreciate the importance of meeting addicts and alcoholics where they are….creating the most appropriate treatment to support them in their life-long struggle against addiction
- Knowing that "one-size" treatment does not fit all, we at CRC launched the country’s first nationally accredited online substance abuse treatment program, using live video stream for counselors and clients
- eGetgoing is revolutionary, and catalyzes the move towards incorporating technology into treatment -- it accommodates addicts’ privacy through anonymity, and is easy to use from home with live video.
- The obvious question is. It may be efficient and glitzy, but does it work?
- Our first full year of operations involved over 600 individuals and more than 15,000 online outpatient sessions. The data indicates an 80% program completion rate compared with 41% reported in SAMHSA’s Treatment Episode Data Set (TEDS). In other words roughly twice the completion rate of traditional outpatient programs.
- Almost all eGetgoing clients rated their Overall Quality of Life Improved following their online treatment program experience measured at 1 week, 3 months, 6 months and 9 months post treatment. In all four quality of life measurements (health, family life, employment, sobriety) the Improved responses were 94% or better.
- Clients state the privacy and convenience of treatment through online technology is were major inducements for completing the full treatment program
- These numbers clearly demonstrate the importance of alternate online help, which adds to but does not replace traditional treatment. This bears repeating: technology mediated treatment is a value addition to traditional treatment rather than a substitute for it.
- Offering a full continuum of care along with comprehensive services, including online treatment, as CRC and eGetgoing are now providing, is a revolutionary contribution to help reduce the treatment gap.
- Incidentally, eGetgoing has won the eHealthcare Leadership Award Gold Medal for best websites, achieving the Gold medal for Best Physician/Clinician-Focused Site.
- The health system cannot remain oblivious to our rapidly changing technological landscape and mindset. Perhaps for the first time in history, we have the tools to create flexible services that meet the needs of the addicted population and health professionals alike, regardless of who or where they are. Embracing the potential of this revolution will require a major paradigm shift.
- We must reach out from the last century and enter this one. I couldn’t survive without my email and my Internet access. Neither can many of our clients, figuratively and literally. It’s our job to be there for them, and to help close the nation’s treatment gap in the process.