BEGINNING AT THE END

Jacob Levenson

Extending the care continuum for patients battling chronic illnesses has been well-established as best practice for managing illness and predicting potential relapses. A vital part of extending the continuum of care, the provision of structured, long-term extended support, is critical to successful chronic disease management, particularly when initiated during treatment or in the early stages of recovery.

In regard to addiction treatment, with the chronic nature of the disease of addiction and the myriad challenges of early recovery, the propensity for relapse is high. Generally defined as a return to active use, relapse is acknowledged as a frequent manifestation of the disease. Addiction treatment, whether it is residential or out-patient, is an important initial step toward health and healing. Whether treatment is completed in 28 days or longer, due to the high risk for relapse in the first year, effective addiction treatment (the long-term management of the disease), actually begins at the completion of professionally rendered care.

Population health management has begun to make inroads into the field of behavioral health and this movement has resulted in embracing the individual battling addiction in a comprehensive, holistic way. As treatment teams begin to collaborate, individuals who complete addiction treatment are increasingly positioned to receive extended professional care in order to maintain their health and effectively manage their chronic disease. The decisions for this movement toward extending the care continuum is backed by science and treatment providers have begun to be reimbursed by payers for this extended care.

Extending the care continuum is well established in the management of chronic illnesses such as cancer and diabetes, however it is a comparatively new concept in the field of addiction treatment. In one example, the state of Connecticut has led the way in the development and integration of recovery supports as
it relates to behavioral health systems and addiction treatment. The state has noted that recovery has recently emerged as a new organizing paradigm for behavioral healthcare and has begun to invest resources into best practice methodologies for extended support services (including professionals and consumers, e.g., peers) and their effects on short-term and long-term prospects of recovery.

At MAP Health Management, we have recently reported on five years of data collected on individuals who completed addiction treatment and participated in a 12-month extended care program. The science speaks for itself. The propensity for individuals to remain in contact with a post-treatment professional is directly related to their ability to maintain long-term recovery and effectively manage their chronic disease.

Once a novelty, post-treatment recovery support has garnered the respect of the behavioral healthcare and addiction treatment fields. Professionally trained and certified recovery specialists, therapists, and counselors begin to work with their clientele prior to their completion of treatment and the data demonstrates that forming a bond in the transitory phase from treatment to short-term recovery is important.

Sean O’Brien has worked with individuals striving to recover from addiction for close to five years. As Director of Recovery Support Services at MAP, Sean has been through many scenarios’ with individuals as they transition from treatment to early recovery to long-term recovery. Sean has witnessed the relapse of clients and one-time use events and helped guide them back to health. Once homeless and addicted to heroin, Sean has the lived experience that many of clients are facing. However, we are beginning to discover that extended support can also be delivered by trained counselors and therapists who understand the disease and its many manifestations.

Treatment providers, once limited by state regulations to the amount of contact and communication they could have with clients following completion of treatment, have begun to employ technology in order to extend the care continuum and effectively reach across state lines. Telehealth and software platforms enable providers and recovery professionals to maintain a connection following treatment which provides the ability to collect critical outcomes data. Sean O’Brien has seen the effect of this data collection and by using predictive analytics has experienced, first-hand, that relapse or a return to active addiction can be accurately predicted and in many cases, prevented.
According to Sean:

“The work we do is simple, but the results we achieve are astounding. Through telehealth, I’ve worked with clients throughout the U.S. and in New Zealand, Hong Kong, Canada and Europe. One of my first clients was a man who lived in Alaska. Due to his remote location he had very limited resources, the only support meeting within 500 miles was held once a week which isn’t enough for someone in early recovery. We communicated every two or three days. He was isolated, but by leveraging technology we successfully stayed in close contact with him and offered him course correction when he needed it. He didn’t want to use again, most of us don’t, but not wanting to isn’t enough. He, like other clients, call from time-to-time thanking me for the support and letting me know how well they are doing. Telehealth fills the void and through our technology and outcomes data we know when a relapse is coming weeks and months before they do. We aren’t always successful at preventing a relapse but we have been very successful at maintaining the connection with clients, even when they have returned to active use and that connection is what brings them back. By using this technology, clients are getting well and staying well.”

Extending the care continuum for individuals in recovery who suffer from the chronic disease of addiction has yielded promising results. Sean O’Brien is one example of a professional involved with this type of telehealth-delivered support and there are similarly trained individuals residing and working in every state. The field is on the precipice of providing opportunities to every individual who completes treatment as well as to the many individuals capable of providing extended care.

The fields of behavioral health and addiction treatment are undergoing remarkable change. We are beginning to see certain treatment providers adopt new opportunities and technologies in order to improve their treatment plans which ultimately improves their treatment outcomes which is the collective goal. We all want to improve the treatment outcomes for individuals battling addiction.

The data shows that extending the care continuum for individuals following the completion of treatment significantly improves the likelihood of effectively managing the illness and maintaining long-term recovery. Telehealth is proving to be a successful tool in the ability to maintain connections with individuals striving for long-term recovery, making the transition from early recovery to long-term recovery as smooth as possible.

Effective disease management begins at the end of addiction treatment and results with individuals living healthy, meaningful lives in long-term recovery.

Jacob Levenson founded Austin-based MAP Health Management, LLC in 2011, and has served as Chief Executive Officer since its inception. MAP has established itself as the nation’s leader in the provision of a comprehensive, accessible technology platform specifically developed to improve treatment outcomes for individuals treated for addictions and other behavioral health illnesses. Levenson has hired research analysts, clinical directors, recovery advocates, technology professionals and billing experts all dedicated to improving outcomes, empowering treatment providers with data, reducing costs and driving facility revenue. Levenson is a frequent contributor to leading addiction and population management publications. For more information, visit www.ThisIsMap.com.