Telemedicine Addiction Treatment

Introduction

Overview of Opioid Use Disorder in the US

Opioid addiction — or opioid use disorder — is more common than you might think. The latest figures show that 10.3 million Americans misuse opioids and an estimated 2 million meet the criteria for opioid use disorder. Unfortunately, those figures continue to rise, year-on-year. 

The effects of untreated substance misuse are wide-ranging and potentially fatal, including: 

  • Increased tolerance, cravings, and dependence resulting in severe withdrawal symptoms 
  • Health problems such as difficulty sleeping, heart failure, and increased risk of injury
  • Deficits in working memory
  • Onset of psychiatric disorders such as depression and anxiety
  • Miscarriage, stillbirth, and birth defects, including neonatal abstinence syndrome
  • Spread of infectious disease like HIV and hepatitis through needle sharing
  • Chronic unemployment and financial or legal problems

A staggering 128 Americans die every day from opioid overdoses. Even though drug overdose deaths decreased slightly between 2017 and 2018 and medication-assisted treatments have increased, the US still saw 67,367 deaths involving an opioid in 2018. That figure was four times higher than in 1999. A total of 450,000 Americans have died from opioid-related overdoses between 1999 and 2018.

Treatment Gaps and treatment accessibility

Despite opioid use disorder being an epidemic-level public health concern, there are large treatment gaps — now more than ever in the midst of a pandemic. Care is limited where the need is often greatest, and many traditional models of addiction care are neither accessible nor effective. These widening treatment gaps affect patients of all backgrounds and lived experiences.

There is substantial evidence supporting Medication Assisted Treatment (MAT) as the most efficient way to treat opioid addiction. The medications used — which include buprenorphine (Suboxone®, Subutex®), methadone, and extended release naltrexone (Vivitrol®) — have been classified as essential medicines according to the World Health Organization. 

The most effective way to use MAT is in combination with behavioral counseling. 

Evidence shows that MAT:

  • Decreases opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission
  • Increases social functioning and retention in treatment 
  • Improves outcomes for babies when used by opioid-dependent pregnant women

COVID-19 & Virtual Healthcare

Social distancing requirements during the COVID-19 pandemic means that opioid treatment options have become even more restricted. Fortunately, insurance companies as well as regulatory agencies like SAMHSA have loosened restrictions around how patients access medical care, and patients can now obtain a prescription of medication-assisted treatment via telehealth or telemedicine for addiction treatment. 

Telemedicine for addiction treatment offers innovative and user-friendly approaches for the treatment of substance use disorders — such as computerized screening, telephone-based recovery supports, telehealth therapy, virtual appointment reminders, and mobile apps — while still safely treating patients who need medication-assisted treatment. This not only reduces the risk of COVID-19 transmission but also protects vulnerable populations. 

Virtual healthcare provides an opportunity to reach patients who have limited access to these much-needed medical services. Telemedicine features many of the benefits of in-person addiction treatment, allowing a medical provider to monitor patient progress, make medication adjustments, and offer digital therapies. These services may include digital addiction courses, phone-based addiction programs, virtual medicine, and virtual addiction treatment.

Workit began providing medication-assisted treatment in 2017, using telehealth addiction coaching and telehealth addiction counseling to provide holistic care for people with opioid use disorder. We use telehealth to provide an alternative that overcomes barriers, enhances the efficiency of evidence-based recovery using MAT, and reduces the financial burden on the health system.

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The Basics of Telemedicine Addiction Treatment

Purpose of guide

Welcome! We’re excited that you’re here. 

The purpose of this guide is to provide our patients and their loved ones with accurate and reliable information about opioid use disorder, an overview of telemedicine, and how medication-assisted treatment via telehealth is a proven and effective means of treating substance use disorders. 

Our goal is to answer the most frequently asked questions about telehealth for addiction treatment and to reassure our patients and their families that Workit’s model of care is a proven and effective means of treating opioid use disorder with minimal risk and disruption.

If you already have a solid understanding of telemedicine, you can skip to Chapter 2. However, we’d still recommend skimming the key components of Telemedicine 101, at the end of this section, as a useful refresher.

What is telemedicine?

You may think of telemedicine, telehealth, and telecare to be technical terms that all mean the same thing. However, that’s not quite accurate; rather, each term is used to describe a slightly different way of delivering healthcare. 

Telehealth

Telehealth is an umbrella term that refers to the remote delivery of health care services (including monitoring vital signs, remote diagnosis and evaluation, and e-prescriptions), health information services, and health care education. Telehealth, as a broad term, includes the delivery of telecare and telemedicine.

Telecare

Telecare refers to the electronic devices and technologies used to deliver remote healthcare services. 

Telemedicine

The World Health Organization (WHO) defines telemedicine as “healing from a distance.” More broadly, telemedicine facilitates the remote delivery of healthcare services that encompass:

  • Interactive medicine, allowing patients and physicians to communicate virtually in real time

  • The electronic exchange of medical information, such as X-rays or test results, that medical providers can share with other healthcare professionals

  • Remote patient monitoring, which allows healthcare providers to monitor patients’ vital signs (such as heart rate, blood pressure, oxygen saturation, and blood sugar levels) with mobile medical equipment.

Providers can offer a range of medical services via telemedicine that can diagnose, treat, and prevent disease and injuries. According to the WHO, there are four key elements crucial to telemedicine:

  1. Its purpose is to provide clinical support.

  2. It is intended to overcome geographical barriers, connecting users who are not in the same physical location.

  3. It involves the use of various types of information and communication technologies, such as computers, the internet, cell phones, and other mobile electronic devices.

  4. Its goal is to improve health outcomes.

In essence, telehealth overcomes a number of barriers, such as access and cost, and takes advantage of advanced technology to advance the health of individuals and communities.

The evolution of telemedicine

The origins of telemedicine can be traced to the early 1900s in Europe, when a Dutch physician, Willem Einthoven, transferred electrocardiograms over long distances using the telegraph in 1905. Telegraphs were also used to order medical supplies and consultations. Historians say that radio consultations followed from medical centers in Norway, Italy, and France in the 1920s-1940s for patients who were aboard ships at sea or on remote islands. 

In 1948, the first radiologic images were sent via telephone to two medical centers in Pennsylvania. 

By the 1950s, the United States had begun electronic transmission of radiograph images. Canada soon followed suit. In 1959, doctors at the University of Nebraska transferred neurological examinations across campus using a two-way interactive television. By 1960, the Nebraska Psychiatric Unit and Norfolk State Hospital were connected for consultations by closed-circuit television.

In the 1960s, telemedicine expanded on a larger scale throughout the US and Canada, driven by military and space technology industries as well as industries using commercial equipment. By the mid-1960s, formal telemedicine programs were offered in America, via both closed-circuit television and video communication. 

The more recent milestones in telemedicine over the last 50 years were advanced as communication moved from analog to digital, and the associated technologies became more affordable. The introduction of the internet enabled video conferencing, email, and digital transfer of information, as well as the rise of mobile telephones and satellite communication.

Today, the scope of telemedicine has advanced considerably. Web-based applications and multimedia approaches are more readily available. These include digital conferences, teleconsultations, digital video conferencing, and mobile monitoring devices. 

Telemedicine 101

  • Telehealth: An umbrella term used to describe telecare and telemedicine

  • Telemedicine: The delivery of healthcare and exchange of health information remotely and in real-time

  • Types of telemedicine: Patient and physician interaction, the transfer of healthcare information, remote patient monitoring, and healthcare education

  • Telemedicine devices: Telephone, computers, video technology, electronic devices, mobile phones, and mobile healthcare monitoring devices

  • History of telemedicine: Telemedicine has advanced considerably from telegraphs in the early 1900s to video conferencing today

  • What telemedicine is not: Telemedicine is not a technology or separate branch of medicine and does not require any extraordinary technical know-how

 

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How Telemedicine for Addiction Treatment Works

This section describes in a little more detail how telemedicine and telemedicine for addiction treatment works, who can benefit from it, the pros and cons of telemedicine, and why it is an important service for most people, especially those with substance use disorder.

 

How does telemedicine work?

As we discussed earlier, telemedicine is the use of technology to make virtual healthcare more readily accessible (for a refresher, see: What is Telemedicine?). 

Telemedicine is useful for a range of non-urgent health care services and follow-ups, comparable to a visit to your primary care physician. It isn’t appropriate, however, for emergency situations such as broken bones requiring X-rays, heart attacks, major physical traumas, or surgery. 

Telemedicine allows health care providers to assess, diagnose, and treat patients without the need for an in-person visit. During a telemedicine appointment, you might want to discuss with your provider: birth control, psychological and mental health issues, potential infections and viruses, prescription refills, or even ways to communicate with your doctor while you’re away from home. 

Telemedicine allows the patient to use technology to communicate with their health care provider who is in a different location. Technologies used include phone calls, apps, video conferencing, email, and text messaging. 

All you need for telemedicine to work is a reliable internet connection and a phone, smartphone, computer, or tablet.

 

There are two common ways to access telemedicine services:

  1. Virtual interactions: A provider will ask the patient to download or access a piece of remote healthcare software — this could simply be a link to a secure web browser — that allows the patient to identify themselves and then connects them with their health care provider. The patient can then share health information, such as symptoms and their medical history, and the clinician will assess the person and then make treatment recommendations including prescribing a medication,, a referral to another specialist or provider, or a follow-up appointment.
  2. Patient portals: Providers can offer a patient portal service accessed via a web browser or app. This service allows patients to schedule appointments, request repeat prescriptions, email their provider, and view imaging and lab results. 

 

Other types of telemedicine

Telemedicine allows for remote patient monitoring as well as sharing patient information, a process known as “store and forward.” 

Remote monitoring uses mobile devices to monitor and collect data about a patient’s vital signs. These might include blood sugar levels, blood pressure, temperature, heart rate, and oxygen saturation. 

Store and forward allows health care providers to securely share patient information, including test results, patient histories, and X-rays.

Telemedicine is also used for specialist services for certain conditions, such as treating substance use disorders and providing psychological services, including psychotherapy.

 

Telemedicine for addiction treatment

Telemedicine using web-based psychotherapy for substance use disorders is a relatively new but rapidly expanding model of healthcare that is supported by numerous research studies (see section 3: Research in Support of Telemedicine for Addiction Treatment). 

There are many web-based programs available – or telehealth addiction courses — but some are limited in personalized treatment, the stages of substance use disorder addressed, recovery options and approaches, use of medication, specialist experience of health care providers, and aftercare. 

An effective model of telehealth for addiction treatment is one that is evidence-based and delivered by expertly trained providers with substantial experience with treating substance use disorders. Reliable counselors will have received training in empirically based counseling modalities, including motivational interviewing and trauma-informed care.

Counselors should be available to provide personalized, trauma-informed psychotherapy to individuals in varying stages of opioid use disorder. In addition to an online curriculum, support throughout the program could include real-time communication through text messaging, video calls, or phone calls — an approach found to be generally beneficial for web-based psychosocial treatments.

An effective addiction to web-based psychotherapy is the use of medication-assisted treatment, which is endorsed by SAMHSA for treatment for opioid use disorders.

 

Who can benefit from telemedicine?

Anyone who can access a phone or internet connection can benefit from the convenience of telemedicine. It is especially beneficial to those in remote locations, those who have time constraints or can’t leave work, or those who are home-bound. Patients with substance use disorder may feel less stigma accessing services from the privacy of their own home than when visiting an addiction treatment center. 

 

Why telemedicine is important

Telemedicine is important because it improves access to quality healthcare and allows patients to take care of their health care problems without having to wait for an in-person appointment. It allows patients to communicate with their doctors in real time rather than try to cover all their concerns during an often-rushed appointment. 

Telemedicine is especially important during the pandemic as access to in-patient services are reduced and the risk of transmission, or contracting COVID-19, is increased while sitting in waiting rooms. Additionally, as we’ve set out in the benefits (below), telemedicine allows people to access care more efficiently because they don’t have to worry about missing work or arranging childcare. 

 

Basic principles and guidelines of telemedicine

In 2009, the World Medical Association set out guiding principles for the use of telemedicine. These include: 

  • Duty of care: The provider must give clear direction as to who has ongoing responsibility for the patient’s care and follow-ups.
  • Communication with patients: Providers are responsible for ensuring quality communication during the telemedicine encounter.
  • Standards of practice/quality of clinical care: The provider must be satisfied with the standard of care provided during a telehealth appointment is reasonable. If it fails to meet that standard, then the provider should invite the patient for an in-person appointment.
  • Clinical outcomes: Physicians should strive to provide the best possible outcomes and quality of care
  • Patient confidentiality: Patient information should be protected and kept confidentially in accordance with relevant legislation and governing bodies.
  • Informed consent: Relevant legislation and regulations relating to patient decision-making and consent should be applied before health care services, if possible.

How to get the most out of telemedicine

Check coverage with insurer

Ensure devices work before the appointment

Download software

Have a trial run with equipment and software

Make a list of things to discuss with your provider

The most effective way to use telemedicine is to be prepared. Here is a short checklist to make sure you get the most out of your telemedicine service:

  • Call your insurer and check if telemedicine is covered before booking an appointment.
  • Check mobile/computer devices ahead of time to ensure they work and check the bandwidth of your Wi-fi signal for video. Try video calling a friend to ensure the picture is clear and there isn’t a delay in communicating. If there is, consider calling your internet provider and upgrading your bandwidth.
  • Download the software or access the web browser at least a day before your appointment so you have time to call and receive technical support if something isn’t working properly.
  • Visit the patient portal and learn how it works before your appointment. If possible, schedule a trial run. Find out how you can reach the doctor’s office in case you experience technical difficulties on the day of the appointment.
  • Make a list of symptoms, questions, and anything else you want to discuss before the appointment.

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The Effectiveness of Telemedicine for Addiction Treatment

There is a body of evidence that supports the effectiveness of medication-assisted treatment (MAT), and evidence is emerging to support the use of telemedicine to deliver that treatment. This section briefly explores the research, lists pros and cons of this method of delivery, and compares telemedicine for addiction treatment to inpatient care. 

 

Research in support of MAT

The goal of medication-assisted treatment is to lead a person to a full recovery, including the ability to live a self-directed life. There are numerous studies to support the effectiveness of MAT. According to SAMHSA, this treatment approach:

  • Improves patient survival
  • Increases retention in treatment
  • Decreases illicit opioid use and other criminal activities among people with substance use disorders
  • Increases patients’ ability to gain and maintain employment
  • Improves birth outcomes among pregnant women with substance use disorders

Research shows that MAT is a far more successful treatment of opioid use disorder (than alternatives) resulting in less likelihood of overdoses

 

Telemedicine for addiction treatment

Telemedicine using web-based psychotherapy for substance use disorders is an innovative approach for treating addiction. While relatively new, telemedicine is a rapidly expanding model of healthcare that is supported by numerous research studies.

Research shows that the use of telemedicine technologies — texting, videoconferencing, mobile apps, web-based supports, telephone supports, and the use of virtual interaction — demonstrated superior outcomes compared to traditional care

However, there are limitations to telemedicine for addiction treatment. The majority of platforms don’t focus on the goal of the individual, which may fall within a range of harm reduction goals from abstinence to moderation. Instead, they focus only on abstinence when evidence shows, unequivocally, that medication-assisted treatment is a successful pathway of recovery for opioid use disorder. It’s this lack of personalization that makes telemedicine for addiction treatment limited in potential. 

In contrast, Workit Health delivers personalized psychotherapy to individuals in varying stages of opioid use disorder. We know that psychotherapy is a generally effective addition to MAT, especially if the approaches are tailored and flexible. In addition to the online curriculum, Workit counselors provide real-time support through text messaging, video calls, or phone calls. Our counselors are thoroughly trained in evidence-based counseling modalities.

 

Workit learnings and results

At Workit Health, we strive to measure outcomes to ensure safety for medication users and improve the quality of our program. Our most recent study demonstrated improved clinical outcomes over traditional care models. 

We found that Workit provides these benefits:

  1. It reaches a diverse population across a variety of ages, genders, geographic locations, and socioeconomic backgrounds.
  2. Patients quickly reduce the use of their substance of choice.
  3. Patients are more likely to remain in our program because Workit overcomes many barriers to care.
  4. Workit’s harm reduction model leads to a higher rate of truthful self-reports of use.
  5. Workit members rarely leave our offering for other providers of methods of care.
  6. Workit members report an improvement in quality of life.

Pros and cons of telemedicine

Telemedicine can benefit those who are seeking recovery-related support, because it lends itself to the level of support needed in early recovery. The main benefits of telemedicine are improvements in accessibility and a reduction in the amount of time needed to access care. 

We’ve summarized the main pros and cons of telemedicine as follows:

The Pros and Cons of Telemedicine

Telemedicine can benefit those who are seeking recovery-related support, because it lends itself to the level of support needed in early recovery. The main benefits of telemedicine are improvements in accessibility and a reduction in the amount of time needed to access care. 

PROS

  • Increases access to addiction treatment options
  • Promotes the practice of social distancing
  • Improves the quality and frequency of care
  • Real-time support reduces the risk of relapse
  • Telemedicine can reduce the need to visit the ER
  • Avoid germs in waiting rooms or spreading a virus
  • Reduce waiting times 
  • Patients can see providers in the comfort of their own home
  • Save money on transportation 
  • Spend less time traveling and away from work
  • No childcare constraints
  • Less stress trying to juggle priorities

CONS

  • Some insurers don’t cover telemedicine
  • Uncertain how much of the visit is covered
  • Telemedicine laws vary from state to state
  • It can be difficult to adapt to virtual meetings
  • Security risks with electronic transfer of patient information
  • IT challenges
  • Cost of technology

Telemedicine vs. in-person addiction treatment

As the rate of opioid use disorder has risen fourfold since 1999 and deaths from opioids continue to rise, there is a drastic need for more innovative approaches to treatment. Where MAT treatment was once limited by geographic location and economic barriers, the Covid-19 pandemic has improved access to lifesaving treatment, even though in-person addiction treatment is currently restricted. This is thanks to the innovations in telemedicine and regulatory changes. 

Medication-assisted treatment is now more available because of the pandemic, and more providers are moving to telemedicine. Federal regulations that previously required patients to see a provider in person before being admitted to an opioid treatment program have been lifted, meaning telehealth can now be used to prescribe MAT. You can now see an available, licensed provider no matter where you are. 

Studies assessing the clinical impacts of addiction treatment via telemedicine found that telemedicine could be associated with: 

  • Improved treatment retention compared with in-person treatment
  • Increased access to MAT medicines
  • Patients staying in treatment and engaging in therapy 
  • Improved physical and mental health
  • Reduced drug use, hospitalizations, and mortality

 

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The Workit Health’s Model of Telemedicine for Addiction Treatment

Workit Health began providing MAT in 2017, using telemedicine, coaching, and counseling to provide holistic care for those with opioid use disorder. Since launching in Michigan, Workit has expanded to California, New Jersey, and Alaska, with plans to expand into more states next year. Workit Health’s online therapy program (without medication) is available in all fifty states. 

Workit uses a range of technologies for our telemedicine program that we know (see evidence in section 3) helps to overcome barriers to care. Our digital platform allows us to provide addiction services to patients who may live hundreds of miles from addiction providers. We are able to reach a greater number of patients with our evidence-based program who would otherwise be without care.

Clinical overview

Our unique addiction treatment program uses telemedicine to deliver a range of web-based solutions for opioid use disorder, including individual and group-based psychotherapy delivered by a licenced coach or counselor. Patients in our MAT program also receive medical care. 

Psychotherapy, in addition to MAT, is a highly successful approach to treat opioid use disorder. Our online group sessions are guided by a social worker in order to facilitate community and recovery. This approach is endorsed by SAMHSA. 

SAMHSA recommends group therapy for substance use as a means of creating a supportive environment, reducing isolation, facilitating the exchange of feedback, and highlighting positive examples of recovery. Group therapy can also meet the preferences of individuals who find it to be more effective and comfortable.

The Workit Difference: Designing a Better Solution 

The Workit Health model is made up of six modules based on the following evidence-based practices for substance use.

Mission

Solution-focused therapy, motivational enhancement therapy

Body

Holistic harm reduction, psychoeducation

Mind

Cognitive behavioral therapy, relapse prevention

Heart

Supportive-expressive therapy, dialectical behavioral therapy

Spirit

Acceptance & commitment therapy, mindfulness-based therapy, narrative therapy, existential therapy

Community

Family systems therapy, assertiveness training, 12-step facilitation

How it works

We’ve broken down the key steps to our program as follows:

  • Consultation: To begin teleMAT, all patients must attend a virtual appointment. While we have clinics in Ann Arbor, MI; Lafayette, CA; Bakersfield, CA; and Trenton, NJ, all visits are virtual during the pandemic. 
  • Receive prescription: Workit Health providers typically prescribe buprenorphine-naloxone, which decreases withdrawal symptoms or cravings and ideally eliminates use of illicit opioids. Patients can expect to be sent home with their initial dose. 
  • Follow-up visits: Patients are seen by a nurse practitioner, physician assistant, or medical doctor on a weekly basis for the first 4-6 weeks of treatment before transitioning to monthly appointments. When providers are confident patients are maintained on the medication, they can be transitioned to bimonthly appointments. 
  • Regular testing: Prior to each provider appointment, patients are required to conduct a presumptive drug test in the Workit platform. These tests are performed on our telemedicine platform with a 10-panel urinalysis or oral swab test provided to them at their initial in-person appointment or through the mail. This process is monitored by a medical assistant or social worker and is an additional moment of intervention in which the Workit staff member can check in with the patient.
  • Therapy: You can expect to take part in regular therapy offerings of your choosing. Some members choose to attend weekly online recovery groups led by a licenced counselor, or receive one-to-one counseling sessions with a therapist. A monthly individual or group session is required in order to bill insurance.

 

How the experts describe telemedicine services

Telemedicine for addiction treatment is supported by many experts in the addiction treatment field as a revolutionary practice that removes barriers to care and increases patient engagement as they are more relaxed in their home environment. Here is what the experts say:

“The use of telemedicine to reach patients with OUD is as revolutionary as the approval of buprenorphine in 2002. Now, we are easily able to reach patients who are unable to make it to traditional bricks and mortar medical facilities for a variety of reasons: lack of transportation, mobility issues, child care, distance from a licensed provider, and paralyzing anxiety, to name a few. It is enormously gratifying as a medical provider to have the ability to bring state-of-the-art medicine to suffering patients in the comfort of their own homes. I am convinced that telemedicine treatment of OUD will save countless lives.” 

Dr. Kevin Armington, MD

“Telemedicine breaks down barriers to care in so many ways. There’s the obvious fact that it’s very convenient for our clients — they don’t have to take time off work for appointments, or look for a babysitter, or worry about finding transportation. It lets people continue with their daily lives and still receive high-quality care. There are some more subtle benefits — I find that people are more relaxed when they meet with me via telemedicine. They’re in their own space where they are comfortable. It de-medicalizes the encounter and lets people be themselves and open up.” 

Dorothy Moore, FNP and Assistant Professor of Nursing at San Jose State University

 

Success stories

Our innovative approach of telemedicine for addiction treatment not only reaches a diverse population by reducing barriers to care thus increasing retention rates, but also enables our members to report an improvement in their quality of life — so much so that Workit participants rarely leave our offerings for other providers or methods of care. 

Don’t just take our word for it, though — read what our patients have to say about our telemedicine addiction program, virtual addiction coaches, and digital addiction medicine. 

 

Flexibility and convenience of the program

“For me, in my experience I feel that Workit is an AMAZING program. I only wish I found it sooner. It’s very private, easy to use, and the team is always quick to contact.”

“Workit has changed my life in so many ways! I was trapped in the cycle of addiction and inpatient rehab wasn’t an option for me because I have a family to support. I needed treatment that would flow with my life, not uproot my life.”

“This has helped me greatly. Sometimes it’s as simple as someone not being able to get to their doctor/therapist/drug test/recovery coach several times a week. This app/clinic has enabled lots of people that want help to get it.”

“I’m happy to report that I no longer consider myself addicted — I kicked the unhealthy habit! I’m sure this wouldn’t have happened without an online program like Workit: I’m too mortified to go to in-person help, and it wouldn’t have been convenient either. This is a perfect, self-paced way to get myself healthy.”

“Being able to message counselors anytime I need to. Really be able to reach out anytime with any concerns. Also being able to go with my work schedule has really been a lifesaver (possibly literally.)”

 

When other programs didn’t work

“Great program. I struggled with opiate use for years. I’ve been to several Suboxone doctors, but it was with this program I was able to get clean. I highly recommend it. I received the kindest and most understanding care with Workit. I’ve had two doctors refuse to treat/help me in the past. I’m happy to report that Workit never gave up on me and I now have two years drug free! The app is great: works well and you can access anything in the program via the app. No complaints!” — Mandy, July 2020

“Better than any other recovery program out there. If this is available to you, consider yourself very lucky. I do. Thank you.”

“Workit is AMAZING I have been in the program for a couple of years successfully where I have failed in prior rehab attempts. It’s very easy if time is an issue for you like myself. You get great coaches and I just adore my doctor. Everyone has been so helpful and kind. I HIGHLY RECOMMEND Workit and have referred a few friends who are doing well also.”

 

The use of MAT and manageability of the program

“I have nothing but gratitude for everything that Workit has done for me. Specifically, the access to buprenorphine has allowed me to leave behind the aspect of myself that was dependent on painkillers. My life, as a whole, has been much more manageable since starting with Workit. I deeply appreciate everything the program has done for me. Because the courses are done on one’s own time, rather than forced physical meetings, etc., I’ve been able to heal from my own deep addiction at my own pace, on my own time, on my own terms. This was probably the only way for me to become clean, and I’m grateful to you all.” 

“This is a great program for me! I have tried so many other ways to conquer my 10-year opioid dependence, and all the hassle that comes with it, to no avail! I feel great on this med plus the team of coaches, doctors and administrators are here for me when I need them. I feel like they care and that is something you don’t see every day! I have more time to do positive and constructive things with my day now! Very happy with this program.”

 

Ease of use

“Wow! What an awesome source for help! This app/clinic has been the best medical help I’ve ever received. They’re so personable and truly care about your sobriety. It’s a very easy app to use and very helpful in recovery! I recommend this EVERYONE who needs help with addiction. It’s the best!”

“I love how easy and simple the program is. I love how my doctor keeps it real and wants to see me do better. Overall this has been an amazing experience so far.”

 

Personalized program

“When you’re at hospitals you’re treated almost like an object where you talk and people hear the sound but don’t listen to what you say or even care because the staff is overworked and sees so many people. You’re just another number they want to get in and out. Workit is so much different — it’s convenient, personal, and just better all around. These people are doing a great job.”

 

Improvements to the quality of life

“Moving through the Workit program has been a truly amazing experience. It has helped shape me into the happy, healthy, clean and sober person that I am today. I continue to grow every day and Workit is helping to guide me along in my journey.”

“Workit Health is by far the best program for substance abuse treatment I’ve ever experienced. The program is extremely helpful, and I am doing so well in my recovery. I couldn’t ask for a better program and would suggest it to anyone suffering with addiction.“

You can read more testimonials and reviews of Workit Health here

Section 5: Cost and Insurance Coverage of Telemedicine for Addiction Treatment

Overview

While we try to make this process as straightforward as possible, we’ve taken the opportunity to explain a few more details about the cost of the Workit Health program and details about insurance coverage.

Workit Health coordinates with large, self-insured employers to offer our program as a direct benefit to employees and their dependents. Telemedicine addiction care works well for both employees and employers. 

For employees, it provides discreet and evidence-based support from the privacy of home. Although the program is covered by the employer, the employer only receives anonymized data so they will never know who in the workplace is receiving help. 

For employers, Workit Health can act as an alternative to high-cost inpatient programs, which often don’t utilize the latest methods in their treatment. Workit’s harm reduction focus allows everyone to focus on positive change, including those who might not consider themselves to have a problem with substances but would like to cut back. Workit can partner with insurance partners or employers the same way an employee assistance program (EAP) does, but we’ve found that our members are much more engaged and employees are more comfortable reaching out to a modern digital program for support than calling their employer’s EAP hotline. 

Workit can act as a stand-alone solution billed directly to the employer, or act as an add-on benefit through an insurance company we are contracted with.

Insurance Coverage

The Workit Health model is made up of six modules based on the following evidence-based practices for substance use.

We accept:

  • Medicaid including Meridian, Blue Cross Complete, and McLaren.
  • Commercial plans including Aetna, McLaren, and Priority Health.
  • Original Medicare and some Medicare Advantage plans.

In all states, self-pay program is available at a flat rate.

We accept:

  • Horizon NJ Health Medicaid.
  • Commercial plans including Aetna and Horizon BCBS.
  • Original Medicare and Aetna and Horizon BCBS Medicare Advantage plans.

In all states, self-pay program is available at a flat rate.

We accept Premera.

In all states, self-pay program is available at a flat rate.

We accept:

  • Commercial Premera.
  • Original Medicare.

In all states, self-pay program is available at a flat rate.

We accept:

  • Commercial Aetna and Original Medicare.
  • Blue Cross Blue Shield of California coverage coming soon!

In all states, self-pay program is available at a flat rate.

FAQs about Insurance & Coverage

At Workit Health, we verify insurance coverage before beginning treatment. If you’re ever unsure of coverage you can reach out to your insurance company directly. Many insurance providers are currently waiving copays and fees for telemedicine visits due to COVID-19. However, even if you are out-of-network or not covered, we have affordable out-of-pocket fees for our care. Give us a call at 855-659-7734, select option 1, and our care navigators can confirm insurance coverage and relay self-pay pricing when necessary.

If you are paying out of pocket for services, you should reach out to the billing department of your care provider to understand your bill and what you may owe. If you are using your insurance, contacting your insurance company is a good place to start in order to understand what you may owe. As a provider, we can assist you in understanding your bill, but your agreement with your insurance company ultimately determines what you will be financially responsible for.

Ensuring that we have a copy of your insurance card will help the process!

Our coverage varies by state and type of program. 

  • Michigan
    • Medicaid including Meridian, Blue Cross Complete, and McLaren
    • Commercial plans including Aetna, McLaren, and Priority Health
    • Original Medicare and some Medicare Advantage plans
  • New Jersey
    • Horizon NJ Health Medicaid
    • Commercial plans including Aetna and Horizon BCBS
    • Original Medicare and Aetna and Horizon BCBS Medicare Advantage plans
  • California
    • Commercial Aetna and Original Medicare.
    • Blue Cross Blue Shield of California coming soon!
  • Alaska
    • Premera/Lifewise and Original Medicare
  • Washington
    • Premera/Lifewise

For members with PPO insurance, Workit Health can help you receive reimbursement as we’re an out of network provider. You would pay a flat fee for your care up front, and then submit a receipt with insurance billing codes through your insurance for reimbursement. If you’re not sure that your insurance is a PPO or would reimburse you for out-of-network care, give the number on the back of your insurance card a call and they should verify.

HIPAA

Health Insurance Portability and Accountability Act (HIPAA) is legislation in the United States that was enacted in 1996 to protect the privacy and security of medical information. It specifies how providers protect the confidential health information of patients. 

The security of your data is important to us at Workit Health. We adhere to HIPAA guidelines to ensure that our digital services keep your data safe and secure at all times. Our delivery of telemedicine for addiction treatment ensures safety by using only secure digital connections, keeping patient data behind password protected screens that can only be accessed by trained medical personnel, and by using end-to-end encryption (for those wanting more specific IT information, that means: data is stored at rest using an AES-256 algorithm, and encrypted in transit using SSL). You can be assured that any data reported to an employer is anonymised and they will not be provided direct information about your progress in the Workit Program and they will never know which employee received help. We will destroy your data after 6 years.

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Telemedicine Glossary

Application Programming Interface — an API is software that allows applications to communicate about records and facilitate other practice management.

Application Service Provider — an ASP hosts applications on a central server. This allows customers to access information securely without needing to purchase software.

A phone call between two or more people.

A way of verifying the identity of the person using (sending or receiving) information related to telemedicine.

A measure of the capacity of a communications channel.

A type of communication allowing information to flow over various frequencies.

Computer-based patient record.

Employee Assistance Program

The process of securing data which can only be retrieved by a person carrying a passcode or encryption key.

Equipment (software and hardware) that prevents malicious attacks and unauthorized communication on computers and networks.

Information & Communication Technologies

Health Insurance Portability & Accountability Act

Medication-assisted treatment

The hardware that provides the ability for digital equipment to communicate via networks.

Substance Abuse & Mental Health Services Administration

The delivery of healthcare and exchange of health information remotely & in real-time

An umbrella term used to describe telecare & telemedicine

The electronic devices & technologies used to deliver remote healthcare services.

A technology that allows digital devices (computers, laptops, smartphones, printers) to interface with the internet.

References

  1. SAMHSA: The National Survey on Drug Use and Health (2018). Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/Assistant-Secretary-nsduh2018_presentation.pdf
  2. CDC: Opioid Overdose. Understanding the Epidemic (March 2020)
  3.  National Institute on Drug Abuse: Effective Treatments for Opioid Addiction
  4. World Health Organization. Proposal for the inclusion of methadone in the WHO models list of essential medicines (2005)
  5. P Mattick et al. Cochrane Database of Systematic Reviews (2009)
  6.  RP Mattick et al. Cochrane Database of Systematic Reviews (2014)
  7. Schwartz et al. Am J Public Health (2013) 
  8. WHO: Telemedicine, Opportunities and Developments in Member States — Report on the second global survey on eHealth (2010)
  9. Ryu S. (2010). History of Telemedicine: Evolution, Context, and Transformation. Healthcare Informatics Research, 16(1), 65–66. https://doi.org/10.4258/hir.2010.16.1.65
  10. Craig J, Patterson V. Introduction to the practice of telemedicine. J Telemed Telecare. 2005;11(1):3-9. doi:10.1177/1357633X0501100102
  11. Currell R et al. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews, 2000, Issue 2. Art. No.: CD002098.
  12. SAMHSA: Medication and Counseling Treatment, MAT Effectiveness (April 2020)
  13. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy. Medication-Assisted Treatment for Opioid Use Disorder: Proceedings of a Workshop—in Brief. Washington (DC): National Academies Press (US); 2018 Nov 30. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534504/ doi: 10.17226/25322
  14. Molfenter, T., Brown, R., O’Neill, A., Kopetsky, E., & Toy, A. (2018). Use of Telemedicine in Addiction Treatment: Current Practices and Organizational Implementation Characteristics. International journal of telemedicine and applications, 2018, 3932643. https://doi.org/10.1155/2018/3932643
  15. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy. Medication-Assisted Treatment for Opioid Use Disorder: Proceedings of a Workshop—in Brief. Washington (DC): National Academies Press (US); 2018 Nov 30. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534504/ doi: 10.17226/25322
  16. SAMHSA: FAQs Provision of methadone and buprenorphine for the treatment of OUD in the COVID-19 emergency (April, 2020). Retrieved from: https://www.samhsa.gov/sites/default/files/faqs-for-oud-prescribing-and-dispensing.pdf
  17. Lin, L., Casteel, D., Shigekawa, E., Weyrich, M, Roby, D., & McMenamin, S. (2019). Telemedicine-delivered treatment interventions for substance use disorders: A systematic review. Journal of Substance Abuse Treatment, 101: 38-49. doi.org/10.1016/j.sat.2019.03.007
  18. Yang YT, Weintraub E, Haffajee RL. Telemedicine’s Role in Addressing the Opioid Epidemic. Mayo Clin Proc. 2018;93(9):1177-1180. doi:10.1016/j.mayocp.2018.07.001

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