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Virtual Care in an Outpatient Subspecialty Substance Use Disorder Treatment Program
Sharon Levy1, Diana Deister, John Fantegrossi
1Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, MA (SL, JF, LG, JL, TM, WR, MS, JS, PS); Division of Developmental Medicine, Boston Children's Hospital, Boston, MA (SL, JF, LG, JL, TM, WR, MS, JS, PS); Department of Pediatrics, Harvard Medical School, Boston, MA (DD, EW); Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA (EW).
Objectives:
This article reports on the experience of an outpatient adolescent substance use disorder treatment program transitioning to virtual care during the COVID-19 pandemic. We describe the processes used to make the transition, including development of a safety protocol for patients seen virtually, present clinical volume data before and after the transition, and we describe a range of patient experiences through 3 clinical vignettes.
Methods:
Using data from the electronic health record, we generated counts of the total number of scheduled and completed appointments between December 2019 and June 2020. We used simple proportions to calculate the completed visit rate.
Results:
Both the absolute number of scheduled appointment and the percent of appointments completed increased with the initiation of virtual care, supporting the acceptability of this modality. Several patients experienced clinical improvements in conjunction with greater engagement, though challenges were also noted.
Conclusions:
Virtual visits are a practical mode of treatment for adolescent substance use disorders, and more evidence is needed to understand the risks and benefits of this treatment modality.
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