Framework to Action: Developing and Implementing a Statewide Network to Expand Opioid Treatment Access Using...

Area of Science:

• Public Health
• Health Systems Research
• Implementation Science

Background:

• Opioid use disorder (OUD) treatment access is a major challenge in Texas.
• Underserved populations face significant barriers to effective OUD care.
• The Successful Healthcare Improvement from Translating Evidence in Complex Systems (SHIFT-Evidence) framework offers a structured approach to address these issues.

Purpose of the Study:

• To demonstrate the application of the SHIFT-Evidence framework for developing and implementing a statewide office-based opioid treatment (OBOT) network.
• To improve access to medications for opioid use disorder (MOUD) for underserved populations in Texas.

Main Methods:

• Conducted a needs assessment to identify barriers and facilitators to buprenorphine prescribing.
• Utilized the SHIFT-Evidence framework to guide strategy selection for addressing implementation barriers at multiple healthcare system levels.
• Analyzed data from the Texas Department of State Health Services' Clinical Management for Behavioral Health Services data system to evaluate program reach and client services.

Main Results:

• The SHIFT-Evidence framework facilitated the identification of multilevel barriers (patient, prescriber, organization) and the selection of tailored strategies.
• Successfully developed and expanded an OBOT provider network, increasing from 6 organizations (10 locations) serving 52 clients in FY2019 to 23 organizations (48 locations) serving 1311 clients in FY2023.
• Demonstrated increased geographic reach and client services within the program.

Conclusions:

• The SHIFT-Evidence framework's comprehensive, multilevel approach effectively addressed systemic gaps in OUD treatment.
• The framework proved useful for planning and prioritization, leading to enhanced treatment access within complex healthcare systems.
• Successful implementation highlights the framework's utility for improving healthcare delivery for OUD.