From measurement to action: Overcoming the limits of substance use treatment metrics to improve patient initiation, engagement and recovery.

Erika Crable, PhD, MPH
University of California, Los Angeles

Lindsey Zimmerman, PhD
Stanford University

ABSTRACT:
Starting substance use disorder (SUD) treatment reduces odds of overdose and death, making the period after diagnosis a critical window for intervention. Patients who effectively engage in SUD treatment early are more likely to be retained in treatment for at least six months. Based on these findings, the National Center for Quality Assurance (NCQA) Healthcare Effectiveness Data Information Set (HEDIS) initiation and engagement in treatment (IET) measure became one of the most widely used performance measurement systems for health plans, health systems and states. As a strength, IET provides a standard way to assess whether newly identified patients are connected to SUD care. Unfortunately, studies of IET highlight how often systems fail at moving patients into treatments that can meet their needs and thereby, prevent relapse and overdose. In fact, only a minority of people with a new substance use disorder diagnosis start treatment and even fewer engage in treatment over time. During this grand rounds, Drs Crable and Zimmerman will discuss HEDIS IET measures with the PSMG and CDIAS community. This discussion will consider the needs and perspectives of policymakers, health plans and health systems, as well as recommendations for dissemination and implementation scientists and the clinicians who support patients on their journey to recovery by ensuring they can access and benefit from effective SUD care.