Rural Response to the Opioid Crisis – Models and Innovations
These stories feature model programs and successful rural projects that can serve
as a source of ideas and provide lessons others have learned. Some of the projects
or programs may no longer be active. Read about the
criteria and evidence-base for programs included.
Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural and underserved patients with hepatitis C, a chronic, complex condition that has high personal and public health costs when left untreated.
Intervention: Project leveraging an audiovisual platform to accomplish "moving knowledge, not patients" that used a "knowledge network learning loop" of disease-specific consultants and rural healthcare teams learning from each other and learning by providing direct patient care.
Results: In 18 months, the urban specialist appointment wait list decreased from 8 months to 2 weeks due to Hepatitis C patients receiving care from the project's participating primary care providers. Improved disease outcomes were demonstrated along with cost savings, including those associated with travel. The project model, now known as Project ECHO® – Extension for Community Healthcare Outcomes — has evolved into a telementoring model used world-wide.
Need: Reduction in the number of emergency department dental patients abusing opioid prescriptions in rural southeastern Maine.
Intervention: Using a one-page opioid prescription guideline, opioid prescribing and emergency room visits for dental pain decreased.
Results: The rate of opioid prescription dropped nearly 20% after implementation, and in comparing the 12-month period before and after implementation, dental pain emergency department visits decreased from 26 to 21 per 1,000.
Need: In northern Michigan, a need for an integrated approach to deliver medication-assisted treatment for established patients of Federally Qualified Health Centers with opioid use disorder.
Intervention: Collaboration between one FQHC across 3 sites, a local waivered prescriber group, and a behavioral health organization created an integrated treatment approach for opioid use disorder.
Results: Increased access to medication-assisted treatment and comprehensive substance use disorder services leading to increased retention in treatment and increased engagement in stable recovery from opioid and alcohol use disorders.