Our proposal, “Expanding Medication Assisted Treatment in Central Pennsylvania to Address Opioid Use Disorder,” aims to build upon our successful hub-and-spoke model of treatment (PACMAT) centered at the Pennsylvania Psychiatric Institute, a joint venture between Penn State Health and University of Pittsburgh PinnacleHealth. Each of our current nine spoke clinics is in a medication-assisted treatment (MAT) underserved county located in Central Pennsylvania and serves a combination of urban and rural locations. Death rates from drug-related overdose within our catchment area range from 14.9-30.0 per 100,000 people.
Our overarching goal is to decrease the number of untreated people living with, and dying from, OUD by increasing the capacity to provide comprehensive, timely care in underserved counties in Central Pennsylvania. In order to achieve this goal, we are committed to increasing the impact of our existing PacMAT hub-and-spoke treatment service by three different, yet inter-related efforts. First, we will incorporate telehealth support into our existing model to create a supportive, inclusive and extensive knowledge base for providers that can be used to recruit, train, and retain providers. Second, increased provider support and extended capacity will allow for the identification and service of more patients with OUD, engaging them in treatment at significantly higher rates. Third, we will expand our existing reach by adding more local clinics and care centers, including local hospital emergency departments (EDs), to our existing structure.
In order to enhance our current hub-and-spoke model we plan to supplement our current one-on-one approach with the Project ECHO telehealth model, developed by the University of New Mexico. Project ECHO has the potential to overcome barriers within our current hub-and-spoke model, including concerns of primary care providers to address opioid use disorder due to perceived burden, and failure for current MAT prescribers to reach their capacity of patients. Our specific project objectives include:
1) Incorporate three new spoke clinics per year.
2) Recruit and engage 15-20 providers per year via Project ECHO.
3) Double the number of unique individuals engaged in MAT services at the hub and spokes, with a plan to engage 450 patients throughout the proposed project period.
The proposed integration of Project ECHO into the current PACMAT model is critical to advancing MAT within existing spokes, as well as establishing opportunities for future dissemination across Central Pennsylvania to better address the opioid epidemic.