TY  - JOUR
AU  - Dickerson, Suzanne S
AU  - George, Saliyah J
AU  - Ventuneac, Ana
AU  - Dharia, Arpan
AU  - Talal, Andrew H
PY  - 2024
DA  - 2024/6/12
TI  - Care Integration for Hepatitis C Virus Treatment Through Facilitated Telemedicine Within Opioid Treatment Programs: Qualitative Study
JO  - J Med Internet Res
SP  - e53049
VL  - 26
KW  - hepatitis C virus
KW  - integrated treatment
KW  - facilitated telemedicine
KW  - substance users
KW  - people with opioid use disorder
KW  - opioid
KW  - opioids
KW  - telemedicine
KW  - telehealth
KW  - eHealth
KW  - e-health
KW  - ICT
KW  - substance use
KW  - substance abuse
KW  - HCV
KW  - hepatitis
KW  - liver
KW  - interview
KW  - interviews
KW  - qualitative
KW  - hermeneutic
KW  - phenomenological
KW  - implementation
KW  - integration
KW  - experience
KW  - experiences
KW  - attitude
KW  - attitudes
KW  - opinion
KW  - perception
KW  - perceptions
KW  - perspective
KW  - perspectives
KW  - addict
KW  - addiction
KW  - addictions
KW  - addicts
KW  - hepatic
AB  - Background: Telemedicine has the potential to remove geographic and temporal obstacles to health care access. Whether and how telemedicine can increase health care access for underserved populations remains an open question. To address this issue, we integrated facilitated telemedicine encounters for the management of hepatitis C virus (HCV), a highly prevalent condition among people with opioid use disorder (OUD), into opioid treatment programs (OTPs). In New York State, OTPs are methadone-dispensing centers that provide patient-centered, evidence-based treatment for OUD. We investigated the integration and impact of facilitated telemedicine into OTP workflows in these settings. Objective: This study aims to understand OTP staff experiences with integrating facilitated telemedicine for HCV treatment into OTPs, including best practices and lessons learned. Methods: We conducted semistructured interviews with 45 OTP staff members (13 clinical, 12 administrative, 6 physicians, and 14 support staff members) at least one year after the implementation of facilitated telemedicine for HCV management. We used hermeneutic phenomenological analysis to understand OTP staff experiences. Results: We identified 4 overarching themes illustrating the successful integration of facilitated telemedicine for HCV care into OTPs. First, integration requires an understanding of the challenges, goals, and values of the OTP. As OTP staff learned about new, highly effective HCV therapies, they valued an HCV cure as a “win” for their patients and were excited about the potential to eliminate a highly prevalent infectious disease. Second, the integration of facilitated telemedicine into OTPs fosters social support and reinforces relationships between patients and OTP staff. OTP staff appreciated the ability to have “eyes on” patients during telemedicine encounters to assess body language, a necessary component of OUD management. Third, participants described high levels of interprofessional collaboration as a care team that included the blurring of lines between disciplines working toward a common goal of improving patient care. Study case managers were integrated into OTP workflows and established communication channels to improve patient outcomes. Fourth, administrators endorsed the sustained and future expansion of facilitated telemedicine to address comorbidities. Conclusions: OTP staff were highly enthusiastic about facilitated telemedicine for an underserved population. They described high levels of collaboration and integration comparable to relevant integrative frameworks. When situated within OTPs, facilitated telemedicine is a high-value application of telemedicine that provides support for underserved populations necessary for high-quality health care. These experiences support sustaining and scaling facilitated telemedicine in comparable settings and evaluating its ability to address other comorbidities. Trial Registration: ClinicalTrials.gov NCT02933970; https://clinicaltrials.gov/study/NCT02933970 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e53049
UR  - https://doi.org/10.2196/53049
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38865703
DO  - 10.2196/53049
ID  - info:doi/10.2196/53049
ER  -