Center for Evaluation and Applied Research: Health Care Delivery Initiatives

Physician Training and Clinical Support Center for Methadone Prescribers (PCSS - M)

Over the past several years the prescribing of methadone has dramatically increased, both for the treatment of opioid dependence and for the treatment of chronic pain. Methadone is a well-studied, safe, and efficacious medication when prescribed and consumed properly. When used inappropriately, however, risk of overdose is high. Consequently, increased prescribing, coupled with minimal provider training on its use, has resulted in a significant increase in methadone related deaths. Responding to this need, the SAMHSA-funded Physician Clinical Support System for Methadone (PCSS-M), organized and managed by the American Society of Addiction Medicine (ASAM), educates and mentors physicians and other health care professionals on methadone treatment for opioid addiction and/or pain management. The Center for Evaluation and Applied Research has been contracted to develop a web-based resource center (www.pcssmethadone.org) with relevant educational materials and to design and implement an evaluation of the PCSS-M. Focusing primarily on process, the evaluation uses both quantitative and qualitative methods to gather data on utilization of the web-based resource center and mentorship services, as well as increases in knowledge related to methadone treatment and changes in methadone treatment practice among PCSS-M participants.

Bronx Health REACH Coalition's Faith-Based Outreach Initiative

With funding from NIH's National Center on Minority Health and Health Disparities (NCMHD), the Faith Based Outreach Initiative (FBOI) is focused on prevention and management of diabetes and cardiovascular disease; improved access to and utilization of the health care system; and increased awareness of, and advocacy related to, health disparities and their individual and systemic causes and impact. The evaluation of the FBOI incorporates qualitative and quantitative techniques to assess process, outcomes and impact. Using key informant interviews, focus groups, and observation of project activities, as well as surveys assessing change in health-related knowledge, attitudes, beliefs and behaviors of participants, the evaluation operates on two levels: assessment of FBOI as an integrated whole and focused evaluation studies of specific program activities.

Using Electronic Health Records to Address Health Disparities in Community Health Center Patients

The goal of this HRSA-funded Institute for Family Health-led project is to demonstrate how community health centers can use electronic health records effectively to address health disparities evident among their patients. Specifically, the project will: create a replicable model for documenting detailed patient race, ethnicity and language (REL) data; use enhanced REL data to address identified health disparities and improve services; evaluate the project impact, identify best practices, and disseminate findings. The Center for Evaluation and Applied Research is collaborator in the project, providing research support in the examination of REL data and the evaluation of project impact.

Using Electronic Health Records to Transform Quality Reporting into Quality Improvement

The goal of this HRSA-funded, Institute for Family Health-led project is to improve health outcomes for community health center patients by using EHR data to assess their risk for developing diabetes and diabetes-related complications, and providing targeted outreach to optimize screening and follow-up care. The Center for Evaluation and Applied Research is collaborator in the project, providing research support in the development of the risk stratification protocol and evaluating the success of outreach and intervention activities.

Physician Training and Clinical Support Center for Buprenorphine Prescribers (PCSS-B)

Because buprenorphine (BUP) may be prescribed for the treatment of opioid addiction by physicians in office-based settings, it has tremendous potential to both expand treatment capacity and to create new options for people unable or unwilling to seek treatment at methadone or other opioid treatment programs. The American Society of Addiction Medicine's (ASAM) PCSS-B project, funded (2005-2010) by SAMHSA's Center for Substance Abuse Treatment, was designed to support physicians and other health care providers who are new to BUP treatment and who would benefit from clinical guidance and/or training. The Center for Evaluation and Applied Research conducted a process and outcome evaluation of the PCSS-B, focused on program utilization, characteristics of program participants, and satisfaction with the program activities. Findings have been described in numerous presentations and in two journal articles.