Testing of patient-centered e-health implementation model in addiction treatment

Coronavirus (COVID-19) has disrupted the substance use disorder (SUD) treatment system, demanding anabrupt shift from in-person care to telehealth services. The transition to virtual care could permanently changeSUD treatment delivery. This shift is coinciding with COVID-19-induced social isolation and anxiety, whichcould increase substance use and mental health disorder severity. A common refrain in the treatment andrecovery field is that addiction is a disease of isolation; the cure is connection. To provide virtual treatment andthe connection so essential to recovery, many SUD treatment centers are launching virtual services without amethod for assessing how, where, and why virtual services are affecting their patients' quality of life and SUDrecovery. The ACHESS smartphone app is currently being used at 40 Iowa treatment sites in the parent study,"Test of a patient-centered e-health intervention in addiction treatment settings." ACHESS offers a guide and amethod for assessing use of virtual services and an unprecedented research opportunity. From 3/3/20 to3/20/20, sign-ups for ACHESS in the parent study increased by 67% compared to the two prior weeks. Activityon the ACHESS app has nearly doubled in the same period! This supplement will address patient andorganizational factors because of their integral roles in providing virtual care and adopting patient-centeredtechnologies. The supplement will enhance ACHESS with new COVID-19 related features designed to helppatients comply with social distancing guidelines, cope with unprecedented social isolation, and access virtualservices and supports. The research will study how patients use ACHESS features, how organizations referpatients to the ACHESS, how they interact with patients in ACHESS, and the overall impact of the ACHESSfeatures. The supplement's research aims are: Aim 1a: Refine ACHESS to provide information, support, anddata on COVID-19, social distancing, adjusting to social isolation, and how to use virtual SUD services. Then,study how patients use existing ACHESS features before (for existing ACHESS services only), during, andafter the announcement of social distancing guidelines. Aim 1b: Assess how the enhanced ACHESS APPaffects anxiety, loneliness, and reported COVID-19 infections. Aim 2: Create ten case studies describing howagencies implemented and used COVID-19 enhanced ACHESS and how their patients used COVID-19enhanced ACHESS. This supplement's projected outcomes will help us understand how to design virtualrecovery systems to mitigate the effects of a pandemic and the resulting social isolation. The results will helpdesign a virtual recovery system that can be used in future emergencies and to address the on-goingchallenges of social isolation in society post-COVID-19.