Full engagement is essential for positive outcomes in addiction treatment. Evidence-based practices (EBPs) for enhancing treatment engagement include Motivational Interviewing/Enhancement Therapy (MI/MET) and "Matching" patient services to patient needs. Their adoption in routine clinical practice has been hindered by the inefficient methods available for introducing these practices. Information technology will play an important role in overcoming this barrier. Polaris Engagement Enhancement in Chemical Dependency (EECD) is a web-based system developed and field tested in Phase 1. It consists of (1) a web-based, HIPAA compliant IT platform;and (2) comprehensive assessment, outcomes management and clinical reporting software. Phase 1 innovations of a personalized client feedback report and the first multivariable model for prediction of non-engagement available for use in clinical practice enhanced the overall system capability. EECD represents the first technology designed to facilitate the use of MI/MET and "Matching." The Phase 2 Specific Aims are to (1) strengthen the clinical utility and commercial potential of EECD through enhancements suggested by the field test and integrate EECD with a market-leading electronic health record (Epic);(2) enhance implementation materials developed in Phase 1 by producing a training video, establish a network of trainers expert in both MI/MET and the use of EECD reports for MI/MET and Matching, and develop an Implementation Tool Kit;and (3) conduct a controlled clinical trial to evaluate the effectiveness of EECD for improving engagement and clinical outcomes, and reducing rates of treatment re- entry. Phase 2 will make a significant clinical and research contribution. The products of this translational research include clinical tools that will exert a sustained, powerful impact on the field through increasing the adoption of EBPs that have been shown to improve treatment engagement and clinical outcomes. Polaris EECD will have strong commercial potential. Markets will include CD treatment programs and Accountable Care Organizations. In Phase 3 Polaris will self-fund a version of EECD designed for use in medical settings.
This proposal addresses an important problem for addictions treatment: Of clients that initiate treatment, approximately 50% do not engage, and they drop out within a month. The consequences in terms of human suffering and economic burden on public agencies are great. Non-engagement is associated with increased drug use, criminal activity, and reduced employment status. The proposed Polaris Engagement Enhancement for Chemical Dependency system will combine state-of-the-art information technology with evidence-based practices for improving engagement and an innovative model for predicting risk for non- engagement. It will impact public health by improving engagement and clinical outcomes, and contribute to research on factors predictive of engagement for demographically diverse clients.