People with opioid use disorder (OUD) are at increased risk of contracting the human immunodeficiency virus (HIV). Although effective interventions exist that can significantly reduce HIV infection and opioid overdose, such as pre-exposure prophylaxis (PrEP) and pharmacotherapy for opioid use disorder (MOUD), many patients still face barriers to accessing treatment and continuity of care.
At Boston Medical Center (BMC), Alyssa Tillow, MD, vice chair for family medicine research, is working to change that through a new care delivery platform designed to make evidence-based treatments easier to access and maintain.
Drawing on her experience as an addiction medicine specialist, Dr. Tillow proposed an innovative approach, Leveraging Informatics for Navigation and Knowledge (LINK), which uses electronic health record (EHR) data in combination with both real-time outreach to patients and support to clinicians to ensure that all patients have the opportunity to benefit from comprehensive addiction and HIV prevention services as they enter treatment. Dr. Tillow’s research earned her one of the National Institute on Drug Abuse’s (NIDA) prestigious Avenir Awards, which support highly innovative early career researchers.
I’m trying to break away from traditional healthcare delivery methods to make it as easy as possible for people to receive care. People don’t have to work hard to receive effective treatment. ”
Dr. Alyssa Tiro, Assistant Professor of Family Medicine, Boston University Chobanian-Avedisyan School of Medicine
Through timely and customized telehealth outreach by highly trained clinical teams, the platform proactively connects patients to care, shifting the burden of engagement from the patient to the health system itself. The project will also work with patients and healthcare providers to design workflows that are practical, acceptable, and support long-term engagement and trust. By intentionally grounding the project in system-level informatics, LINK is designed to be highly scalable and adaptable, with the potential for implementation in health systems beyond the BMC.
“You never know exactly when the moment will be when someone is going to make a big change,” Dr. Tilou says. “By increasing opportunities for conversation, we can better meet patients where they are and support them when they are ready.”
An important goal of this initiative is to connect patients to long-term, comprehensive primary care. Patients will be referred to their primary care provider for ongoing support, and additional training will be provided to enable providers to confidently provide high-quality, patient-centered care for both OUD and HIV.
Through the Avenir Award, Dr. Tilleau will advance new approaches to integrating HIV prevention and OUD treatment into routine clinical care, with the potential to improve patient outcomes and inform health systems across the country of best practices.
“This is a remarkable accomplishment and represents the outstanding work Dr. Tihow has done to improve the lives of patients experiencing opioid use disorder,” said Megan Bear Merritt, MD, MSCE, chief scientific officer at BMC Health System.
