The proposed Polaris EECD (Engagement Enhancement for Chemical Dependency/EECD) system will facilitate adoption and strengthen the impact of two evidence based practices for chemical dependency treatment. It will improve treatment engagement and outcomes. Treatment engagement is essential to achievement of positive outcomes. Researchers have documented the potential of several evidence-based practices for improving engagement, but their adoption in routine clinical practice has been hindered by the lack of efficient methods for introducing the practices. Information technology can play an important role in overcoming the barriers to implementation. EECD will incorporate an existing outcomes management system, Polaris CD, which assesses most known predictors of engagement. In Phase I, we will develop and field test three enhancements to Polaris CD: A multivariate model for prediction of risk for non-engagement, a motivational, personalized feedback report for clients, and a Guide for using EECD to implement two evidence-based practices, Patient-Services Matching and Motivational Enhancement Therapy, into routine treatment. Development of a predictive model for engagement is an important clinical and scientific innovation. The existing Polaris CD database of over 50,000 assessments of known risk factors is uniquely suited to model development. A client report linked to self-reported goals and risk factors for engagement and integration of EECD with an electronic health record (EHR) are clinically and commercially important innovations. EECD will have strong commercial potential. It will enable community based organizations to qualify for government funding, which in 2014 will require use of evidence-based practices and EHRs. It will also enable health plans to improve their performance on the NCQA HEDIS measures of treatment engagement. Specific Aims for Phase I include (1) development and (2) field testing of the system. Integration into an EHR, evaluation of the impact of EECD upon engagement and a cost-benefit analysis are Phase II Aims.
Public Health Relevance: 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.
